Searchable abstracts of presentations at key conferences in endocrinology
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UKI NETS 16th National Conference

ea0060p01 | (1) | UKINETS2018

Functional or non-function pancreatic NET; Novel use of a flash glucose monitoring system

Arshad Muhammad Fahad , Iqbal Ahmed , Bury Jonathan , Wadsley Jonathan , Munir Alia

High grade pancreatic NETs are usually non-functional. Here, we report a case of a patient with a high grade pancreatic NET, which was initially non-functional but became functional after chemotherapy. He was initiated on a flash glucose monitoring device (FreeStyle Libre®) avoiding the need for frequent capillary blood glucose monitoring. Using this novel approach, we demonstrated an improvement in his disabling hypoglycaemia with medical treatment. A 45-year-old profess...

ea0060p02 | (1) | UKINETS2018

Overview of neuroendocrine patient demographics and outcomes in the Leicestershire region

de Groot Emily , Chauhan Meera , Porter Sarah , Iwuji Chinenye

Neuroendocrine tumours (NETs) are rare cancers originating from neuroendocrine cells. The estimated prevalence is 35 per 100,000 people per year. A comparative review was conducted at the University Hospitals of Leicester (UHL) to determine the outcomes of treated neuroendocrine patients.Methods: Patients were identified via pharmacy records of Lanreotide, from April 2009 – March 2018. Clinical data was obtained from hospital notes and histopatholog...

ea0060p03 | (1) | UKINETS2018

Second primary malignancies (SPMs) in patients with non-pulmonary well-differentiated neuroendocrine tumours (wdNETs)

Dafnis Anna , Raja Haseem , Chakrabarty Bipasha , Lamarca Angela , Hubner Richard A , Mansoor Wasat , Valle Juan W , McNamara Mairead

Background: Neuroendocrine tumours (NETs) are often associated with SPMs. This study aimed to identify SPMs in patients with non-pulmonary wdNETs.Methods: Patients seen at The Christie with non-pulmonary wdNETs from 2003–2017 were included. After exclusion of patients with hereditary predispositions, notes were retrospectively reviewed for location, functionality, treatment and temporal relation to diagnosis.Results: Of 854 pa...

ea0060p04 | (1) | UKINETS2018

A case series of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia

Pink Grace , Mapfunde Isheunesu , Lara Beatriz

Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH), which was formally recognised in 1992, has been described as an idiopathic pre-invasive condition that may co-exist with carcinoid tumours. Classically it has been described in women with predominantly obstructive lung function and not in association with smoking. Although many have stable disease, in some documented cases there has been progressive lung disease leading to the need for lung transplant. The...

ea0060p05 | (1) | UKINETS2018

Problematic bronchial carcinoid

Pink Grace , Lara Beatriz

We present the case of a 26 year old female who presented unusually at the age of 19 with left basal pneumonia. This was deemed to resolve on follow up chest X-ray, however she was given a diagnosis of asthma and used a salbutamol inhaler for wheeze. She re-presented with a left lower lobe pneumonia in 2018, which did not resolve with antibiotics. She was re-admitted a month later and noted to have a left lower lobe collapse. She underwent a bronchoscopy which showed a proxima...

ea0060p06 | (1) | UKINETS2018

Identifying information and support needs for patients with Merkel Cell Carcinoma

Devlin Lindsey , Catherine Bouvier

Background: Merkel cell carcinoma (MCC) is a neuroendocrine tumour of the skin. It is a rare, highly aggressive cancer with a high propensity for recurrence and an increasing incidence rate. Feedback from patients and clinicians suggests there is very little accessible MCC specific patient information and support available. To improve patient access to accurate and reliable information and support, the NET Patient Foundation are developing existing services to provide MCC spec...

ea0060p07 | (1) | UKINETS2018

Bone metastases (BMs) in patients with neuroendocrine neoplasms (NENs): Prevalence and clinical management in a tertiary cancer centre

Lim Kok Haw Jonathan , Raja Hussain , D'Arienzo Paolo , Barriuso Jorge , McNamara Mairead G , Hubner Richard A , Mansoor Was , Valle Juan W , Lamarca Angela

