ObjectiveTo summary the treatment of pancreatic neuroendocrine neoplasms (pNENs). MethodsArticles relevant to pNENs at home and abroad were collected and reviewed. ResultsBecause of rare incidence and non-specific clinical syndromes of pNENs, clinician had no enough cognition about it. For pNENs, surgery was still the preferred option, combining other treatments included chemotherapy, somatostatin analogue, α-interferon, molecular targeted therapy, and peptide receptor radionuclide therapy (PRRT). ConclusionSurgery is still considered as the preferred option for controlling the associated biochemical syndromes and curtailing the malignant progression of pNENs.
ObjectiveTo summarize the diagnosis and treatment process of a patient who underwent laparoscopic local excision of duodenal papillary tumor, and to explore the safety and feasibility of this surgery. MethodThe clinicopathologic characteristics and surgical procedure of the patient with duodenal papillary neuroendocrine tumor admitted to the West China Hospital of Sichuan University in June 2021 were retrospectively analyzed. ResultsThe patient underwent the laparoscopic local excision of duodenal papillary tumor + in situ cholangiojejunostomy and pancreaticojejunostomy. The operation lasted about 3 hours, the blood loss was about 20 mL, and the patient exhausted on the 3rd day after the operation. On the 7th postoperative day, the gastric tube was pulled out and oral feeding was started. On the 8th day, the plasma drainage tube was pulled out and the patient was discharged smoothly. There was no duodenal fistula, bleeding, wound infection, and other complications. After 6 months of follow-up, the general condition of this patient was good, and no tumor recurrence or metastasis was found. ConclusionLaparoscopic local excision is an appropriate option for benign or low-grade malignancies involving the duodenal papillary tumor.
Large cell neuroendocrine lung cancer（LCNEC） is the rare subtype of nonsmall cell lung cancer. Because of its low incidence rate and the special biological behaviour, it is hard to define in pathology. And we also know little about its epidemiological feature and the purposeful therapy view of LCNEC, and the therapeutic effect is unsatisfactory. This article will review and introduce the advance of research, clinical diagnosis and therapeutic of the LCNEC.
ObjectiveTo investigate the clinical characteristic and treatment of gastrointestinal neuroendocrine neoplasm. MethodsFrom January 2011 to July 2015, the clinical characteristic and treatment of 74 patients with gastrointestinal neuroendocrine neoplasm in The Affiliated Hospital of Xuzhou Medical College were retrospectively analyzed. ResultsCases of gastrointestinal neuroendocrine neoplasm were increasing year by year. This study includes statistics of 74 patients. The number of male and female were 47 and 27, the rate was 1.74:1, the median age was 57.5 years old ranging from 24 up to 82 years. Of all the 74 cases, there were 38 cases (51.4%) in the stomach, 23 cases (31.1%) in rectum, 12 cases (16.2%) in colon, 1 case in duodenum. Of all the 74 cases with clinical symptom information, non-functional symptom accounts for 95.9% (71/74), while functional symptom accounts only for 4.1% (3/74). There were treatment data of 74 cases, including 34 cases in radical surgery, 23 cases in endoscopic excision, 8 cases in local resection, 4 cases in palliative resection, and 5cases in conservative treatment. The lymphatic metastasis was associated with gender, tumor size, tumor depth of invasion and tumor differentiation (P < 0.05). There was no statistically significant between the lymphatic metastasis and tumor location (P > 0.05). Preoperative distant metastasis was associated with tumor size and tumor depth of invasion (P < 0.05). Syn had a higher positive rate than CgA (P < 0.01). The positive rate of Syn and CgA was respectively 96.1% (49/51) and 72.9% (35/48). Conciusions Cases of gastrointestinal neuroendocrine neoplasm are increasing year by year, of which men has a higher morbidity than women. Radical surgery and endoscopic resection are the main treatment methods. The Syn and CgA test are helpful to the diagnosis of gastrointestinal neuroendocrine neoplasm.
Thymic neuroendocrine tumors (TNETs) are a series of rare diseases with aggressive biology and poor prognosis. Clinical manifestations of TNETs are atypical, and ectopic secretion of adrenocorticotropic hormone can be found in some cases, resulting in associated endocrine symptoms. Due to the low morbidity and strong heterogeneity, it’s difficult to diagnose, treat and obtain new treatment regimen. Early complete surgical resection is an effective treatment. For advanced cancer, clinical trials of new drugs are expected to improve the survival of patients.
目的总结直肠神经内分泌肿瘤（RNEN）的临床诊断和治疗方法。 方法回顾性分析2009年1月至2013年12月期间南京中医药大学附属医院（江苏省中医院）收治的16例RNEN患者的临床资料。 结果16例患者均顺利完成手术，手术时间30～120 min，平均50 min；术中出血量10～80 mL，平均55 mL；均无手术死亡，术中均未见严重并发症发生。术后住院时间10～35 d，平均17 d。手术创面均一期愈合，均顺利出院。术后所有患者均获访，随访时间为2个月～5年，中位随访时间为20个月。随访期间所有患者均未见复发或转移，无死亡病例。 结论RNEN发病隐匿，具有恶性潜能，且常无特异性临床表现，故应加深对该病的认识，及时对就诊患者进行全面检查，做到早发现、早诊断及早治疗，且治疗后应对患者进行严密随访。
Objective To discuss the CT appearances and clinicopathologic features of gastrointestinal neuroendocrine neoplasms (GI-NENs). Method The clinical and CT materials of 33 cases of GI-NENs who treated in our hospital from Jan. 2013 to Dec. 2015 were retrospectively analyzed. Results Of the 33 cases, 25 males and 8 females were enrolled. The median age was 62-year old (27–78 years), and the age at diagnosis mainly focused in the 50–70 years period. GI-NENs situation: 12 cases in the stomach, 11 cases in the rectum, 3 cases in the esophagus and colon respectively, 2 cases in the duodenum and appendix respectively. The main clinical symptoms included: abdominal pain in 13 cases, dysphagia and obstruction in 9 cases, hematemesis and hematochezia in 8 cases, abdominal distention in 5 cases, stool and bowel habits change in 5 cases, subxyphoid pain in 3 cases, belching in 2 cases, diarrhea in 1 case, protrusion of the neoplasm when defecation in 1 case, obstructive jaundice in 1 case. Seven cases of G1 grade, 6 cases of G2 grade, 15 cases of G3 grade, and 5 cases of mixed adenoneuroendocrine carcinomas were found according to pathologic grading. The immunohistochemical marker: synaptophsin was positive in 31 cases, cytokeratin A was positive in 23 cases, and cytokeratin was positive in 9 cases. The CT appearances of GI-NENs were mainly thickening of the walls and formation of nodules or masses in local area. Moderately homogeneous enhancement (in 20 cases) and irregularly heterogeneous enhancement (in 13 cases) were both commonly seen. In addition, 13 cases of lymphadenophathy, 6 cases of liver metastasis, and 3 cases of lung metastasis were also detected by CT. Conclusions GI-NENs have a preference for elderly male. The most common site of onset is the stomach. Its clinical symptoms and CT appearances are nonspecific, however, the enhancement pattern of the tumors has a certain characteristic.