Neuroendocrine Tumors Research Articles

Structured reporting of neuroendocrine tumors in PET/CT using [18F]SiTATE - impact on interdisciplinary communication

Our retrospective single-center study aims to evaluate the impact of structured reporting (SR) using a self-developed template on report quality compared to free-text reporting (FTR) in [18F]SiTATE Positron Emission Tomography/Computer Tomography (PET/CT) for the primary staging and therapy monitoring of patients diagnosed with neuroendocrine tumors (NET). In total 50 patients were included. FTRs and SRs were generated post-examination. All reports were evaluated by a radiologist and a surgeon through a questionnaire to determine their contribution to facilitating clinical decision-making and to assess their completeness, linguistic quality, and overall quality. SR significantly increased the capacity of facilitating therapy decision-making from 32% in FTR to 55% in SR (p < 0.001). Trust in the report was significantly higher in SR with a mean of 5.0 (SD = 0.5) vs. 4.7 (SD = 0.5) for FTR (p < 0.001). SR received significantly higher mean ratings regarding linguistic quality with 4.7 for SR vs. 4.4 for FTR (p = 0.004) and overall report quality with a mean of 4.9 for SR vs. 4.6 for FTR (p < 0.001). Concluding that SR enhances the overall quality of reports in [18F]SiTATE-PET/CTs for NET staging, serving as a tool to streamline clinical decision-making and enhance interdisciplinary communication in the future.

Radiological and Histopathological Insights into Primary Breast Endocrine Carcinoma: A Case Study

A 75-year-old woman with a medical history of hypothyroidism presented to the triple assessment breast clinic with a 2 weeks history of right sided breast lump, no history of pain or nipple discharge with no significant family history of breast cancer. Her clinical examination revealed 4 x 4 cm hard, nonmobile right upper outer quadrant (10 O’clock) breast mass with multiple enlarged right axillary lymph nodes. No evidence of skin or underlying muscle involvement. No nipple discharge was noted. Her radiological assessment with mammogram and ultrasound showed two supicious masses; occupying the right upper outer and central outer breast, one at 9 O’clock and the second at 11-12 O’clock (the largest), with suspicious pleomorphic microcalcification in mammogram. Multiple significant axillary lymphadenopathies are also detected. Ultrasound-guided core biopsy was performed and the histopathology was in favor of a triple negative neuroendocrine carcinoma in keeping with small cell carcinoma with axillary metastasis. An extensive work-up was done for the patient to detect distant metastasis (PET/CT scan) versus other primary tumor. Her PET scan demonstrated multicenteric breast tumor with uptake in the splenic flexure, therefore gastrocolposcopy were performed and showed adenoma with low grade dysplasia on final histopathology.The tumor was staged as cT2N2M0. The patient started on neoadjuvant chemotherapy and on further follow up the tumor size had regressed completely, and the patient will be scheduled for surgery upon finishing her chemotherapy.

Descriptive analysis and outcomes of PitNETs treated surgically during pregnancy and postpartum.

Data on pituitary neuroendocrine tumors (PitNETs) surgically treated during pregnancy is limited, and no studies have compared these cases to those treated in non-pregnant women. This study aimed to describe the clinical, radiological, and histological profiles of patients treated surgically for PitNETs during pregnancy and evaluate long-term prognosis. This study was multicentric, observational and retrospective. We included 10 patients from 5 university hospitals who underwent surgical treatment for PitNETs during pregnancy or within 12 months postpartum, along with 30 matched non-pregnant controls treated surgically for PitNETs. Clinical and histological data, as well as progression-free survival without additional treatment, were compared between pregnant and non-pregnant patients. Among the 10 PitNETs, 4 were corticotropic, 2 gonadotropic, 2 lactotropic, and 2 somatotropic. The primary surgical indication (tumour syndrome with or without failure of medical treatment) was similar between the two groups: 7/10 vs 19/30 (p = 1.00). There was no statistically significant difference in volume (p = 0.072) or radiological invasion markers (optic chiasm compression, p = 0.059, and cavernous sinus invasion, p = 0.274). However, PitNETs in pregnant women showed higher mitotic activity (p = 0.038) and were more frequently classified as grade 2b (Trouillas clinicopathological classification; p=0.049). The need for second-line treatment was also more frequent (p = 0.005). PitNETs requiring surgical treatment during pregnancy are characterized by increased proliferative activity and progression after surgery. Despite this, the long-term prognosis remains favorable. These results need confirmation in a larger study.

