Endocrine Abstracts

Background: Patients with neuroendocrine neoplasms (NENs) may often develop other malignancies. This study aimed to identify the frequency at which these second non-NEN malignancies occurred in England.Methods: Data was extracted from the National Cancer Registration and Analysis Service (NCRAS) on all patients diagnosed with a NEN at one of eight NEN site groups between 2012-2018: appendix, caecum, colon, lung, pancreas, rectum, small intestine and stom...

Introduction: LAN, a somatostatin analogue, is a common first-line treatment for NETs. LAN comes as a pre-filled, ready-to-use syringe, administered every 4 weeks. In the UK, patients may receive LAN at home. The aim of PREF-NET was to generate real-world evidence describing patient’s experience of LAN administered in homecare and hospital settings, and the associated impact of treatment setting on other areas of patients’ lives.Methods: PREF-N...

Aim: Organoid cultures are a powerful model system for the study of cell biology and human disease. Manipulation of the composition of the culture medium has been used to promote cellular differentiation in gastric organoids to allow more accurate modelling of the mature epithelial cells present in the stomach. However, methods to promote the differentiation of neuroendocrine cells and specifically enterochromaffin-like (ECL)-cells within a gastric organoid system have not yet...

Background: Neuroendocrine tumours (NET) are rare cancers arising from cells of the neuroendocrine system and frequently present with advanced disease. They are characterised by the presence of somatostatin receptors (SSTR) on the tumour surface. The presence of SSTR are associated with the inhibition of NET proliferation and have formed the basis of peptide receptor radionuclide therapy (PRRT), such as Lutathera. PRRT relies on SSTR tumour expression and patients without this...

Introduction: There is controversy over the best technique for resecting small bowel NETs and performing right hemicolectomies in patients with appendiceal NETs at risk of nodal involvement. Most guidelines recommend open over laparoscopic surgery but a survey suggests that surgeons favour a laparoscopic approach. We have reviewed a series of 14 consecutive primary (not recurrent) small bowel NET resections and post-appendicectomy right hemicolectomies including operative tech...

Introduction: The COVID-19 pandemic has affected the delivery of NET services and patient care. We retrospectively analysed the recovery of NET service provision over the COVID-19 recovery period 2020-2021.Method: The NET database was searched using 3 NET physician codes. Anonymised data was analysed, including PRRT, MIBG, endoscopy and bronchoscopy rates. In February 2022, patient satisfaction questionnaires were posted out to 87 randomly selected NET p...

Introduction: Established guidelines recommend carefully selected patients with Carcinoid Heart Disease (CHD) may undergo surgical valve replacement as definitive management. Right sided heart valve involvement is classical, occurring as result of plaque deposition on valve leaflets as a consequence of vasoactive peptides secreted by the NET because of carcinoid syndrome. Tricuspid and Pulmonary valve involvement leads to right heart failure (RHF) increasing mortality and morb...

Adrenocortical carcinomas (ACCs) are a group of aggressive neuroendocrine cancers that affect 1-2 people/million/year (1) and are mostly diagnosed in advanced stages. ACCs have poor overall survival (OS) rates (2). This study aimed to determine potential factors influencing OS of ACC patients in Yorkshire by a retrospective investigation of potential factors and OS of all 30 adult patients with ACC seen at St James University Hospital (SJUH) from 01/01/2000 to 01/10/2021. Anal...

Introduction: Here we present our experience of managing patients with orbital well-differentiated neuroendocrine tumour (NET) metastases.Methods: Six patients were identified from the hospital NET database: four male; two female.Results: Median age at diagnosis of primary NET: 69.5 years (range: 40-74 years). Three patients were alive at time of data capture. Of those who passed away: mean survival from diagnosis of primary NET = ...

Introduction: Bile acid malabsorption (BAM) may be a contributing factor causing diarrhoea in patients with NETs, particularly among those who have undergone previous surgical resection of the terminal ileum and/or right colon or cholecystectomy (Naraev et al 2019). Aim(s): To identify the prevalence of bile acid malabsorption in neuroendocrine tumour patients (NET) at the Queen Elizabeth Hospital Birmingham (QEHB). Materi...

A 51 year old female patient presented in 2000 with a 7 month history of diarrhoea and weight loss. Bloods revealed hypokalaemia (1.9). Infection and malabsorption screen negative, but patient remained hypokalaemic despite maximum iv and oral replacement. No abnormality was found endoscopically. Fasting gut hormone profile showed raised Vasoactive Intestinal Polypeptide (VIP) >400 (NR <30). CT scan confirmed 5cm mass in body of pancreas, no metastatic disease. Response...

Introduction: Selective internal radiation therapy (SIRT) is a novel intervention used to treat both primary and metastatic malignant liver lesions. Adrenocortical carcinoma (ACC) is a rare cancer with limited treatment options; evidence for SIRT use in ACC liver metastases is limited to case reports only. In this case we report prolonged and successful disease control using recurrent SIRT in a gentleman with liver-limited ACC.Case study: A 49-year-old g...

Introduction: PNETs are rare with an annual incidence of 5 per million population. 75 % of pancreatic NET are functioning, PTHrP secretion regarded as a rarer entity and few case reports have been identified worldwide. Surgical resection is definitive management, however SSA treatment and Peptide Receptor Radionuclide Therapy (PRRT) have shown promising results in reducing PTHrP secretion.Case report: Here we describe a 61 years old lady who presented wi...

Olfactory neuroblastoma (ONB) is a rare neuroendocrine tumour with a slow onset of symptoms, and classically a propensity for recurrence and a poor prognosis. Due to its rarity, there is no agreed standard therapy, but treatment will usually include surgical resection, adjuvant radiotherapy and/or chemotherapy. However, such tumours very often show positive uptake on somatostatin receptor radionuclide scanning, and selective use of peptide receptor radionuclide therapy (PRRT) ...

Metastasis to the pituitary gland is a rare occurrence. Here we discuss our experience managing a patient with pituitary neuroendocrine metastasis who first presented with ocular symptoms. A 65-year-old lady presented in July 2015 with progressive diplopia. An MRI scan revealed a pituitary mass lesion with aggressive features and two abnormal enhancing nodules within the brain white matter, raising suspicion of metastatic disease. Radiotherapy was commenced on the basis that t...