Endocrine Carcinoma Research Articles

First case of huge classic papillary thyroid cancer rupturing spontaneously leading to ischemic necrosis, perforation and inflammation of overlying skin: Case report and review of the literature.

IntroductionPapillary thyroid cancer (PTC) is the commonest form of well-differentiated endocrine carcinoma. It is categorized into indolent and aggressive, where the indolent subtypes (classic, follicular) rarely demonstrate aggressive behavior. We present a classic PTC presenting with a rapidly growing huge anterior neck mass that subsequently spontaneously ruptured subcutaneously resulting in ischemia, necrosis, and perforation of overlying skin leading to inflammation.Presentation of caseA 37-year-old female with no comorbidities presented to our emergency department with a neck swelling of 2 years duration that rapidly enlarged one week prior to presentation. Though the mass initially appeared of inflammatory nature, the tumor was a PTC, and she underwent total thyroidectomy with selective right side neck dissection and debridement of necrotic skin. The gross specimen revealed a fragmented non-intact right thyroid lobe mass causing pressure ischemia, necrosis and perforation of the skin. Histopathology showed a 9 × 9 × 5 cm classic PTC staged as pT3b N1b. Postoperative course was uneventful, she was discharged by the eighth postoperative day, and then she received a high dose of radioactive iodine ablation (RAI).DiscussionClassic PTC is usually of a smaller size and a relatively benign course compared to other PTC subtypes and thyroid cancers. It is indolent with favorable prognosis. Although it is associated with increased risk of lymph node metastases at the time of diagnosis, it is slow growing with high survival rates approaching 95%.ConclusionDespite that classic PTC progresses slowly, it should still be suspected in neck swellings presenting with rapid and aggressive behavior. Prompt and systematic assessment is required with surgical intervention and radioactive iodine ablation therapy.

Carboxypeptidase A1 (CPA1) immunohistochemistry is highly sensitive and specific for acinar cell carcinoma (ACC) of the pancreas

Carboxypeptidase A1 (CPA1) is a zinc metalloprotease which is produced in pancreatic acinar cells and plays a role in cleaving C-terminal branched-chain and aromatic amino acids from dietary proteins. This study assessed the utility of immunohistochemical CPA1 staining for diagnosing pancreatic acinar cell carcinoma. A total of 15,680 tumour samples from 132 different tumour types and subtypes as well as 8 samples each of 76 different normal tissue types were analyzed by immunohistochemistry in a tissue microarray format. CPA1 was strongly expressed in acinar cells of all normal pancreas samples but not in any other normal tissues. CPA1 immunostaining was detected in 100% of 11 pancreatic acinar cell carcinomas and one mixed acinar endocrine carcinoma (MAEC), but absent in 449 pancreatic ductal adenocarcinomas, 75 adenocarcinomas of the ampulla Vateri, and 11,739 other evaluable cancers from 128 different tumour entities. In conclusion, our data show that CPA1 is a highly sensitive and largely specific marker for normal and neoplastic pancreatic acinar cells. CPA1 immunohistochemistry greatly facilitates the otherwise often difficult diagnosis of pancreatic acinar cell carcinoma.

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Journal of Cutaneous PathologyVolume 48, Issue 7 p. i-i COVER IMAGEFree Access Cover Image First published: 21 June 2021 https://doi.org/10.1111/cup.14081AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Graphical Abstract The OBC cover image is based on the Case Report A case of endocrine mucin-producing sweat gland carcinoma with distant metastasis by Ata Moshiri et al., https://doi.org/10.1111/cup.13999. Volume48, Issue7July 2021Pages i-i RelatedInformation

Factors predicting the risk of biochemical incomplete response in well-differentiated thyroid cancer after total thyroidectomy.