Advances in the pathology of digestive system diseases in China over the past ten years: retrospect and prospect

The incidence of digestive system diseases is high. So digestive system pathology is widely concerned. In the past 10 years, Chinese pathologists insist on hard work and have made significant progress. This article reviews the research and practice progress in digestive system tumors and non-tumors in the past 10 years, including the establishment of diagnostic criteria for gastrointestinal tract, hepatobiliary and pancreatic diseases, the establishment and classification of new diseases with special morphology, the classification and standard update of gastrointestinal and pancreatic neuroendocrine tumors, the progress of molecular pathology, and non-tumor lesions of the digestive system. The future development trend of digestive system pathology is also prospected.

Rectal neuroendocrine tumors: Can we predict their behavior?

Rectal neuroendocrine tumors (r-NETs) are the second most common type of neuroendocrine tumor in the gastrointestinal tract, with an increase in incidence in the last decades. They are low-grade tumors and, given their low risk of metastasis, current guidelines recommend endoscopic resection for small lesions. The GATIS predicting score, proposed by Zeng et al , represents an innovative model designed to predict individualized survival outcomes for patients with r-NETs, analyzing the relationship between clinicopathological features and patient prognoses. The authors identified tumor grade, T stage, tumor size, age, and prognostic nutritional index as key prognostic factors, demonstrating that the GATIS Score provides a more accurate prognosis assessment compared to the World Health Organization classification or the tumor-node-metastasis staging system. Nevertheless, further larger prospective studies are necessary, and the scientific community's efforts in this context should be directed toward developing international multicentric prospective studies, with the ultimate aim of accurately defining and understanding the behavior of these conditions.

Identification of IFI27 involvement in the progression of neuroblastoma through bioinformatics analysis and experimental assays.

Neuroblastoma (NB) is a prevalent extracranial malignant neuroendocrine tumor in children, originating from the sympathetic nervous system. This study aims to investigate new therapeutic targets for NB. The differentially expressed genes were screened by analyzing the GSE35133 and GSE90689 datasets. Hub genes were identified by constructing a protein-protein interaction network. The diagnostic value of the hub genes was assessed through the analysis of receiver operating characteristic (ROC) curves and the expression, prognosis, and immune infiltration of IFI27 in pan-cancer were analyzed on the online website Sangerbox. The hub gene expression levels were validated by performing real-time reverse transcriptase-polymerase chain reaction. The functions of IFI27 in NB were investigated by Cell Counting Kit-8, 5-ethynyl-2'-deoxyuridine, wound healing, and Transwell assays. Six candidate genes (IFI27, TNFSF10, IFI44, DDX58, HIST1H1C, and HIST1H1E) were identified as potential diagnostic biomarkers for NB. The expression levels of IFI27, TNFSF10, IFI44, and DDX58 were significantly decreased, while HIST1H1C and HIST1H1E were elevated. Notably, IFI27 displayed correlations with prognosis and immune infiltration in multiple tumors. In vitro, functional assays demonstrated that the knockdown of IFI27 promoted the proliferation, migration, and invasion of U251 cells. Conversely, in SK-N-AS cells, IFI27 overexpression inhibited cell proliferation, migration, and invasion. IFI27 was lowly expressed in NB and participated in the progression of NB, which provides a new insight into the pathogenic mechanism and novel therapeutic strategy for NB.

