Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007095 (carcinoid)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

About 5% of T1 non-small cell lung cancers (ie, lung cancers less than 3 cm in diameter), mostly focal nodular bronchioloalveolar carcinomas and carcinoid tumors, demonstrate no uptake at fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) and appear to be indolent in growth; consequently, they are associated with long-term patient survival. About 21% of T1 lung cancers show mediastinal nodal metastasis at the time of diagnosis and about 24% show extrathoracic metastasis, mostly brain metastasis, either at the time of diagnosis or at 1-year follow-up. T1 lung cancers with a large ground-glass attenuation component (50% of tumor volume) at thin-section computed tomography (CT) have a good prognosis with less likelihood of mediastinal nodal or extrathoracic metastasis. On the other hand, solid cancer lesions, especially those with a spiculated margin or with bronchovascular bundle thickening in the surrounding lung, more frequently demonstrate local vessel invasion, lymph node metastasis, and extrathoracic metastasis. In these tumors, work-up for extrathoracic metastases (including whole-body FDG PET or brain magnetic resonance imaging and mediastinoscopy for mediastinal nodes) may be needed, even when CT demonstrates no enlarged nodes in the mediastinum.
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PMID:T1 non-small cell lung cancer: imaging and histopathologic findings and their prognostic implications. 1553 72

Endocrine tumors (ET) of the digestive tract (formerly called neuroendocrine tumors) are rare. They are classified into two principal types: gastrointestinal ET's (formerly called carcinoid tumors) which are the most common, and pancreaticoduodenal ET's. Functioning ET's secrete polypeptide hormones which cause characteristic hormonal syndromes. The management of ET is multidisciplinary. Poorly-differentiated ET's have a poor prognosis and are treated by chemotherapy. Surgical excision is the only curative treatment of well-differentiated ET's. The surgical goals are to: 1. prolong survival by resecting the primary tumor and any nodal or hepatic metastases, 2. control the symptoms related to hormonal secretion, 3. prevent or treat local complications. The most common sites of gastrointestinal ET's ( carcinoids) are the appendix and the rectum; these are often small (<1 cm), benign, and discovered fortuitously at the time of appendectomy or colonoscopic removal. Ileal ET's, even if small, are malignant, frequently multiple, and complicated in 30-50% of cases by bowel obstruction, mesenteric invasion, or bleeding. The carcinoid syndrome (consisting of abdominal pain, flushing, diarrhea, hypertension, bronchospasm, and right sided cardiac vegetations) is caused by the hypersecretion of serotonin into the systemic circulation; it occurs in 10% of cases and is usually associated with hepatic metastases. More than half of the cases of pancreatic ET are non-functional. They are usually malignant and of advanced stage at diagnosis presenting as a palpable or obstructing mass or as liver metastases. Insulinoma and gastrinoma (cause of the Zollinger-Ellison syndrome) are the most common functional ET's. 80% are sporadic; in these cases, tumor size, location, and malignant potential determine the type of resection which may vary from a simple enucleation to a formal pancreatectomy. In 10-20% of cases, pancreaticoduodenal ET presents in the setting of multiple endocrine neoplasia (NEM type I), an autosomal-dominant genetic disease with multifocal endocrine involvement of the pituitary, parathyroid, pancreas, and adrenal glands. For insulinoma with NEM-I, enucleation of lesions in the pancreatic head plus a caudal pancreatectomy is the most appropriate procedure. For gastrinoma with NEM-I, the benefit of surgical resection for tumors less than 2-3 cm in size is not clear. The lesions are frequently small, multiple, and widespread and recurrence is frequent after excision. The long-term prognosis is nevertheless fairly good. But the eventual development of liver metastases which are the most common cause of mortality still argues for an aggressive surgical approach in the early stages of the disease.
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PMID:[Surgical treatment of gastric, enteric, and pancreatic endocrine tumors Part 1. Treatment of primary endocrine tumors]. 1614 76

Primary neuroendocrine neoplasms of the lung represent a clinical spectrum of tumors ranging from the relatively benign and slow-growing typical carcinoid to the highly aggressive small-cell lung carcinoma. The rarity of carcinoids has made the role of radiation therapy in their management controversial. This review considers the results of published studies to generate treatment recommendations and identify areas for future research. Surgery remains the standard of care for medically operable disease. Histology plays the most important role in determining the role of adjuvant radiation. Resected typical carcinoids likely do not require adjuvant therapy irrespective of nodal statius. Resected atypical carcinoids and large-cell neuroendocrine carcinomas have a significant risk of localfailure, for which adjuvant radiation likely improves local control. Definitive radiation is warranted in unresectable disease. Palliative radiation for symptomatic lesions has demonstrated efficacy for all histologies. Collaborative group trials are warranted.
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PMID:Primary carcinoid tumors of the lung: a role for radiotherapy. 1715 7