Differentiated thyroid cancer (DTC) is the most common endocrine carcinoma with an overall good prognosis. However, persistent or recurrent disease (P/R disease) and incomplete biochemical response (BIR) are causes of morbidity. Histopathology and TNM stage may not predict P/R disease and BIR in all patients. Various clinical parameters, histopathological features and preablative-stimulated thyroglobulin (presTg) have been proposed to predicts P/R disease. However, there is uncertainty for presTg cutoff and diagnostic accuracy. The study's objective was to predict the BIR before radioiodine ablation from available clinical, histopathological and biochemical parameters. A retrospective, single-center study, including DTC patients, was done. Demography and factors predicting BIR evaluated. In comparison to the patients in remission, patients with BIR were older (P = 0.042), had higher presTg (P < 0.001), and lymph nodes (LN) metastases [central or lateral compartment (P < 0.001)]. Visualization of LN on whole-body scan (P = 0.014), higher TNM stage (P = 0.001) and distance metastasis (P < 0.001) were also associated with BIR. On multivariate analysis, high presTg (P < 0.001) and LN metastases (LNscan and histopathologically proven LN involvement, P < 0.001) were associated with BIR. A presTg level ≥12.30 ng/ml has high sensitivity (90.6%) and specificity (80.6%) to predict the BIR (odds ratio 39.90). The presTg and LN involvement are robust markers that predict BIR. A raised presTg level with LN metastases and nonvisualization of the LN on the whole-body scan is a worrying feature for the future BIR. We propose the inclusion of high presTg as a high-risk factor in DTC.

Utility of Insulinoma-Associated Protein 1 (INSM1) and Mucin 2 (MUC2) Immunohistochemistry in the Distinction of Endocrine Mucin-Producing Sweat Gland Carcinoma From Morphologic Mimics.

Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare low-grade adnexal malignancy with a predilection for the eyelids of elderly White women, which is associated with invasive mucinous carcinoma with endocrine features in one-third of cases. EMPSGC is characterized by the presence of neuroendocrine differentiation and mucin production. However, EMPSGC displays a variety of architectural patterns including solid, cribriform, papillary, and cystic growth. In addition, EMPSGC may also display nonendocrine cytologic features, such as apocrine change. Because of their variable appearance, EMPSGC can show significant morphologic overlap with certain histologic mimics, namely basal cell carcinoma, hidrocystoma, apocrine hidradenoma, and tubular adenoma. In addition, the often limited sampling of this anatomically delicate area can make the diagnosis of EMPSGC challenging. EMPSGC expresses neuroendocrine markers, including synaptophysin and chromogranin, often in a focal distribution. However, insulinoma-associated protein 1 (INSM1) has been found to be a more sensitive marker for EMPSGC. Recent studies have also demonstrated the expression of the gel-forming mucin 2 (MUC2) in EMPSGC, possibly signifying a lacrimal or conjunctival origin of these neoplasms. In this article, we discuss EMPSGC in the context of its histologic mimics (BCC, hidrocystoma, apocrine hidradenoma, and tubular adenoma) and we investigate the utility of the immunohistochemical expression of INSM1 and MUC2 in the distinction of EMPSGC from them. We demonstrate that INSM1 and MUC2 can reliably distinguish EMPSGC from these histologic mimics.

Assessment and management of undifferentiated carcinoma with osteoclastic like giant cells of the pancreas: a case report and revision of literature

BackgroundUndifferentiated carcinoma with osteoclast-like giant cells (UCOGCs) is a rare and aggressive non endocrine pancreatic carcinoma characterized by the presence of osteoclastic giant cells mixed with mononuclear cell. Very few cases have been reported in the literature and the histogenesis is controversial as, at the time of diagnosis, the tumor is often of advanced size and stage and it is difficult to pathologically observe its relationship with the pancreatic duct.Case presentationWe present a case of 65-year-old male patient presenting with abdominal pain, nausea, and weight loss, which was treated with surgical resection. Histological examination revealed an undifferentiated pancreatic carcinoma with osteoclast-like giant cells. The patient underwent to a routine pylorus preserving pancreatoduodenectomy. Actually, the patient was in good performance status and disease-free five months.ConclusionsBased on the present case and limited previous data, further researches preferably with large cohorts are necessary to clarify the pathogenesis of the neoplasm. However, as show in this case, histopathological and immunohistochemically studies are the gold standard for the diagnosis of UCPOGC. Investigation of the genomic alterations in UPOGCs could help to explain the histologic diversity of variant tumor and could provide a genetic basis for prognosis and treatment.