Background: Bone metastases (BMs) are rare in neuroendocrine neoplasms (NENs). There is no global consensus on the optimal management, and treatment is often extrapolated from experience in other tumour groups. The aim of this study was to review the current management and outcomes of patients with BMs in NENs.Method: A retrospective study was performed of all patients with NENs, except G3 lung NENs, treated at a tertiary centre from April 2002–Marc...

ea0060p08 | (1) | UKINETS2018

Periodic endoscopic surveillance in patients with low risk type I gastric neuroendocrine tumours (gNETs) also detects associated gastric adenocarcinoma in a subset of patients

Hu Haiyi , Exarchou Klaire , Moore Andrew , Pritchard D Mark

Background: People who have autoimmune atrophic gastritis commonly develop type 1 gNETs, but are also at increased risk of developing gastric adenocarcinoma. Type I gNET patients usually have multiple gastric polyps and have an excellent prognosis when the polyps measure.Method: Retrospective audit of type I gNET patients managed within Liverpool ENETS Centre of Excellence 2004–2018.Results: 86 patients (median age 67 years, 5...

ea0060p09 | (1) | UKINETS2018

Lesson learnt: severe skin reaction to somatostatin analogue injections

Mike Bayne , Southern Mark

Background: Very little is written regarding injection site reactions to somatostatin analogues and although very rare we are unprepared in dealing with these reactions. Patients are then met with an uncertain clinical team leading to significant delay in treatment. This poster aims to highlight the potential risks of injection site reactions by sharing an extreme case study. It will also share our attempt to deal with injection site reactions, lesson learnt and recommendation...

ea0060p10 | (1) | UKINETS2018

Everolimus – associated grade 4 pneumonitis: a case report and literature discussion

Saunders Elspeth , Sizer Bruce , McStay Mary , Akhtar Mateen

Noninfectious pneumonitis is a recognised toxicity associated with mTOR inhibitors, such as everolimus. We report a 75 year old female with histologically confirmed on colonoscopy, non-functioning Grade 2 (Ki 9%) in situ terminal ileal NET with ileocolic lymphadenopathy and multiple liver metastases, who was commencedon somatostatin analogue therapy at presentation in May 2017, but developed progressive disease on CT by February 2018. Based on RADIANT – 4 which s...

ea0060p11 | (1) | UKINETS2018

Nutritional status of patients at diagnosis with a bronchial NET

Whyand Tara , Pupkevich Marina , de Lima Yasmin Chotai

Background: Sarcopenia is characterised by a loss of muscle mass and function and is negatively correlated with quality of life and clinical outcomes. It may be present despite a healthy or even high body mass index (BMI). Up to a quarter of NET patients are at risk of malnutrition, which may impact treatment outcomes and length of hospital stay. Research has shown that patients with pancreatic and intestinal NETs are at higher risk of weight loss than bronchial NETs. With an ...

ea0060p12 | (1) | UKINETS2018

Glenfield Pulmonary Neuroendocrine Guidelines

Weaver Helen , Sridhar Rathinam

Introduction: Accurate survival data for patients with neuroendocrine tumours (NETs) across the UK has been difficult to capture. Individual centres often report good survival rates, however, national data has not previously been available. Pulmonary neuroendocrine tumours (NETs) cover a spectrum of histological disease, including typical carcinoid, atypical carcinoid and large cell neuroendocrine carcinoma. Surgical resection with curative intent is advocated in the majority ...

ea0060p13 | (1) | UKINETS2018

Automated finger prick genomic diagnosis of neuroendocrine tumors

Modlin Irvin , Kidd Mark , Drozdov Ignat , Bodei Lisa , Malczewska Anna , Matar Somer , Chung Kyung-Min

Background: The diagnosis of neuroendocrine tumor disease has been tardy due to a lack of sensitive, noninvasive technology to facilitate identification. In the 1960’s, diagnosis required tumor tissue attained by surgery or biopsy. Identification was by histopathology and immunohistochemistry (1975). Acquisition of information was limited by the morbidity of invasive strategies, inability to reassess and interpretation was user-dependent with low kappa values. The introdu...

