National Cancer Institute®
Last Modified: August 1, 2002
UI - 12097278
AU - Goebel SU; Iwamoto M; Raffeld M; Gibril F; Hou W; Serrano J; Jensen RT
TI - Her-2/neu expression and gene amplification in gastrinomas: correlations with tumor biology, growth, and aggressiveness.
SO - Cancer Res 2002 Jul 1;62(13):3702-10
AD - Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, Maryland 20892-1804, USA.
A proportion of gastrointestinal neuroendocrine tumors are aggressive; however, little is known of molecular determinants of their growth, and molecular studies have identified no useful prognostic factors. Overexpression of HER-2/neu is common in some nonendocrine tumors, frequently correlates with increased tumor aggressiveness, and can be used as a basis of treatment with trastuzumab. Little is known of its expression in malignant pancreatic endocrine tumors. In the present study HER-2/neu gene amplification and expression was determined in 43 gastrinomas from different patients. Results were correlated with clinical, laboratory, and tumor characteristics including tumor growth. HER-2/neu gene amplification was assessed by differential PCR, mRNA levels assessed by quantitative PCR, and protein by immunohistochemistry. Fourteen percent of patients had HER-2/neu gene amplification in tumors compared with levels in their WBCs. HER-2/neu mRNA varied over a 700-fold range. However, only 3% exceeded levels seen in normal pancreas, and immunohistochemistry did not show protein overexpression in any tumor (n = 10). HER-2/neu mRNA levels were significantly higher (P = 0.032) in tumors associated with liver metastases but not with tumor location or size. These results show that HER-2/neu amplification/overexpression does not seem to play a role in the molecular pathogenesis of most gastrinomas, as suggested in a previous study involving small numbers of cases. However, mild gene amplification occurs in a subset, and overexpression is associated with aggressiveness. Therefore, HER-2/neu levels could have prognostic significance as well as identify a patient subset with gastrinomas who might benefit from trastuzumab treatment.
UI - 11942775
AU - Eledrisi MS; Stuart CA; Alshanti M
TI - Insulinoma in a patient with tuberous sclerosis: is there an association?
SO - Endocr Pract 2002 Mar-Apr;8(2):109-12
AD - Department of Internal Medicine, Division of Endocrinology and Metabolism, University of Texas Medical Branch, Galveston, Texas 77555, USA.
OBJECTIVE: To describe a patient with tuberous sclerosis who, on initial assessment, had neurologic symptoms, which were ultimately found to be caused by an insulinoma. METHODS: We present a case report with clinical, laboratory, and radiologic data. The literature is reviewed relative to tuberous sclerosis and islet cell tumors, and a possible association is discussed. RESULTS: A 43-year-old man with a history of tuberous sclerosis required medical attention because of mental confusion and slurred speech and was found to have hypoglycemia. Neuroradiologic imaging showed no new lesions to account for his symptoms. His physical examination was striking for a large abdominal mass, which showed increased uptake on octreotide scanning. After surgical resection, the mass measured 21 cm and was found to be an insulinoma. Blood glucose values were normal postoperatively and on follow-up, and the patient had no recurrence of the symptoms. CONCLUSION: From this report, we emphasize two findings. First, we draw clinicians' attention to the possibility of an association between islet cell tumors and tuberous sclerosis and suggest consideration of this diagnosis in patients with tuberous sclerosis who have new or worsening neurologic symptoms. Second, the insulinoma we describe is, to our knowledge, the largest to be reported thus far in the literature.
UI - 12004358
AU - Jhala D; Eloubeidi M; Chhieng DC; Frost A; Eltoum IA; Roberson J; Jhala
TI - N Fine needle aspiration biopsy of the islet cell tumor of pancreas: a comparison between computerized axial tomography and endoscopic ultrasound-guided fine needle aspiration biopsy.
SO - Ann Diagn Pathol 2002 Apr;6(2):106-12
AD - Division of Anatomic Pathology, Department of Pathology, University of Alabama at Birmingham, 35249, USA.
The objective of the present study is to compare the cytologic features of islet cell tumor (ICT) of pancreas obtained by endoscopic ultrasound guided fine needle aspiration (EUS-FNA) and computed tomography guided FNA (CT-FNA). We also describe the cytologic features associated with malignant ICT. Eleven cytology samples from 121 CT- FNA and 30 EUS- FNA of the pancreas were obtained from nine patients with ICT. Diff-Quik, Papanicolaou, and immunohistochemical stains to determine neuroendocrine differentiation and the hormonal status were evaluated. Cytologic features and specimen adequacy were compared between the two techniques. Cytologic features noted in both benign and malignant ICT were also compared. Nine patients (5 men, 4 women) ranging in age from 29 to 84 years (mean age, 53.8 years). Diagnoses consisted of benign (4) and malignant (5) ICT. EUS-FNA was superior to CT-FNA in obtaining adequate cells (2/2 v 7/9) for the diagnosis and increased cellularity to perform additional immunohistochemical stains (2/2 v 4/7). Single, plasmacytoid cells with finely granular chromatin distribution characterized ICT on cytology. Mitoses (3/5) and necrosis (1/5) were noted in malignant ICT but not in benign ICT. EUS-FNA is superior to CT- FNA for obtaining cells for the diagnosis of ICT. Detection of mitoses and or necrosis from patients with ICT should initiate a search for metastasis. Copyright 2002, Elsevier Science (USA). All rights reserved.