Primary large cell neuroendocrine carcinoma of the urethra: a case report

BackgroundPrimary neuroendocrine carcinoma of the urethra is a very uncommon malignant tumor, and no reports have been made about large cell neuroendocrine carcinoma (LCNEC) in the past.Case descriptionA 43-year-old non-smoking female patient presented with symptoms of dysuria and urination-related pain at TangDu Hospital in April 2022. A biopsy subsequently confirmed the diagnosis of primary urethral LCNEC. Following radical resection, the patient exhibited abnormal lymph node enlargement in the first month and pelvic metastases in the fourth month. Ultimately, the patient succumbed to the disease 486 days after the radical resection, attributed to widespread tumor metastases and concurrent multi-organ failure. The final pathological examination confirmed the presence of a high-grade LCNEC.ConclusionThe occurrence of primary LCNEC in the urethra is exceptionally uncommon. This particular instance was notable for its aggressive progression and unfavorable prognosis. Historically, there have been no prior documented instances of primary pure LCNEC in the urethra. It is imperative to emphasize that early identification and intervention for LCNEC could potentially offer patients a more favorable survival outcome.

Demographic and temporal variations in gallbladder adenocarcinoma and neuroendocrine carcinoma: insights from a retrospective analysis of the national cancer database.

Gallbladder adenocarcinoma is the most common histologic subtype of gallbladder malignancies. In contrast, gallbladder neuroendocrine carcinomas are rare and poorly studied. This study aims to identify the demographic variables that may be associated with each histologic subtype. A retrospective analysis was conducted on 53,447 patients diagnosed with gallbladder neoplasms using data from the National Cancer Database (NCDB) between 2011 and 2020. Associations between demographic variables and the incidence of gallbladder adenocarcinoma and neuroendocrine carcinoma were compared using chi-square tests and post hoc analyses. A total of 51,694 (96.7%) patients had adenocarcinoma, and 1753 (3.3%) had neuroendocrine histologic subtypes. The comparative analysis revealed significant associations with age, gender, and race (p < 0.05). Neuroendocrine carcinoma patients were diagnosed at a younger age compared to those with adenocarcinoma (z = 14.7). Moreover, patients with privately managed insurance had a higher likelihood of neuroendocrine carcinoma (z = 5.7), while those with Medicare were less likely (z = -4.7). Gender differences were also notable; males were more predisposed to neuroendocrine carcinoma (z = 4.4, OR = 1.3), while females were less so (z = -3.1). A significant increase in neuroendocrine cases was observed after 2016 (z = 2.4), while the incidence of adenocarcinoma subtypes was stable. Notable racial disparities in the diagnosis of gallbladder cancer were identified with black patients more likely to have neuroendocrine carcinoma. This study highlights the differences in demographic and clinical characteristics of patients diagnosed with gallbladder neuroendocrine carcinomas compared to adenocarcinoma tumors. These findings highlight potential opportunities for targeted screening programs to enhance early detection efforts.

Overlapping presentations and diverse genetic defects characterize neuroendocrine neoplasms in a Mexican cohort.

Genetic tests are part of the routine clinical approach to syndromic and nonsyndromic phenotypes of neuroendocrine neoplasms (NENs). Current data on phenotype-genotype associations in NENs, however, do not accurately represent all populations. To describe the frequency, inventory, and clinical associations of germline defects associated with multiple types of NENs in a Mexican cohort. Blood DNA from Mexican adults with NENs was analyzed with a 53-gene NGS panel developed ad hoc (n=90) or Sanger sequencing (n=2). Single nucleotide variants, indels and structural variants were identified, classified, and subjected to orthogonal confirmation. When possible, tumor samples and blood DNA from additional family members were tested using Sanger sequencing. Ninety-two probands (70.7% women, 51.5% sporadic) were included; sixteen carried pathogenic or likely pathogenic (P/LP) variants and were significantly younger at disease onset, compared with the rest (29.6±10,7 vs. 40 [21.5-51.5] years, P=0.0384). Likely driving variants were identified in three-quarters of Von Hippel Lindau syndrome cases, one-third of multiple endocrine neoplasia type 1 (MEN1), one-quarter of early-onset acromegaly/gigantism, and individual cases of Cushing's disease, MEN2A, and medullary thyroid carcinoma. One patient with clinical MEN1 associated with an SDHA variant and one with a pituitary tumor and neurofibromatosis type 1 were also identified. Probands with familial disease were more likely to carry P/LP variants, compared with sporadic cases (26.7 vs 8.5%, P=0.0282). P/LP variants were identified in 17.4% of individuals with NENs. Our research provides a view of the landscape of NEN drivers in a population not previously characterized.