We report a case of collision tumor of the cecum in a 50-year-old woman and discuss the morphological criteria used for classifying mixed glandular-endocrine neoplasms of the digestive tract in a large series of reported cases. The cecal tumor showed clear geographic polarization, with no admixture or transition of the 2 neoplastic components. A lymph nodal metastatic deposit contained both tumors. Immunohistochemical stainings were consistent with the carcinomatous and carcinoidal nature of the 2 neoplasms, except for a minute area of carcinoembryonic antigen positivity in the carcinoid. A review of the literature shows that many mixed glandular-endocrine tumors of the digestive tract escape precise classification using established morphological criteria. Collision and composite tumors can share common histological and immunohistochemical features, including polyclonal metastases and carcinoembryonic antigen expression in the carcinoidal area. Mixed tumors of the cecum showing a collision-like morphology appear to behave more aggressively than other colonic adenoendocrine carcinomas.
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PMID:An unusual case of colonic mixed adenoendocrine carcinoma: collision versus composite tumor. A case report and review of the literature. 1763 Jan 14

The paper describes a case of gastric tumor comprising moderately differentiated adenocarcinoma and atypical carcinoid with metastases of both types of tumor cells in the lymph nodes. Electron microscopic and immunohistochemical studies of primary gastric tumor and lymph nodal metastases confirmed the presence of both differentiation types within one space-occupying lesion: such as goblet (mucin-producing) and neuroendocrine cells. The differentiation varied in different fields of vision with a preponderance of low-grade ultrastructural differentiation cells. Thus, electron microscopic and immunohistochemical studies of tumors not only verify their diagnosis and make a histogenetic differential diagnosis of various neoplasms, but also define the degree of their maturation.
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PMID:[Gastric tumor of complex structure]. 1772 97

The multistep complex metastatic cascade in cancer has been extensively studied in recent years. In addition, the concept of metastatic organ specificity has been elaborated. Histological studies in clinical situations have become far more sophisticated, enabling the frequent discovery of minor collections of cells in bone marrow and lymph nodes. Pertinent clinical evidence of the selective nodal metastatic pattern exists in differentiated thyroid cancer in younger, low-risk patients, yet none of the published risk group definitions indicate that lymph node metastases have a relationship to thyroid cancer survival. This unique clinical situation with very frequent nodal metastases but excellent survival is replicated in carcinoid cancers of the gastrointestinal tract. The lymph node metastatic frequency without distant organ metastases in these two human cancers help cement the understanding gained from laboratory and animal research regarding metastatic specificity and hopefully will help place the role of lymph node metastases generally and their surgical removal on a more scientifically and logically based understanding. More broadly, the elaboration of the frequency of metastatic cell dissemination to distant organs as well as lymph nodes, and comprehension of the metastatic cascade with metastatic specificity may reorient our understanding of the evolution from metastatic cells to clinical metastatic disease. Additionally, these concepts reemphasize that lymph node metastases are indicators, not governors, of distant metastases and survival, and add the assumption that metastatic tumor cells and tumor cell clusters, and perhaps even micrometastases in other organs, are themselves only indicators and not governors of distant metastases and survival in human cancers since they represent dormant metastases prior to their host microenvironmental changes that, on rare occasions, lead to angiogenesis and clinical metastases. Thus, the future may allow us to abandon some aspects of our surgical or systemic attack on clinical cancer metastases, such as lymph node removal or use of toxic chemotherapy, but open the door to more physiological and hopefully less traumatic approaches to the highly manipulable multistep genetic and physiological process of metastatic development. The future biological models of clinical cancer behavior will have to incorporate aspects of understanding the intricate metastatic cascade, and particularly the host microenvironmental factors that permit or prevent progressive growth of dormant cells or cell clusters to clinical metastases.
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PMID:Regional lymph node metastases, a singular manifestation of the process of clinical metastases in cancer: contemporary animal research and clinical reports suggest unifying concepts. 1734 68

