Raffaele Manta1, Elisabetta Nardi2, Nico Pagano3, Claudio Ricci3, Mariano Sica4, Danilo Castellani2, Helga Bertani4, Micaela Piccoli5, Barbara Mullineris5, Alberto Tringali6, Francesco Marini7, Ugo Germani7, Vincenzo Villanacci8, Riccardo Casadei3, Massimiliano Mutignani6, Rita Conigliaro4, Gabrio Bassotti2, Angelo Zullo9. 1. Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile Sant'Agostino-Estense, Baggiovara-Modena, Italy. r.manta@libero.it. 2. Gastroenterology Section, Department of Medicine, University of Perugia School of Medicine, Perugia, Italy. 3. Department of Internal Medicine and Surgery (DIMEC), University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy. 4. Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile Sant'Agostino-Estense, Baggiovara-Modena, Italy. 5. Department of General Surgery, Nuovo Ospedale Civile Sant'Agostino-Estense, Baggiovara-Modena, Italy. 6. Endoscopy Unit, Niguarda Ca-Granda Hospital, Milan, Italy. 7. Gastroenterology Unit, Ospedali Riuniti Ancona, Italy. 8. Pathology Unit Spedali Civili, Brescia, Italy. 9. Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy.
Abstract
BACKGROUND AND AIMS: Diagnosis of pancreatic neuroendocrine tumors (p-NETs) is frequently challenging. We describe a large series of patients with p-NETs in whom both pre-operative Computed Tomography (CT) and Endoscopic Ultrasonography (EUS) were performed. METHODS: This was a retrospective analysis of prospectively collected sporadic p-NET cases. All patients underwent both standard multidetector CT study and EUS with fine-needle aspiration (FNA). The final histological diagnosis was achieved on a post-surgical specimen. Chromogranin A (CgA) levels were measured. RESULTS: A total of 80 patients (mean age: 58 +/- 14.2 years; males: 42) were enrolled. The diameter of functioning was significantly lower than that of non-functioning p-NETs (11.2 +/- 8.5 mm vs 19.8 +/- 12.2 mm; P = 0.0004). The CgA levels were more frequently elevated in non-functioning than functioning pNET patients (71.4% vs 46.9%; P = 0.049). Overall, the CT study detected the lesion in 51 (63.7%) cases, being negative in 26 (68.4%) patients with a tumor </=10 mm, and in a further 3 (15%) cases with a tumor diameter </=20 mm. CT overlooked the pancreatic lesion more frequently in patients with functioning than non-functioning p-NETs (46.5% vs 24.3%; P = 0.002). EUS allowed a more precise pre-operative tumor measurement, with an overall incorrect dimension in only 9 (11.2%) patients. Of note, the EUS-guided FNA suspected the neuroendocrine nature of tumor in all cases. CONCLUSIONS: Data of this large case series would suggest that the EUS should be included in the diagnostic work-up in all patients with a suspected p-NET, even when the CT study was negative for a primary lesion in the pancreas.
BACKGROUND AND AIMS: Diagnosis of pancreatic neuroendocrine tumors (p-NETs) is frequently challenging. We describe a large series of patients with p-NETs in whom both pre-operative Computed Tomography (CT) and Endoscopic Ultrasonography (EUS) were performed. METHODS: This was a retrospective analysis of prospectively collected sporadic p-NET cases. All patients underwent both standard multidetector CT study and EUS with fine-needle aspiration (FNA). The final histological diagnosis was achieved on a post-surgical specimen. Chromogranin A (CgA) levels were measured. RESULTS: A total of 80 patients (mean age: 58 +/- 14.2 years; males: 42) were enrolled. The diameter of functioning was significantly lower than that of non-functioning p-NETs (11.2 +/- 8.5 mm vs 19.8 +/- 12.2 mm; P = 0.0004). The CgA levels were more frequently elevated in non-functioning than functioning pNET patients (71.4% vs 46.9%; P = 0.049). Overall, the CT study detected the lesion in 51 (63.7%) cases, being negative in 26 (68.4%) patients with a tumor </=10 mm, and in a further 3 (15%) cases with a tumor diameter </=20 mm. CT overlooked the pancreatic lesion more frequently in patients with functioning than non-functioning p-NETs (46.5% vs 24.3%; P = 0.002). EUS allowed a more precise pre-operative tumor measurement, with an overall incorrect dimension in only 9 (11.2%) patients. Of note, the EUS-guided FNA suspected the neuroendocrine nature of tumor in all cases. CONCLUSIONS: Data of this large case series would suggest that the EUS should be included in the diagnostic work-up in all patients with a suspected p-NET, even when the CT study was negative for a primary lesion in the pancreas.
Authors: Roberta Elisa Rossi; Alessandra Elvevi; Camilla Gallo; Andrea Palermo; Pietro Invernizzi; Sara Massironi Journal: World J Gastroenterol Date: 2022-07-14 Impact factor: 5.374
Authors: Alessandra Pulvirenti; Deepthi Rao; Caitlin A Mcintyre; Mithat Gonen; Laura H Tang; David S Klimstra; Martin Fleisher; Lakshmi V Ramanathan; Diane Reidy-Lagunes; Peter J Allen Journal: HPB (Oxford) Date: 2018-10-23 Impact factor: 3.647
Authors: Ferga C Gleeson; Jesse S Voss; Benjamin R Kipp; Sarah E Kerr; John S Van Arnam; John R Mills; Cherisse A Marcou; Amber R Schneider; Zheng Jin Tu; Michael R Henry; Michael J Levy Journal: Oncotarget Date: 2017-06-28