Case report: Neuroendocrine carcinoma of the nasal cavity in a roe deer (Capreolus capreolus)

Neuroendocrine tumors of the nasal cavity are rare in both animals and humans. This report describes the macroscopic, histopathological and immunohistochemical characteristics of a neuroendocrine tumor in a three-year-old female roe deer (Capreolus capreolus) that was shot due to a facial deformity caused by an oval, firm, exophytic lesion effacing the left frontal and parietal regions. Longitudinal sectioning of the skull revealed a nasal cavity tumor that had invaded the cribriform plate, the rostral bones of the skull, the rostral aspect of the cranial cavity and the frontal sinuses and extended through the lacrimal, sphenoid and zygomatic bones into the subcutaneous tissue. Histopathologically, the tumor consisted of neoplastic cells forming sheets, nests, trabecular and cribriform structures separated by a delicate fibrovascular stroma. Mitoses were rare. Based on the histopathological and immunohistochemical findings, a neuroendocrine carcinoma was diagnosed. Based on thorough database searches, this is the first known case of a nasal neuroendocrine carcinoma in a roe deer.

Low-activity [18F]-somatostatin receptor (SSTR) imaging using [18F]SiTATE on a long axial field-of-view PET/CT scanner

Purpose18F-labelled somatostatin receptor tracers have recently gained popularity due to their better spatial resolution, longer half-life and lower costs compared to 68Ga-labeled tracers. The aim of this study was to evaluate the impact and limitations of reduced administered activities of [18F]SiTATE on image quality, lesion detectability and quantitative PET parameters in a long axial field-of-view (LAFOV) PET/CT scanner.MethodsTwenty-four patients with histologically confirmed neuroendocrine tumor, who underwent clinically indicated [18F]SiTATE PET/CT examination (3.0 MBq/kg, 5 min PET scan time) on a Siemens Biograph Vision Quadra LAFOV PET/CT, were included retrospectively in this study. PET list-mode data were rebinned for shorter frame durations to simulate 5 min scans with lower activities of injected radiotracer. A comparison of image reconstruction in high sensitivity (HS) and ultra-high sensitivity mode (UHS) mode was performed. Subjective image quality, noise and lesion detectability of n = 122 lesions were rated using a 5-point Likert scale. The molecular tumor volume (MTV), signal-to-noise ratio (SNR), tumor-to-liver activity concentration ratio (TLR) and standardized uptake values (SUV) were analyzed.ResultsSubjective image quality decreased with simulated reduction of injected activity with generally superior ratings in the UHS mode compared to the HS mode. Despite a reduction to 1 MBq/kg of [18F]SiTATE all lesions were still detected while at 0.25 MBq/kg lesion detectability decreased to 70% (HS) and 93% (UHS). Only minor changes in SUVmean and TLR were detected with reduced activity. However, reduced activities led to an increase in SUVSD, which in turn caused a decrease in SNR (at 1 MBq/kg: 7.3 in HS and 9.0 in UHS mode and an increase in deviation of the MTV.ConclusionReducing the administered activity of injected [18F]SiTATE by 66% to 1 MBq/kg (HS & UHS) is feasible in a LAFOV PET/CT scanner, maintaining clinically diagnostic image quality without statistically significant deviations in PET uptake parameters and MTV. Furthermore, in low activity [18F]SiTATE PET/CT, the UHS mode improves image quality and noise as well as lesion detectability compared to HS mode, further reinforcing the clinical benefits of this recently introduced reconstruction mode.