Carcinoid tumour is an endocrine neoplasia described for the first time in 1888 and rarely observed in the extrahepatic bile ducts. Gallbladder carcinoid tumour was first reported by Joel in 1929. An endoluminal gallbladder lesion, with a bizarre echogenicity, and a mass in the upper pole of the left kidney were found in a 27 year-old man. The patient underwent a cholecystectomy with partial hepatectomy and a polar renal resection. Histological examination revealed a typical gallbladder carcinoid tumour with regional lymph nodal metastasis and a renal cell carcinoma, with morphological and histochemical features of the chromophobe type. This is a distinctive, rare variant, often described in the literature in association with other neoplastic and non-neoplastic diseases. To our knowledge, this is the first report of gallbladder carcinoid tumour with an unexpected aggressive behaviour in a very young patient, with concurrent renal cell carcinoma, chromophobe variant.
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PMID:Simultaneous occurrence of metastasizing carcinoid tumour of the gallbladder and chromophobe renal cell carcinoma in a young man. 1833 96

Gastrointestinal carcinoid tumors are rare neuroendocrine tumors with no staging system in existence. The goal of this study was to establish a staging system consistent with the American Joint Commission on Cancer Staging Systems using the TNM strategy. A retrospective review of our prospective database of 990 hepatopancreaticobiliary patients and our tumor registry identified 108 patients with gastrointestinal carcinoid tumors from June 1990 to September 2006. Tumors were classified into our staging system by depth of penetration, size of primary tumor, nodal status, and the presence/absence of distant metastasis. Patients were staged as Stage 1, 22 per cent; Stage II, 29 per cent; Stage 3, 12 per cent; and Stage 4, 35 per cent. There were 41 men and 57 women with a median age of 58.5 years (range, 19-86 years). Primary tumors included 52 small bowel, 12 colon, 19 rectum, nine stomach, and seven of unknown primary origin. The use of our initial staging system demonstrated a trend in differences in survival across all four stages. The use of our initial staging proposal delineates the biology of the disease with accurate overall survival estimates. The addition of a dedicated American Joint Commission on Cancer staging system is needed for gastrointestinal carcinoids. Widespread use of this staging system may contribute to the future management and treatment of gastrointestinal carcinoid tumors.
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PMID:Proposed staging system for gastrointestinal carcinoid tumors. 1848 99

We present a case of nodal recurrence of carcinoid tumor in a 48-year-old male patient, 30 years after resection of primary tumor. Octreoscan was used for diagnosis and localization of the mass. Surgical resection was successful and histopathologic examination revealed lymph node infiltrated with atypical carcinoid.
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PMID:Nodal recurrence of pulmonary carcinoid 30 years after primary resection. 1852 Aug 14

S100 protein is a sensitive marker for melanomas and peripheral nerve sheath tumors. It is, however, expressed by other mesenchymal and epithelial tumors. Despite its low specificity, S100 protein is valuable for the diagnosis of desmoplastic melanomas and peripheral nerve sheath tumors, for which no specific marker is available. Sox10 is a neural crest transcription factor crucial for specification, maturation, and maintenance of Schwann cells and melanocytes. Anti-Sox10 antibody was applied to a variety of neural crest-derived tumors, mesenchymal and epithelial neoplasms, and normal tissues. Sox10 nuclear expression was found in 76 of 78 melanomas (97%) and 38 of 77 malignant peripheral nerve sheath tumors (49%) whereas S100 protein was expressed in 71 melanomas (91%) and 23 malignant peripheral nerve sheath tumors (30%). Sox10 was diffusely expressed in schwannomas and neurofibromas. Sox10 reaction was seen only in sustentacular cells of pheochromocytomas/paragangliomas, and occasionally carcinoid tumors from various organs, but it was not seen in the tumor cells. In normal tissues, Sox10 was expressed in Schwann cells, melanocytes, and myoepithelial cells of salivary, bronchial, and mammary glands. Sox10 reaction was not identified in any other mesenchymal and epithelial tumors except for myoepitheliomas and diffuse astrocytomas. Sox10 was expressed by metastatic melanomas and nodal capsular nevus in sentinel lymph nodes, but not by other lymph node components such as dendritic cells. Our results indicate that Sox10 will serve as a more sensitive and specific marker for the diagnosis of melanocytic and schwannian tumors than S100 protein.
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PMID:Sox10: a pan-schwannian and melanocytic marker. 1863 17


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