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Metastatic well differentiated neuroendocrine carcinoma in liver

78-year-old male was diagnosed with Metastatic well differentiated neuroendocrine carcinoma in liver. There is an undefined finding in the cecum that might be the primary tumor, and hepatic metastases that can be surgically respected. The imaging tests support the assumption that the primary tumor is in the small intestine.

Metastatic well differentiated neuroendocrine carcinoma in liver_2

78-year-old male was diagnosed with metastatic well differentiated neuroendocrine carcinoma with unknown primary. He recently underwent explorative laparotomy that revealed solitary metastasis in the liver, and a hard lesion in the mid-ileum suspicious for the primary carcinoid. A frozen section showed foreign body type giant cell granuloma. Left lateral segmentectomy of the liver showed a white hard lesion. The expert recommends a regular follow-up that should consist of abdominal ultrasonography combined with CT or MRI.

Pulmonary Heteroplasia – additional opinion

66-year-old female was diagnosed, following persistent cough, with lung tumour with concomitant pulmonary nodules and a measurable enlargement of lymph nodes. FBS was positive for well differentiated neuroendocrine carcinoma and a needle biopsy revealed adenocarcinoma with associated neuroendocrine differentiation.

Pulmonary heteroplasia_2

66-year-old female was diagnosed, following persistent cough, with non-operable tumor of her lung with satellite nodules, and chemotherapy was initiated (first Cisplatin and Gemcitabine, and then switched to Tarceva). Response evaluation following the fourth cycle of chemotherapy showed either stability or an initiation of tumor response, but bone scintigraphy that was performed 6 months later revealed an area of increased uptake in the left hemithorax which could be suggestive of a secondary bone lesion.

Pulmonary heteroplasia_3

66-year-old female was diagnosed, following persistent cough, with non-operable tumor of her lung with satellite nodules, and chemotherapy was initiated (first Cisplatin and Gemcitabine, and then switched to Tarceva). Response evaluation following the fourth cycle of chemotherapy showed either stability or an initiation of tumor response, but bone scintigraphy that was performed 6 months later revealed an area of increased uptake in the left hemithorax which could be suggestive of a secondary bone lesion.

 

Neuroendocrine Neoplasia

60-year-old male was diagnosed with a symptomatic metastatic well differentiated rectal neuroendocrine tumor, with multiple liver metastases. This tumor is over-expressing somastatin receptors, which was demonstrated by an otreoscan. He was started on Sandostatin LAR 30 once a month.

Pulmonary heteroplasia

66-year-old female was diagnosed with lung tumour within the right hemithorax with concomitant pulmonary nodules and a measurable enlargement of lymph nodes. FBS was positive for well differentiated neuroendocrine carcinoma and a needle biopsy revealed adenocarcinoma with associated neuroendocrine differentiation. The patient was then treated with altogether four courses of induction chemotherapy.

Small Cell Neuroendocrine Tumor of the Cervix – additional opinion

36-year-old otherwise healthy female presented with an atypical pap smear. Biopsy of cervix revealed poorly Differentiated Neuroendocrine Carcinoma. Immunohistochemical staining showed the cells positive for NSE, SYN, CHR, and 90% positive for Ki67 (proliferative index). The findings of the PET-FDG test showed pathological absorption of FDG as a primary tumor of the cervix, towards the left side of the body. Moreover, evidence is seen of nodal metastatic spread in the retroperitoneum and pelvis, mainly on the left.