Endoscopic resection with one-port placement for duodenal neuroendocrine tumor: toward more minimally invasive endoscopic management.

Endoscopic resection with one-port placement for duodenal neuroendocrine tumor: toward more minimally invasive endoscopic management.

Cabozantinib in the Treatment of Neuroendocrine Neoplasms: Insights Across Different Tumor Origins.

Neuroendocrine neoplasms (NENs) are a heterogeneous group of tumors arising from neuroendocrine cells, exhibiting a wide range of behaviours from indolent to highly aggressive forms. Treatment options remain limited, particularly for progressive cases. Cabozantinib, a multitarget tyrosine kinase inhibitor, has demonstrated potential in targeting key pathways related to tumor growth, angiogenesis, and metastasis. This review provides a comprehensive analysis of cabozantinib's therapeutic role across various NEN subtypes, including gastroenteropancreatic NENs, lung NENs, pheochromocytomas/paragangliomas, Merkel cell carcinoma, presacral NENs, pituitary neuroendocrine tumors, and neuroendocrine prostate cancer. The paper discusses several preclinical and clinical studies that demonstrate the efficacy of cabozantinib in slowing tumor progression and improving progression-free survival, particularly in patients with progressive, well-differentiated NENs. However, cabozantinib's complex toxicity profile limits its broad application, necessitating further research to optimize dosing, particularly in syndromic NENs. Ongoing trials are investigating cabozantinib in combination with somatostatin analogues, peptide receptor radionuclide therapy, temozolomide and immunotherapies in order to overcome treatment resistance and expanding therapeutic strategies for advanced NENs.

Association of pituitary neuroendocrine tumors and neurofibromatosis type 1: assessing causation versus coincidence. Case report

IntroductionPatients with neurofibromatosis type 1 (NF1) are at risk for developing various neoplasms. Since the early twentieth century, multiple cases of pituitary neuroendocrine tumors (PitNETs) occurring in this context have been published. Yet, the role of NF1 (17q11.2) loss-of-function (LOF) variants in pituitary tumorigenesis remains unclear.AimWe report the clinical and molecular characterization of a case of PitNET diagnosed in a patient with NF1. We also review the available data for and against a causal association between NF1 defects and pituitary tumors.MethodsOur patient was recruited via an ongoing prospective study of individuals with neuroendocrine neoplasms. Genetic testing was carried out by means of targeted next generation sequencing (NGS) and Sanger sequencing in blood and tumor DNA, respectively. NF1 expression was analyzed via quantitative polymerase chain reaction (qPCR) in blood and tumor cDNA. Similar cases were searched in the literature.ResultsA 54-year-old-man was incidentally diagnosed with a clinically non-functioning PitNET via brain imaging. He had a personal and family history of NF1 and carried the germline pathogenic variant NF1 (NM_001042492.3): c.147C&amp;gt;A, p.Y49*. Via transsphenoidal surgery, a 16 mm lesion was resected, showing strong granular cytoplasmic immunoreactivity with patchy distribution for NF1 and preserved heterozygosity for the NF1 defect. Additional NGS ruled out germline defects in PitNET-associated genes. By qPCR, NF1 was significantly overexpressed in the tumor when compared with another NF-PitNET, but not when compared with a corticotropinoma. We reviewed twenty-three case reports of PitNETs occurring in patients with either clinical NF1 without genetic study, individuals with NF1 germline variants with or without clinical NF1 or associated with somatic NF1 defects. Predominance of GH-secreting and large PitNETs, with young-onset in around half of the cases, were noticed. Two individuals developed multiple endocrine neoplasia-like phenotypes but tested negative for other relevant genetic defects.ConclusionsAlthough the association of NF1 and PitNETs could be coincidental, the clinical characteristics of the reviewed cases differ from those of typical incidentalomas. NF1 could drive pituitary tumorigenesis via haploinsufficiency, but this hypothesis requires further research. Additional clinical and molecular data from large cohorts of affected individuals should help clarify this question.