ea0060p14 | (1) | UKINETS2018

Circulating neuroendocrine tumor gene expression is effective in monitoring peptide receptor radionuclide (PRRT) efficacy

Bodei Lisa , Kidd Mark , van der Zwan Wouter , Singh Aviral , Severi Stefano , Drozdov Ignat , Cwikla Jarowslaw , Kolasinska-Cwikla Agnieska , Baum Richard , Paganelli Giovanni , Krenning Eric , Modlin Irvin

Background: Predicting and monitoring PRRT is based upon NET overexpression of somatostatin receptor (SSR) to deliver targeted isotope therapy. Imaging SSR expression is ~60% accurate as a predictor of efficacy. However, it and other imaging modalities e.g., CT/MRI, have utility for monitoring response. Specific blood NET gene expression (Positive Predictor Quotient- [PPQ]) is accurate in predicting PRRT response (93–97%, Bodei et al. EJNMMI 2018). The utility of NET tran...

ea0060p15 | (1) | UKINETS2018

NETest liquid biopsy is diagnostic of lung neuroendocrine tumors and identifies progressive disease

Malczewska Anna , Kos-Kudla Beata , Filosso Pier-Luigi , Aslanian Harry , Lewczuk Anna , Cwikla Jaroslaw , Rofinella Mateo , Bodei Lisa

Background: There are no effective blood biomarkers for bronchopulmonary carcinoids (BPC). We examined the utility of a neuroendocrine multigene transcript ‘liquid biopsy’ (NETest) in bronchopulmonary carcinoids (BPC) for diagnosis and monitoring of disease status.Aim: To independently validate the utility of the NETest in diagnosis and management of BPC in a prospective multicenter, multinational blinded study.Material a...

ea0060p16 | (1) | UKINETS2018

Validation of the NETest liquid biopsy as a diagnostic for gastroenteropancreatic neuroendocrine tumors (GEP-NETs)

Malczewska Anna , Kos-Kudla Beata , Witkowska Magdalena , Walter Agata , Makulik Karolina , Bocian Agnes

Background: The NETest, a neuroendocrine multigene transcript ‘liquid biopsy’, is a novel biomarker for GEP-NETs. Current biomarkers are monoanalyte amines or peptides whereas the NETest is a multianalyte signature providing molecular biological information pertinent to clinical disease.Aim: Independently validate the utility of the NETest for the diagnosis of GEP-NETs and identification of disease progression.Material an...

ea0060p17 | (1) | UKINETS2018

Use of choline PET-CT in the diagnosis of neuroendocrine tumours

Hussain Tahir , Malde Deep , Iwuji Chinenye , Ganatra Rakesh

Introduction: Choline PET-CT is a recognised modality for imaging prostate cancer; both for initial staging and restaging. It is, however, a non specific tracer and is also positive in numerous other conditions such as inflammatory processes and other malignancies.Method: We present a case of a 60 year old patient with a PSA of 9 ng/ml and a firm abnormal right prostate lobe. Prostate MRI demonstrated a lesion in the apex of the prostate but no associate...

ea0060p18 | (1) | UKINETS2018

The impact of 68Ga-based PET-CT scanning on the management of patients with sporadic pancreatic neuroendocrine tumours (pNETs)

Cuthbertson Daniel , Barriuso Jorge , Pizanais Michail , Jaffa Matthew , Lamarca Angela , Vivian Gillian , Halloran Tom , Westwood Tom , Prachalias Andreas , O'Reilly Derek , Weismann Hulya , Martin Wendy , Vinjamuri Sobhan , Pritchard D Mark , Hubner Richard , Srirajaskanthan Raj , Ramage John , Raraty Mike , Ganeh Paula , Fenwick Steve , Valle Juan , Yip Vincent