Diagnostic Immunostaining and Tumor Markers Predict the Prognosis of Esophageal Neuroendocrine Cell Carcinoma Patients.

Esophageal neuroendocrine carcinoma (ENEC) has a poor prognosis, and predicting the prognosis by examining various markers may contribute to the determination of treatment strategies. Therefore, a multiple-institution retrospective study was performed to identify biomarkers using diagnostic immunohistochemistry and serum tumor markers that predict the prognosis of patients with ENEC. The results of immunohistochemical examination and serum tumor markers were extracted from the data of 141 ENEC patients at 39 institutions certified by the Japan Esophageal Society. The study then examined correlations between these data and prognosis or treatment effects. The ENEC patients with positively for all expression of synaptophysin (Syn), chromogranin A (CgA), and CD56 had a significantly worse prognosis than the patients with other expression patterns. Additionally, surgery and chemoradiotherapy were significantly more effective treatments than chemotherapy for the patients who were not positive for all expressions of Syn, CgA, and CD56. In terms of serum tumor markers, the patients with a high neuron-specific enolase (NSE) value had a significantly worse prognosis than the patients with a normal NSE value, and complete response (CR) cases treated with chemotherapy were significantly fewer in the high-NSE group. The results of multivariate analysis demonstrated that high NSE levels were an independent poor prognostic factor for esophageal endocrine cell carcinoma. This study showed that positivity for all expressions of Syn, CgA, and CD56, and a high NSE value were significantly worse prognostic factors for ENEC patients than other expression patterns and may be important prognostic biomarkers of ENEC.

Endoscopic and pathologic motifs for the clinical diagnosis of Epstein-Barr virus-associated gastric cancer.

ObjectivesBased on the recent therapeutic trends for gastric cancer (GC), the clinical impact of the diagnosis of Epstein–Barr virus (EBV)‐associated GC (EBVaGC) appears to be important. We retrospectively analyzed endoscopic and pathologic motifs of GC lesions to narrow the number of candidates for EBV testing.MethodsWe performed EBV tests for 32 upper gastrointestinal lesions of 32 patients in the clinical setting. These tests were ordered by endoscopists or by pathologists without an endoscopist's order. EBV‐encoded small RNA1 (EBER1) in situ hybridization was used for the EBV tests. The endoscopic motif for the EBV test was the location in the upper part of the stomach or remnant stomach, mainly the depressed type with a submucosal tumor‐like protrusion of the lesion. The pathologic motif was carcinoma with lymphoid stroma (CLS) or CLS‐like histology of the lesion. We retrospectively analyzed the results of EBV tests for the endoscopic and pathologic motifs.ResultsThe final pathological diagnoses of the 32 subjects were 26 GCs including CLS, gastric endocrine cell carcinoma, gastric hepatoid carcinoma, gastric T‐cell lymphoma, gastritis of the remnant stomach, esophageal adenocarcinoma, and esophageal squamous cell carcinoma. When nontypical lesions were excluded, the EBER1‐positive rate was 42.3% (11/26) in GCs. Of the 14 GC lesions ordered examined by endoscopists, three (21.4%) were EBVaGC. Eight of the 12 (66.7%) GCs ordered examined by pathologists were EBVaGC.ConclusionsThe pathologic motif is expected to be useful and the endoscopic motif may be helpful for EBVaGC diagnosis.

Can we still consider thyroid hyperfunction a protective condition for the onset of thyroid cancer?