5-HT orchestrates Histone Serotonylation and Citrullination to Drive Neutrophil Extracellular Traps and Liver Metastasis.

Serotonin (5-HT) is a neurotransmitter that has been linked to tumorigenesis. Whether and how 5-HT modulates cells in the microenvironment to regulate tumor metastasis remains to be largely unknown. Here, we demonstrate that 5-HT is secreted by neuroendocrine prostate cancer (NEPC) cells to communicate with neutrophils and to induce neutrophil extracellular traps (NETs) in the liver, which in turn facilitates the recruitment of disseminated cancer cells and promotes liver metastasis. 5-HT induces histone serotonylation (H3Q5ser) and orchestrates histone citrullination (H3cit) in neutrophils to trigger chromatin decondensation and facilitate the formation of NETs. Interestingly, we uncover in this process a reciprocally reinforcing effect between H3Q5ser and H3cit and a crosstalk between the respective writers TGM2 and PAD4. Genetic ablation or pharmacological targeting of TGM2, or inhibiting 5-HT transporter (SERT) with the FDA-approved antidepressant drug fluoxetine reduces H3Q5ser and H3cit modifications, suppresses NETs formation, and effectively inhibits NEPC, small cell lung cancer, and thyroid medullary cancer liver metastasis. Collectively, the 5-HT-triggered NETs production highlights a new targetable neurotransmitter-immune axis in driving liver metastasis of neuroendocrine cancers.

Clinical and rehabilitation aspects of managing patients with meningiomas, schwannomas, ependymomas, and pituitary neuroendocrine tumors

The rehabilitation of neurooncology patients represents a critical issue due to the high incidence of brain tumors of varying locations and the severity of associated neurological symptoms, which significantly reduce the patient’s quality of life. Over the past decades, the prevalence of central nervous system tumor has increased by more than twofold in individuals aged 65 and above. Neurooncology patients represent a complex group that requires long-term restorative treatment. The early initiation of rehabilitation facilitates the recovery of impaired functions prior to the formation of persistent pathological patterns. This article examines neurorehabilitation methods using the example of the most common benign brain tumors, which include meningiomas, schwannomas, ependymomas, and pituitary neuroendocrine tumors. Significant advancements have been made in the treatment of these tumors in recent years, particularly through combined treatment modalities. A multidisciplinary approach to neurooncology is becoming increasingly recognized as a key element in global healthcare. However, the needs of these patients and their families extend beyond medical care, necessitating the involvement of psychologists, occupational therapists, speech-language pathologists, and social workers. A comprehensive approach to treatment, early restorative interventions and the development of innovative neurorehabilitation methods can facilitate a personalized strategy for patients with benign brain tumors, thereby increasing their rehabilitation potential.

Size-dependent dose estimation applied to 177Lu and 90Y -DOTATATE using ICRP Phantoms Nuclear Science and Engineering

Purpose: radiolabeled peptide has attracted growing interests for neuroendocrine cancer therapy. We aim to calculate S-values of Lu-177, In-111 and Y-90 in different size of International commission of radiation protection (ICRP) male and female phantoms for pre-estimation of absorbed dose in critical target organs using Monte Carlo simulation to see the extent of difference. Materials and methods: We employed the most advanced hybrid ICRP phantom and used its different male and females BMIs to resemble reality. Twenty different size of ICRP male and female phantoms were generated. GATE code was used to perform dosimetry calculations. Spline, bladder, kidneys, and liver were chosen as the source organs and the S- values were calculated in interested target organs for twenty different body mass indexes (BMIs). Results: The S-values in both self-absorptions and target organs were dramatically lower for 177Lu -DOTATATE compared to 90Y-DOTATATE. The highest difference between the absorption in kidneys is for BMI of 24.3. The highest S-value in bladder from bladder is 0.01 mGy/MBq.s in BMI of 34.4 for 177Lu-DOTATATE, whereas it is 0.0049 mGy/MBq.s in BMIs of 34.4 for 90Y-DOTATATE. It was found that dose per unit cumulated activity had a tendency to decrease with BMI. Conclusion: Variability in 177Lu -DOTATATE and 90Y-DOTATATE dosimetry across morphometrically different patients are important in optimizing therapy protocols and research studies. Using size-dependent phantoms for dosimetry, estimations more accurate dose per cumulated activity relative to standard reference dosimetry. To prevent excessive dosage to patients, it is important to consider the relationship between body size and dose.