UI - 12170715
AU - Naribayashi Y; Tai S; Nakata Y; Yokogawa S
TI - [A case of small pancreatic glucagonoma detected by health care]
SO - Nippon Shokakibyo Gakkai Zasshi 2002 Jul;99(7):838-42
AD - Department of Internal Medicine, Chibune General Hospital.
UI - 12070411
AU - Mirallie E; Pattou F; Malvaux P; Filoche B; Godchaux JM; Maunoury V;
TI - Palazzo L; Lefebvre J; Huglo D; Paris JC; Carnaille B; Proye C [Value of endoscopic ultrasonography and somatostatin receptor scintigraphy in the preoperative localization of insulinomas and gastrinomas. Experience of 54 cases]
SO - Gastroenterol Clin Biol 2002 Apr;26(4):360-6
AD - Service de Chirurgie Generale et Endocrinienne, Clinique Chirurgicale Adultes Est, Hopital Claude Huriez, CHU Lille, France.
AIM: The classic morphological techniques for the localization of insulinomas and gastrinomas are of limited value. Endoscopic ultrasonography and somatostatin receptor scintigraphy have shown high sensitivity for the detection of gastroenteropancreatic endocrine tumors. The aim of the study was to evaluate the sensitivity of endoscopic ultrasonography and that of somatostatin receptor scintigraphy in the localization of insulinomas and gastrinomas.PATIENTS AND METHODS: This retrospective study concerned 54 patients with examinations. Forty-two patients had scintigraphy (17 with insulinoma, 25 with gastrinoma), 47 had endoscopic ultrasonography (28 with insulinoma, 17 with gastrinoma). One of the ten patients with MEN 1 had both tumors. All diagnosis were confirmed by histologic examination.RESULTS: The sensitivity of scintigraphy for the localization of insulinomas was 47%. There was one false positive. Sensitivity of endoscopic ultrasonography for insulinomas was 85%. The sensitivity of scintigraphy in the detection of gastrinomas was 65% for the tumors in the duodenopancreatic area, 20% for the tumors in the pancreatic tail and 71% for metastasis. The sensitivity of endoscopic ultrasonography was 46% for duodenal tumors, 75% for pancreatic tumors and 57% for lymph node metastasis. The combination of both localization studies increased sensitivity to 94%.CONCLUSION: Endoscopic ultrasonography and somatostatin receptor scintigraphy are the gold standard for localization of gastrinomas. Association of both examinations increases the sensitivity. Scintigraphy for the detection of insulinomas should be performed when endoscopic ultrasonography is negative.
UI - 12142749
AU - Kouraklis G; Stamoulis J; Tassiopoulos S; Glinavou A; Hatzinikolaou P
TI - Islet cell carcinoma of the pancreas presenting as chylous ascites.
SO - Pancreas 2002 Aug;25(2):213-5
AD - Second Department of Propedeutic Surgery, Medical School, University of Athens, Athens, Greece.
UI - 11972219
AU - Mahon D; Allen E; Rhodes M
TI - Laparoscopic distal pancreatectomy. Three cases of insulinoma.
SO - Surg Endosc 2002 Apr;16(4):700-2
AD - Department of Surgery, Norfolk & Norwich University Hospital NHS Trust, Norwich NR1 3SR, England, UK.
BACKGROUND: Surgery for benign pancreatic disease has traditionally required a major laparotomy however the minimal-access approach is now being applied to a wide variety of procedures, and surgery of the pancreas need not be excluded. METHODS: Laparoscopic distal pancreatectomy was performed on three patients presenting with insulinomas found on preoperative investigation to lie within the tail of the pancreas. RESULTS: All three patients had an excellent clinical outcome and returned to a state of normoglycemia. All of them made a rapid recovery with no major complications. CONCLUSION: Laparoscopic distal pancreatectomy is a viable technique for removing insulinoma of the tail of the pancreas.
UI - 12173721
AU - Dionisi S; Minisola S; Pepe J; De Geronimo S; Paglia F; Memeo L;
TI - Fitzpatrick LA Concurrent parathyroid adenomas and carcinoma in the setting of multiple endocrine neoplasia type 1: presentation as hypercalcemic crisis.
SO - Mayo Clin Proc 2002 Aug;77(8):866-9
AD - Department of Clinical Sciences, University of Rome La Sapienza, Italy.
We describe a patient with multiple endocrine neoplasia type 1 characterized by the simultaneous occurrence of parathyroid cancer, parathyroid adenomas, and pancreatic gastrinoma, who presented with an episode of acute hypercalcemia. The rapid parathyroid hormone assay provided a basis for the diagnosis of parathyroid hyperfunction. Mediastinal metastasis of the parathyroid carcinoma was found at autopsy. However, the staining of pancreatic and gastric tissue for parathyroid hormone-related protein does not make it possible to exclude completely the contribution of this peptide in mediating the hypercalcemia. To our knowledge, this is the first reported case of parathyroid carcinoma as part of the multiple endocrine neoplasia type 1 syndrome.
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