Thyroid cancer is the ninth most commonly diagnosed cancer in the world, and the most common endocrine carcinoma. It was originally believed to be a rare event in patients with thyroid hyperfunction and it was reported that hyperthyroidism had a protective role against thyroid neoplasms. However, in recent years, several studies have hypothesized that differentiated thyroid carcinomas and hyperthyroidism may coexist. Our study aims therefore to evaluate the incidence of differentiated thyroid carcinomas on definitive histological examination, in patients undergoing total thyroidectomy or hemithyroidectomy with coexisting hyperfunctioning thyroid disease, to understand whether hyperthyroidism can be considered a protective condition against the onset of thyroid neoplasms. The study involved 1,449 patients underwent to thyroid surgery from 2010 to 2018 at the General Surgery Unit, Department of Surgery, University Hospital of Parma, Parma, Italy, presenting thyroid cancer at postoperative histological exam. Patients were divided in two groups based on the presence (Group A) or absence (Group B) of hyperfunction. All data were collected in a dedicated database and include demographic data, such as age and sex, preoperative cytology, date and type of surgery, postoperative diagnosis, characteristics of aggressiveness of the neoplasm and postoperative complications. For data analysis, a P value of less than 0.05 was considered statistically significant. The incidence of thyroid carcinomas was lower in patients suffering from hyperfunction compared to the incidence found in non-hyperthyroid patients, both in preoperative cytological examination and in postoperative diagnosis through histological examination. Furthermore, the tumors that have developed in patients with hyperfunction had a comparable degree of aggression and invasiveness in the two groups studied. However, we have found an equal incidence of microcarcinomas and occult carcinomas on postoperative histological examination. Postoperative complications in patients with cancer were similar, regardless of the presence or absence of hyperfunctioning thyroid disease. Our study confirms that hyperthyroidism is a protective condition against thyroid carcinoma, but the finding of an equivalent incidence of occult carcinomas in the two groups stresses the need to perform a cytological examination in case of a nodular pathology in a hyperthyroid patient before performing a treatment.

Endocrine mucin‐producing sweat gland carcinoma and associated primary cutaneous mucinous carcinoma: Review of the literature

Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare, low-grade, cutaneous adnexal carcinoma with neuroendocrine differentiation. It is considered to be a precursor of invasive neuroendocrine type primary cutaneous mucinous carcinoma (PCMC). To review clinicopathological literature summary of EMPSGC and associated neuroendocrine PCMC from all reported cases and compare its behavior vs non-neuroendocrine PCMC data reported in the literature. A review of English literature of all EMPSGC cases with and without associated PCMC was carried out. EMPSGC was associated with invasive neuroendocrine type PCMC in 35.7% of cases. We found the recurrence rate of PCMC associated with EMPSGC of about 12.3% and is much less than that 30% recurrence rate reported for the non-neuroendocrine subtype of PCMC. The non-neuroendocrine subtype of PCMC shows a 4% and 11% rate of distant and lymph node metastasis, respectively, vs EMPSGC-associated neuroendocrine type of PCMC, which is very indolent and only one recent case of locoregional metastasis out of 190 EMPSGC cases has been reported so far. Limitation of our study includes data derivation from case reports and case series in the literature. The prognostic benefits for this cohort of patients may be considered in their overall management.

Next-generation sequencing analysis suggests varied multistep mutational pathogenesis for endocrine mucin-producing sweat gland carcinoma with comments on INSM1 and MUC2 suggesting a conjunctival origin

Endocrine mucin-producing sweat gland carcinoma is a low-grade eyelid tumor. Small biopsies and insensitive immunohistochemistry predispose to misdiagnosis. We aimed to identify clarifying immunohistochemical markers, molecular markers, or both. Clinicopathologic data (22 cases) were reviewed. Immunohistochemistry (insulinoma-associated protein 1, BCL-2, mucin 2 [MUC2], mucin 4, androgen receptor, β-catenin, and Merkel cell polyomavirus) and next-generation sequencing (Memorial Sloan Kettering integrated mutation profiling of actionable cancer targets, 468 genes) were performed (3 cases). Female patients (n=15) and male patients (n=7) (mean age 71.8years; range 53-88years) had eyelid or periorbital tumors (>90%) with mucin-containing solid or cystic neuroendocrine pathology. Immunohistochemistry (insulinoma-associated protein 1, BCL2, androgen receptor, retinoblastoma-associated protein 1, and β-catenin) was diffusely positive (5/5), MUC2 partial, mucin 4 focal, and Merkel cell polyomavirus negative. Memorial Sloan Kettering integrated mutation profiling of actionable cancer targets identified 12 single-nucleotide variants and 1 in-frame deletion in 3 cases, each with DNA damage response or repair (BRD4, PPP4R2, and RTEL1) and tumor-suppressor pathway (BRD4, TP53, TSC1, and LATS2) mutations. Microsatellite instability, copy number alterations, and structural alterations were absent. Insulinoma-associated protein 1 and MUC2 are positive in endocrine mucin-producing sweat glandcarcinoma. MUC2 positivity suggests conjunctival origin. Multistep pathogenesis involving DNAdamage repair and tumor-suppressor pathways may be implicated.

