Endocrine Abstracts

Collectively, typical and atypical lung carcinoids are referred to as the well differentiated lung neuroendocrine cancers (pulmonary NETS). Pulmonary NETS account for only 2% of lung malignancies, however, account for 25% of the total NET presentations. The incidence and prevalence of these cancers is growing. Most pulmonary NETs tend to be localised at presentation and, therefore, amenable to surgical resection. Following surgical resection, there is very little evidence base...

The incidence and prevalence of well-differentiated Bronchial NETs has been increasing globally in recent years. This may be due to better diagnostic/detection techniques and a greater awareness of these conditions. Despite this, these cancers are still uncommon and therefore most clinicians will not manage many of these patients. As a consequence, gaining experience in treating these cancers can become challenging. In the absence of a move to centralise their care, guidelines...

Well differentiated lung neuroendocrine tumours (WD lung NETS) are common NETs accounting for 25% of all the presenting neuroendocrine tumours. However, they are classified differently compared to GEP NETs, their mode of presentation; pattern of metastatic spread; associated syndromes, and how they respond to therapies are different from GEP NETs. They even present to a different group of specialists (respiratory physicians and thoracic surgeons) whereas the GEP NET patients t...

Multiple Endocrine Neoplasia Type 1(MEN1) syndrome is commonly associated with the three ’P’s-pituitary, parathyroid and pancreatic lesions. However, increasingly, thoracic neuroendocrine tumours (NETs) are being recognised with the syndrome. We present a case of MEN1 syndrome who primarily presented with a lung carcinoid tumour. A 31-year-old lady with without a significant past medical history presented with 2-month history of a persistent cough. ...

Introduction: Close long-term follow-up of patients with pulmonary carcinoid (PC) tumours is important for detection of recurrence, which can occur many years after primary surgery. Expert consensus guidelines for management of PC were published in 2015 (European Neuroendocrine Tumor Society (ENETS)) and provide recommendations for follow-up type, frequency and duration. The LEAP Project aimed to describe current follow-up practices in the UK following publication of the guida...

Case history: We report the case of a previously healthy 69-year-old female who was referred to our centre after she presented with rapidly progressive weight-gain, hyperglycaemia, hypokalaemia and hypertension. She had no symptoms suggestive of carcinoid syndrome. On assessment, she had pathognomonic features of Cushing’s syndrome: central weight gain (peripheral wasting) proximal myopathy, leg oedema, skin thinning, bruising and facial puffiness; this appearance being m...

Background: Pulmonary carcinoids (PC) are rare neuroendocrine tumors (NETs). The course of PCs is considered to be indolent, but patients with advanced disease have low survival rates and their treatment options are limited. As PCs are under-represented in trials, therapeutic decisions are based on evidence extrapolated from other types of NETS. Capecitabine-Temozolamide (CAPTEM) has demonstrated significant efficacy in pancreatic NETs. However, its role in PCs is still unexpl...

Background: New nuclear medicine imaging techniques have improved diagnosis, staging and treatment planning for BC. 68Ga-DOTA PET is preferable to standard somatostatin receptor scintigraphy where available (ENETS guidelines); however, its role in the management of BC remains unclear.Methods: All consecutive patients diagnosed with BC from two ENETS Centres of Excellence were identified retrospectively; patients with high grade tumours or lack...

Background: In patients with advanced GEPNETs, psychological symptoms may result due to potential disturbances in biogenic amines, particularly serotonin. This study compared HRQoL, anxiety, depression, and impulsivity in patients with and without carcinoid syndrome (CS) and correlated with serum 5-HIAA.Methods: Consecutive patients with advanced GEPNETs (with liver metastases) receiving treatment, with and without CS completed (single time-point) HRQoL ...

Background: Despite encouraging advances in the systemic therapy options for patients with pNETs (sunitinib and everolimus), no predictive biomarkers have been established for these drugs. We aimed to identify distinctive genomic alterations associated with benefit from treatment in patients with pNETs, by comparing exceptional-responders (ER) to poor-responders (PO).Methods: Patients who achieved an objective radiological response (complete or partial) ...