Background: Pancreatic neuroendocrine tumours (panNETs) are rare tumours (prevalence 4/100,000). Diagnosis and staging of panNETs requires biochemical screening, cross-sectional imaging (with CT/MRI), endoscopic ultrasound (EUS) and where available, functional imaging using 68Ga-labelled synthetic octreotide analogues using PET-CT due to its reported higher sensitivity and specificity.Methods: A retrospective, electronic case note study was ca...

ea0060p19 | (1) | UKINETS2018

Imaging in paragangliomas and phaeochromocytomas: a pictorial review

Hussain Tahir , Farhad Mustafa , Levy Miles , Ganatra Rakesh

Imaging in paragangliomas can be challenging as they arise from a number of locations including the adrenals, abdomen, pelvic and thoracic sites of chromaffin sympathetic tissue. They can also arise in the head and neck at sites of parasympathetic tissue. They are considered within the group of heterogenous neuroendocrine tumours. In addition to manifesting at multiple sites, they can metastasise, have variable expression of catecholamines and can be a manifestation of heredit...

ea0060p20 | (1) | UKINETS2018

Chest metastases in advanced small bowel neuroendocrine neoplasms: incidence and outcome

Birk Jasryan , Jacobs Ben , Bailey James , Musaddaq Besma , Stempel Conrad Von , Brown Adam , Furnace Myles , Mandair Dalvinder , Caplin Martyn , Cleverley Joanne , Toumpanakis Christos

Introduction: Liver is the most common site in patients with advanced small bowel neuroendocrine neoplasms (SBNEN) and distant metastases. On the contrary, lung metastases are relatively uncommon, occurring in 5–13.6% of patients. Although hepatic metastases often progress and have implications to the disease outcome, not enough data are available for lung metastases.Aim: Our aim was to assess the incidence of chest (including lung, mediastina/hilar...

ea0060p21 | (1) | UKINETS2018

Utility of PRRT therapy in invasive intra-cardiac paraganglioma

Healy Ultan , Tadman Mike , Grossman Ashley , Weaver Andrew , Jafar-Mohammadi Bahram

We present the case of a 51-year-old woman who attends the NET service at the Oxford University Hospitals Trust with multiple known secretory paragangliomas (predominantly 3-methoxythyramine), including a carotid body tumour and, most recently, an intrapericardial paraganglioma. She is SDHC mutation positive. Multiple surgical resections of paragangliomas, at sites other than the cardiac lesion, had previously been undertaken. Due to disease progression and symptomati...

ea0060p23 | (1) | UKINETS2018

Seeking the unseen: a case of occult sporadic insulinoma: localization, surgical strategy: a rare case

Subasinghe Duminda , Gunathilake Sonali , Jayakanthi Chandrika , Ganewaththa Eranga , Somasundaram Noel , Garusinghe Chaminda , Sivaganesh Sivasuriya

Insulinoma is a rare pancreatic neuro endocrine tumour. It is the commonest cause for endogenous hyperinsulinaemic hypoglycemia in a seemingly well individual. Insulinomas are small tumors which may not be detected on conventional imaging modalities. Image negative endogenous hyperinsulinemia poses a diagnostic challenge to the clinicians. Interventional radiological techniques with higher sensitivity can be used in such situations for correct localization of the small s for b...

ea0060p24 | (1) | UKINETS2018

Assessment of fat-soluble vitamins and trace elements in neuroendocrine tumour (NET) patients on somatostatin analogues

Ewang-Emukowhate Mfon , Whyand Tara , Chotai De Lima Yasmin , Toumpanakis Christos , Mandair Dalvinder , Hayes Aimee , Grossman Ashley , Nair Devaki , Caplin Martyn

Introduction: NETs are a diverse group of neoplasms that originate from cells of the diffuse endocrine system. Often somatostatin analogues (SSA) are used as a first line treatment. Loose stools and steatorrhea are common adverse effects of SSA. This can affect the absorption of fat soluble vitamins and trace elements (TE). In this study we assess the prevalence of these deficiencies.Methods: A prospective study of 66 patients on SSA. Vitamins A,D,E,K an...

ea0060p26 | (1) | UKINETS2018

Tumour growth rate (TGR) in neuroendocrine tumours (NETs): changes following systemic treatment and external validation of previous findings; the GREPONET-2 study