SLC34A2 Up-regulation And SLC4A4 Down-regulation Correlates With Invasion, Metastasis, And The MAPK Signaling Pathway In Papillary Thyroid Carcinomas.

Papillary thyroid carcinoma (PTC) is one of the fastest growing endocrine system malignant carcinomas detected over the past decade. Unfortunately, more than 25% of PTC patients are characterized by their aggressiveness and subsequent metastasis; these characteristics usually indicate poor prognosis. Recently, increasing evidence has suggested that solute carrier (SLC) transporters may play a pivotal role in the initiation, invasion and metastasis of human carcinoma. However, the expression and clinicopathological significance of SLC transporters in patients with PTC remains undetermined. In this study, we aimed to elucidate how the differential expression of SLC transporters affects clinicopathological features, as well as determine the possible regulatory signaling pathways involved. Three differentially expressed SLC transporters were screened from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) database using a bioinformatics approach. The results indicated that high SLC34A2 and low SLC4A4 protein expression exhibited a higher percentage of capsular invasion and extra-thyroid metastasis in patients. Logistic regression analysis showed that high SLC34A2 expression in tumors was identified as an independent risk factor for capsular invasion [odds ratio (OR)=11.400, 95% confidence interval (CI)=1.733-74.995, P=0.011] and extra-thyroid metastasis (OR=4.920, 95%CI=1.234-19.623, P=0.024), while low SLC4A4 expression in tumors was only identified as independent risk factors for extra-thyroid metastasis (OR=8.568, 95%CI =1.186-61.906, P=0.033). Specifically, for tumors with capsular invasion and extra-thyroid metastasis, the protein expression staining of SLC34A2 was markedly enhanced in the cytoplasm of follicular epithelial cells, contrastingly, SLC4A4 expression was notably weakened in the cytomembrane and nucleus. Intriguingly, both high SLC34A2 and low SLC4A4 protein expression were significantly linked to a high urinary iodine concentration in patients with PTC. Mechanistically, compared with adjacent normal thyroids, p-ERK was significantly up-regulated by 17.8% in the invading tumor; p-ERK, p-JNK, and p-P38 were markedly up-regulated by 29.2%, 67.1%, and 38.9% for metastatic tumors, respectively. Importantly, SLC4A4 negatively correlated with p-JNK (r=-0.696, P= 0.004) and p-P38 (r=-0.534, P=0.049). In conclusion, we suggest that up-regulated SLC34A2 (mainly in the cytoplasm) and down-regulated SLC4A4 (mainly in the cytomembrane and nucleus), which might be attributed to excess iodine intake, were closely linked to extra-thyroid metastasis in PTCs. Furthermore, this effect of SLC4A4 may be through the activation of JNK/P38 MAPK signaling pathway. Future in vivo and in vitro gain- or loss-of-function experiments are needed to verify these findings and further elucidate the deeper molecular mechanisms.

15713 Endocrine mucin-producing sweat gland carcinoma: Expanding the differential of eyelid tumors

Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is an uncommon low-grade adnexal neoplasm that most commonly occurs on the eyelid of elderly women. Clinically, this neoplasm presents as a flesh-colored to bluish or pink papule, nodule or swelling, often with overlying telangiectasias. It is often mistaken for basal cell carcinoma. Histopathologically, EMPSGC is positive for one or more neuroendocrine markers: synaptophysin, chromogranin, or neuron-specific enolase. It is often also positive for cytokeratin 7 (CK7), estrogen receptor (ER), and progesterone receptor (PR). Although EMPSGC is uncommon, it is being increasingly reported in the literature. This is likely due to an increase in diagnosis, not necessarily an increase in incidence. EMPSGC can be locally aggressive and can recur, but it is not known to metastasize. Treatment options include excision with wide margins or Mohs micrographic surgery. We present a case series of three biopsy proven EMPSGCs at our institution that demonstrated classic histopathologic and immunohistochemical patterns. We hope to increase awareness of this entity in the clinical and histopathologic differential diagnosis of eyelid tumors. We also hope to stress the importance of using immunohistochemistry to aid in the diagnosis of basaloid neoplasms.

