Introduction Pulmonary carcinoid (PC) tumors are low- and intermediate-grade neoplasms that are subdivided into typical carcinoid (TC) and atypical carcinoid (AC) based on the mitotic count and presence of necrosis ( 1 ). PCs belong to
Tiina Vesterinen, Teijo Kuopio, Maarit Ahtiainen, Aija Knuuttila, Harri Mustonen, Kaisa Salmenkivi, Johanna Arola, and Caj Haglund
Samira M Sadowski, Emanuel Christ, Benoit Bédat, Attila Kollár, Wolfram Karenovics, Aurel Perren, Frédéric Triponez, and on behalf of the SwissNET registry
metastasizes locally to hilar lymph nodes, and also distally to other organs ( 5 ). Regarding the management of pulmonary carcinoids, Caplin and coworkers ( 6 ) have published a recent European Neuroendocrine Tumor Society expert consensus with
Filippo Ceccato, Diego Cecchin, Michele Gregianin, Giacomo Ricci, Cristina Campi, Filippo Crimì, Marta Bergamo, Annibale Versari, Carmelo Lacognata, Federico Rea, Mattia Barbot, and Carla Scaroni
Introduction and aim
Ectopic ACTH secretion (EAS) is mostly secondary to thoracic/abdominal neuroendocrine tumours (NETs) or small cell-lung carcinoma (SCLC). We studied the diagnostic accuracy of CT with 68Ga-Dota derivatives (68Ga-SSTR) PET in localizing ACTH-secreting tumor in patients with EAS.
Materials and methods
68Ga-SSTR-PET/CT was performed and compared with the nearest enhanced CT in 18 cases (16 primary and 2 recurrent neoplasms). Unspecific, indeterminate and false-positive uptakes were assessed using conventional imaging, follow-up or histology.
We diagnosed 13 thoracic (9 primary and 2 recurrent bronchial carcinoids, 2 SCLCs) and 1 abdominal (pancreatic NET) tumors. Eight ACTH-secreting tumors were promptly identified at EAS diagnosis (’overt’, four pulmonary carcinoids with two recurrences and two SCLC); six EAS have been discovered during the subsequent follow-up (’covert’, five bronchial carcinoids and one pancreatic NET). At the time of EAS diagnosis, imaging was able to correctly detect the ACTH-secreting tumour in 8/18 cases (6 new diagnosis and 2 recurrences). During the follow-up, six out of initially ten ‘occult’ cases became ‘covert’. At last available follow-up, CT and 68Ga-SSTR-PET/CT were able to diagnose 11/18 and 12/18 ACTH-secreting tumours, respectively (11/14 and 12/14 considering only overt and covert cases, respectively). Four cases have never been localized by conventional or nuclear imaging (’occult EAS’), despite an average follow-up of 5 years.
The 68Ga-SSTR-PET/CT is useful in localizing EAS, especially to enhance positive prediction of the suggestive CT lesions and to detect occult neoplasms.
Sara Storvall, Helena Leijon, Eeva Ryhänen, Johanna Louhimo, Caj Haglund, Camilla Schalin-Jäntti, and Johanna Arola
previously used and verified ( 25 , 26 , 27 , 28 , 33 ) with Western blotting and/or in vitro somatostatin receptor autoradiography. The same antibodies have previously been used by our research group for a study on pulmonary carcinoid tumors ( 23 ) as
B C M Hermans, J L Derks, H J M Groen, J A Stigt, R J van Suylen, L M Hillen, E C van den Broek, E J M Speel, and A-M C Dingemans
L Fisseler-Eckhoff A Jonigk D Keller M Ott G Rieker RJ Sinn P Soder S Soltermann A , Interobserver agreement of proliferation index (Ki-67) outperforms mitotic count in pulmonary carcinoids . Virchows Archiv 2013 507 – 513
Erik Rösner, Daniel Kaemmerer, Elisa Neubauer, Jörg Sänger, and Amelie Lupp
H Salmenkivi K Arola J Haglund C PD-1 and PD-L1 expression in pulmonary carcinoid tumors and their association to tumor spread . Endocrine Connections 2019 8 1168 – 1175 . ( https://doi.org/10.1530/EC-19-0308 ) 31 Tsao MS Kerr KM
Kjell Oberg, Eric Krenning, Anders Sundin, Lisa Bodei, Mark Kidd, Margot Tesselaar, Valentina Ambrosini, Richard P Baum, Matthew Kulke, Marianne Pavel, Jaroslaw Cwikla, Ignat Drozdov, Massimo Falconi, Nicola Fazio, Andrea Frilling, Robert Jensen, Klaus Koopmans, Tiny Korse, Dik Kwekkeboom, Helmut Maecke, Giovanni Paganelli, Ramon Salazar, Stefano Severi, Jonathan Strosberg, Vikas Prasad, Aldo Scarpa, Ashley Grossman, Annemeik Walenkamp, Mauro Cives, Irene Virgolini, Andreas Kjaer, and Irvin M Modlin
neuroendocrine tumors and pulmonary carcinoids . Frontiers of Hormone Research 2015 44 115 – 138 . ( doi:10.1159/000382138 ) 39 Banck MS Kanwar R Kulkarni AA Boora GK Metge F Kipp BR Zhang L Thorland EC Minn KT Tentu
E T Aristizabal Prada and C J Auernhammer
expression, suppressed cell growth and caused cell cycle arrest because of a p21 and p27 increase and a cyclin D1 degradation in neuroendocrine gastrointestinal and pulmonary carcinoid cells in vitro ( 172 ). In addition, VPA also suppressed growth of