A Deep Dive into the RAISE Project Methodology

This animation explains the methodology used in the Research for Artificial Intelligence-Based Surrogate Endpoint (RAISE) project, presented in two manuscripts recently published in Future Oncology. This exploratory work assessed whether deep learning techniques could improve early progression-free survival (PFS) in patients with neuroendocrine tumors (NETs), using features extracted from computerized tomography scans from patients in the CLARINET phase 3 trial. As part of the RAISE project, response heterogeneity (the coexistence of responding and non-responding lesions in the same patient) was also investigated to assess whether it could be used as a biomarker to allow earlier prediction of PFS in patients with NETs. Previous definitions of response heterogeneity are not suitable for assessing slow-growing tumors, such as NETs, so the definition of response heterogeneity was adapted in this study and is described in this animation.

Arare case of arectal neuroendocrine neoplasm growing within alipoma with ulcerative lesions.

Neuroendocrine neoplasms (NENs) are aheterogeneous group of tumors with different immunophenotypes, morphological features, clinical presentations, and outcomes. Therefore, the diversity of NENs can easily confuse clinicians and lead to misdiagnosis. This article reports acase of arectal NEN (r-NEN) growing within alipoma with ulcerative lesions, which had been mistaken for rectal cancer. Fortunately, an experienced surgeon questioned the initial diagnosis (rectal cancer) after combining the results of acolonoscopic biopsy and the digital anorectal examination, thus enabling the patient to avoid unnecessary surgery. Through the review of this case and relevant literature, we further analyze the growth pattern of NENs and lipomas. Additionally, we hope to enhance clinicians' awareness of aNEN that grew insidiously within alipoma with surface ulcerative lesions, to make accurate diagnoses and treatments in time.

Equine tongue tumours: A multicentre retrospective study

SummaryBackgroundTumours of the oral cavity in horses are rare, and because they are not easily visible, their diagnosis is often delayed. Different types of equine tongue tumours have been described, but information about clinical signs, treatments and outcomes is very limited.ObjectivesTo identify horses with a confirmed antemortem diagnosis of a tongue tumour and to document their clinical presentation, treatment and outcome.Study designRetrospective multicentre study.MethodsMedical records (1997–2024) from eight specialty or referral practices were reviewed. Horses met inclusion criteria if an antemortem diagnosis of a tongue tumour was made and confirmed by cytology or histopathology.ResultsThirteen horses met the inclusion criteria. Presenting complaints included one or more of the following: tongue mass (4) or wound (2), difficulty eating (6), external facial swelling (2) and abnormal respiratory noise (2). Tumours were identified as squamous cell carcinoma (SCC) (5), melanoma (2), mast cell tumour (2), anaplastic carcinoma (1), poorly differentiated carcinoma (1), B‐cell lymphoma (1) and neuroendocrine tumour (1). Seven of 13 horses (54%) underwent surgical treatment. Five of the seven (71%) had no recurrence for ≥1 year, and two were euthanised earlier for reasons other than tumour regrowth. One mast cell tumour responded to conservative treatment. All horses with SCC were euthanised following palliative or no treatment.Main limitationsThe main limitations are the small sample size, a result of the rarity of the condition and the diversity of performed diagnostics and treatments, a consequence of the multicentre study design.ConclusionHorses with tongue tumours frequently present for evaluation of a tongue laceration or mass and biopsy or cytology is required for definitive diagnosis. While the prognosis for lingual SCC was uniformly grave, surgical excision for other types of tongue tumours carried a good long‐term prognosis in this study.