ALDH5A1 acts as a tumour promoter and has a prognostic impact in papillary thyroid carcinoma.

Thyroid cancer is the most common endocrine carcinoma, with papillary thyroid carcinoma (PTC) accounting for 80%-90% of thyroid cancers. Accumulating studies reported that mitochondria plays an important role in the regulation of cell proliferation. ALDH5A1, may function as an oncogene or tumour suppressor in various human cancers, and the role of ALDH5A1 in PTC is still unclear. The aim of this study was to investigate the clinical significance of ALDH5A1 expression and its functions in PTC. In this present study, we studied ALDH5A1 expression on primary papillary thyroid carcinoma (PTC) in The Cancer Genome Atlas (TCGA) database. Results showed that the levels of ALDH5A1 were found positively correlated with tumour stage, metastasis, lymph node stage, and higher levels of ALDH5A1 demonstrated poor disease-free survival (DFS). Immunohistochemistry (IHC) revealed that significantly higher expression of ALDH5A1 was found in PTC tissues. On the other hand, knockdown of ALDH5A1 significantly inhibited PTC cell proliferation, migration and invasion detection found the migration and invasion of cells also were hindered when ALDH5A1 level was reduced. The knockdown of ALDH5A1 inhibited the expression of Vimentin and promoted the expression of E-cadherin. In brief, knockdown of ALDH5A1may act as a novel molecular target for the prevention and treatment of PTC. SIGNIFICANCE OF THE STUDY: The present study focused on the role and the potential mechanism of ALDH5A1 in papillary thyroid carcinoma. We demonstrated that reduced expression of ALDH5A1 might inhibit the progression of TC by inhibiting cell proliferation, migration and invasion and reversing epithelial-mesenchymal transition (EMT). The findings ensured the interaction relation between ALDH5A1 and EMT in PTC, providing a novel biological marker for PTC and enriching the potential strategies for TC treatment.

A comprehensive review of childbearing after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Our aim is to present a review on childbearing following CRS and HIPEC for peritoneal malignancy. A review of the English literature, up to December 2019, was conducted, using PubMed/MEDLINE, EmBase and Google Scholar bibliographic databases, following the MOOSE guidelines. The terms "Cytoreductive Surgery", "Hyperthermic Intraperitoneal Chemotherapy", "Peritoneal Carcinomatosis", "Pregnancy", "Fertility Preservation", "Conception" were used. All study designs were eligible for inclusion in the final analysis. In total, 7 studies (5 case reports and 2 case series) were included in the final analysis, reporting on 14 successful pregnancies after CRS and HIPEC. The mean age of patients at the time of CRS/HIPEC was 28.8 ± 5.9years (range 18-36), while the mean interval between CRS/HIPEC and pregnancy was 29.6 ± 20.3months (range 9-80months). Nine patients were treated for pseudomyxoma peritonei, four for primary peritoneal mesothelioma and one for endocrine carcinoma. Mean Peritoneal Carcinomatosis Index was 9.8 ± 7.8 (range 1-26). All patients underwent fertility-sparing CRS (preservation of at least one ovary and the uterus). In 12 cases, conception was spontaneous, whereas two pregnancies were achieved through in-vitro fertilization. One patient developed gestational hypertension, while two labors were preterm. Mean disease-free survival was 64.1months (range 24-106months). A successful pregnancy is feasible in selected patients, after CRS and HIPEC. Assisted reproduction techniques (IVF using frozen oocytes or frozen embryos, ovarian tissue cryopreservation, preoperative treatment with GnRH analogs) should be discussed pre-operatively with the patient, without, however, compromising overall survival or risking locoregional recurrence.