Lamarca Angela , Ronot Maxime , Moalla Salma , Crona Joakim , Opalinska Marta , Lopez-Lopez Carlos , Pezzutti Daniela , Najran Pavan , Carvhalo Luciana , Otaviano Franca Bezerra Regis , Borg Philip , Vietti-Violi Naik , Vidal-Trueba Hector , de Mestier Louis , Scaefer Niklaus , Baudin Eric , Sundin Anders , Costa Frederico , Pavel Marianne , Dromain Clarisse

Background: TGR represents the percentage change in tumour volume per month (%/m). Previous results from the GREPONET study (A. Lamarca et al, ENETS 2018) showed that TGR measured after 3 months (TGR3m) of starting systemic treatment (ST) or watch and wait (WW) was an early biomarker predicting progression-free survival (PFS) in NETs.Methods: Pts from 7 centres with advanced grade (G) 1/2 NETs from the pancreas (P)/small bowel (SB) initiating ST...

ea0060p27 | (1) | UKINETS2018

Unmasking ectopic ACTH secretion and changing functionality of a pulmonary neuroendocrine tumour with carcinoid syndrome

Wijesinghe Achini , Lorenz Eleanor , Munir Alia

Pulmonary neuroendocrine tumors (NET) are well recognized, but quite an uncommon group of disorders to cause ectopic Cushing’s syndrome. Pulmonary NETs have also undergone a change in treatment paradigms. We present a 62 year old female with incidentally detected left lower lobe lung nodule with biopsy proven well differentiated NET with ki67 index of 5–10% in 2011. She had a metachronous slow growing left sided renal tumor (hypernephroma), long standing type 2 diabe...

ea0060p28 | (1) | UKINETS2018

Bronchial carcinoid presenting in young adults. A case series highlighting issues in disease management, unusual sites of metastases and long term surveillance

Williams Christopher , Madhan Mohan Annet , Seligman Jenny , Anthoney Alan

The prevalence of bronchial carcinoid, both typical (TC) and atypical (AC), has increased significantly over the past 30 years, most likely as a consequence of better awareness and diagnostic tools e.g. carcinoid specific immunohistochemistry stains. The peak incidence of TC and AC are in the fourth and fifth decades of life respectively. Diagnosis at younger ages is much rarer although carcinoid represents one of the commonest pulmonary tumours in children, teenagers and youn...

ea0060p29 | (1) | UKINETS2018

The role of imaging in neuroendocrine tumours

Hussain Tahir , Ganatra Rakesh

The imaging of neuroendocrine tumours (NET) is multimodal and is often initiated by cross sectional imaging, usually CT. Imaging with CT demonstrates metastatic disease more frequently than locating the primary lesion. Subsequent imaging relies on somatostatin receptor (SSR) scintigraphy, usually with the use of indium octreotide. SSR scintigraphy is commonly supplemented with SPECT CT to help localise the sites of metastatic deposits more accurately by delineating the associa...

ea0060p30 | (1) | UKINETS2018

The impact of 68Ga-based PET-CT scanning on the management of patients with familial pancreatic neuroendocrine tumours (panNETs)

Cuthbertson Daniel , Barriuso Jorge , Pizanias Michail , Jaffa Matthew , Nuttall Christina , Vivian Gillian , Halloran Tom , Westwood Tom , Prachalias Andreas , Lalloo Fiona , Weismann Hulya , Martin Wendy , Vinjamuri Sobhan , Mark Pritchard D. , Fenwick Steve , Ganeh Paula , Raraty Mike , McNamara Mairead , Srirajaskanthan Raj , Ramage John , Manoharan Prakash , Yip Vincent

Background: Pancreatic neuroendocrine tumours (panNETs) may arise as part of an underlying genetic condition such as multiple endocrine neoplasia type 1 (MEN type 1). The value of functional imaging using 68Ga-labelled synthetic octreotide analogues using PET-CT has not been extensively evaluated in patients with MEN1 to determine its value.Methods: We investigated the effect of 68Ga-based PET-CT imaging on patient management in pat...