Endocrine Abstracts

Introduction: Surgery is the only cure for neuroendocrine tumor (NET) disease. R0 resection is critical for successful tumor resection. Early detection of residual disease is key for optimal management. Both imaging and current biomarkers have intrinsic limitations and are largely ineffective up to 3 months post-surgery. NETest, a multigene blood biomarker test, identifies NETs with >90% accuracy. We hypothesized that surgery would decrease NETest levels and that elevated scor...

Background: Neuroendocrine tumors are uncommon and complex neoplasms with increasing incidence and prevalence worldwide. SCAN assessed global delivery of healthcare to NET patients.Methods: During Sept-Nov 2019, 2359 NET patients/carers and 436 healthcare professionals (HCPs) from 68 countries completed an online survey, available in 14 languages.Results: 12% NET patients/carers were from United Kingdom (UK) [279/2359], 5% from Ire...

Background: 177Lu-DOTATATE is increasingly used in patients with advanced neuroendocrine tumour (NET). However, few circulating biomarkers are available to predict progression-free survival (PFS) of patients received 177Lu-DOTATATE.Materials and methods: Clinicopathological data and data of baseline circulating biomarkers including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), e...

Carcinoid syndrome occurs in 20% patients, presenting with flushing, abdominal pain, diarrhoea, and wheeze and can be challenging to manage. The standard of care for carcinoid syndrome is somatostatin analogues (SSAs) with add-on Creon, codeine and loperamide therapy. Nonetheless, half of patients experience debilitating diarrhoea. Telotristat-ethyl is a peripheral tryptophan-hydroxylase inhibitor approved for treatment of diarrhoea, supported by Phase 3 clinical trials but la...

Introduction: Our knowledge of the genomic background of neuroendocrine neoplasms (NENs) is rapidly expanding with more widespread use of sequencing technologies. Although known to be mutationally quiet compared to some other malignancies, many NENs harbour somatic copy number alterations (SCNAs), however the significance of these are unclear.Aims: We sought to identify SCNAs in a cohort of patients with NENs.Methods: Whole exome s...

Introduction: The aetiology of NENs vary; some are sporadic, others familial. An association between index NENs of the mid gut (ileum and colon) with subsequent colorectal primaries has been reported.Aim: We determined to evaluate the relationship between the diagnosis of an index primary malignancy and subsequent diagnosis of NEN.Methods: A population-based retrospective cohort study was under taken for persons with NEN diagnosis ...

Introduction: Up to half of patients with carcinoid syndrome develop carcinoid heart disease; this is thought to be mediated by serotonin from disordered tryptophan metabolism. Valve degeneration can lead to right heart failure which drives morbidity and mortality in this patient population. Surgical replacement of affected valves is an effective therapy. Peptide receptor radiotargeted therapy (PRRT) has demonstrated better progression-free survival compared to high dose sando...

Background: Depression and anxiety are frequently associated with functional gastrointestinal disorders (FGID), inducing personal suffering and a decreased quality of life. There is limited data in patients with NETs. Therefore, adequate research identifying the prevalence of these mood disorders among GI patients and NETs are necessary to inform holistic clinical management. Further, due to the nature of hospital clinics being fast-paced, quick and effective screening tools a...

Background: NHS England’s Five Year Forward View refers to peer support as one of the ‘slow burn, high impact’ interventions that should be seen as ‘essential’ to the future of healthcare services, with evidence pointing to benefits in both physical and psychosocial well-being of attendees and potential cost savings to healthcare through improved health condition self-management. However the COVID pandemic has meant that groups cannot currently meet fa...

Background: Neuroendocrine tumours (NETs) are a rare and heterogeneous group of neoplasms that mainly originate from the gastroenteropancreatic tract (GEP-NETs). The vast majority of NETs tend to overexpress somatostatin receptors (SSTRs), which can be targeted by somatostatin analogues (SSAs). 68Gallium DOTA SSTR peptide positron emission tracer computed tomography (68Ga PET-CT) has emerged as superior to other imaging modalities in identifying SSTRs. Th...

Interferon alfa-2a was discontinued in June 2020. Here we present a case of an unfortunate patient for whom this change has dramatically impacted the course of her illness. A 64-year-old woman initially presented in 2007 with refractory hypertension and was found to have a phaeochromocytoma which was resected. Metastatic recurrence of her disease in the liver and vertebrae was confirmed by CT/MRI in 2014 following rising catecholamines on monitoring. Her MIBG scan in early 201...

We report a new diagnosis of a pituitary TSH-oma together with a metastaticneuroendocrine tumour. A 61 year old man presented with a 3-year history of diarrhoea. His past medical history includes paroxysmal atrial fibrillation, for which he has had an ablation in the past. He takes no regular medications. Initial investigations were suggestive of hyperthyroidism in the context of unusual thyroid function test results (elevated freeT4 and freeT3 with elevated TSH). A pituitary ...

Purpose: Neuroendocrine neoplasms are known to have heterogeneous biological behavior. G3 neuroendocrine tumours (NET G3) are characterized by well-differentiated morphology and Ki67>20%. The prognosis of this disease is understood to be intermediate between NET G2 and neuroendocrine carcinoma (NEC). Clinical management of NET G3 is challenging due to limited data to inform treatment strategies.Methods: We describe clinical characteristics, treatment, an...

A 23-year-old woman presented in May 2018 with acute left-sided hemiparesis following increasingly frequent episodes of morning drowsiness with associated weight loss. She had no significant past medical history or family history. Brain imaging excluded intracranial pathology. Blood tests during a spontaneous hypoglycaemic episode (1.5 mmol/l) identified significant hyperinsulinaemic hypoglycaemia [insulin 392 pmol/l (18–173) and C-peptide 3913 pmol/l (370–1470)]. MR...

Background: Nutritional data in NETs is lacking. There are a range of gastrointestinal issues which can be related to the NET, treatment, surgical intervention, or pre-existing diseases1. Many of these can have nutritional consequences or be improved through altering diet with the support of a specialist dietitian.From October 2018, a gastrointestinal specialist dietitian joined the weekly clinic for 12 months. The aim of the service evaluatio...

Background: MiNEN are a rare histological subgroup defined by the association of at least two morphologically different neoplastic components, including one neuroendocrine. The diagnosis and therapeutic management of MiNEN is considered challenging resulting from the rarity and heterogeneity of this subgroup.Case: We present the case of a 68-year-old Caucasian male who attended the emergency department with symptomatic hypoglycaemia on a background of po...