A Case of Gastric Endocrine Cell Carcinoma with Abscess Formation

A 84-year-old male patient complained of epigastric pain and fever. A computed tomographic (CT) scan revealed thickening of the stomach wall, and an increased peripheral fat tissue concentration, which was suspected to be caused by gastric cancer. The next day, an upper gastrointestinal endoscopy A type 2 lesion was found in the stomach. The abdominal pain worsened, and CT was repeated. Fluid retention was observed in contact with the tumor, and gastric perforation was suspected. Surgical findings showed a large number of abscesses in the wall. The pathological diagnosis was gastric endocrine cell carcinoma. Endocrine cell carcinoma of the stomach is a rare disease, and the prognosis is poor. In this report, we describe a rare intramural abscess associated with gastric endocrine cell carcinoma and review the related literature.

Tumor lysis syndrome after chemotherapy for metastatic colic carcinoma: About two adult cases

Tumor Lysis Syndrome (TLS) is a major oncological emergency involving metabolic perturbations. It occurs when tumor cells release their contents into the bloodstream, either spontaneously or in response to therapy. TLS is characterized by hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia following massive lysis of malignant cells. Although this syndrome is well described, it is rarely seen or suspected in solid malignancies. The frequency and severity of TLS is partly dependent upon the biology of the disease and type of therapy administered. We report in this work two cases of tumor lysis syndrome occurring after chemotherapy for endocrine colon carcinoma with small metastatic cells.

Primary Neuroendocrine Carcinoma of the Breast: Mammographic, Ultrasound, and Magnetic Resonance Imaging Findings

Objective: The purpose of this study was to investigate the mammography, ultrasound (US), magnetic resonance imaging (MRI) features that characterise primary neuroendocrine breast carcinomas (NEBC) to improve the awareness of the disease. Materials and Methods: The mammography, sonography, MRI and pathologic features in a total of 54 pathologically proven NEBC cases at Fudan University Cancer Hospital from January 2003 to January 2013 were retrospectively analysed. All 54 patients were women with a mean age of 65 years old (ranging from 35 to 80 years). Results: The 54 NEBC patients had a total of 63 lesions. Pathological diagnosis included endocrine ductal carcinoma in situ (E-DCIS) in 20 lesions, E-DCIS with microinvasion in 17 and invasive solid neuroendocrine carcinoma in 26 lesions. The imaging characteristics of NEBC is a high-density round mass (64.1%) with obscured or indistinct margins on mammograms. All masses without malignant calcifications are the most frequent appearances. A hypoechoic mass (78.4%) with irregular shape and circumscribed margins on sonograms; and lobular or irregular shaped mass with spiculated margins, associated with homogeneous or heterogeneous enhancement on MR images. The highest positive predictive value (PPV) for BI-RADS (Breast Imaging Reporting and Data System) 4, and 5 categories was seen by MRI (0.67 [4/6]). In total, 5 patients (9.2%) had axillary lymph node metastasis. 52 (82.5%) lesions were estrogen receptor-positive and 52 (82.5%) progesterone receptor-positive. 45 (71.4%) lesions were negative for HER2/neu. Thirty patients bearing NEBC received hormone therapy; 5 of these patients underwent radiotherapy and/or chemotherapy. Compared with pure NEBC, NEBC with invasive showed larger size of the lesion (t = –2.41, P = 0.024). Conclusion: MRI may have a role in early detection of NEBC. No calcification is a notable mammographic feature that differ from invasive mammary carcinoma. Positive estrogen and progesterone receptor results and negative Her2/neu results have been linked more frequently to NEBC especially in elderly woman with a palpable lump or nipple discharge.

A Case of Colonic Endocrine Cell Carcinoma with Subsequent Axillary Lymph Node Metastasis of which Resection Led to a Long-term Survival

A Case of Colonic Endocrine Cell Carcinoma with Subsequent Axillary Lymph Node Metastasis of which Resection Led to a Long-term Survival

A Case of Endocrine Cell Carcinoma of the Sigmoid Colon Presented with Intramesenteric Penetration

A Case of Endocrine Cell Carcinoma of the Sigmoid Colon Presented with Intramesenteric Penetration