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Orphanet J Rare Dis. 2019 Feb 22;14(1):54. doi: 10.1186/s13023-019-1034-4.

Intertumor heterogeneity in 60 pancreatic neuroendocrine tumors associated with multiple endocrine neoplasia type 1.

Author information

1
Section "Endocrine Surgery", Division of General Surgery, Department of Surgery, Medical University, Währinger Gürtel 18-20, A-1090, Vienna, Austria. andreas.selberherr@meduniwien.ac.at.
2
Department of Pathology, Medical University, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
3
Section "Endocrine Surgery", Division of General Surgery, Department of Surgery, Medical University, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
4
Department of Anesthesiology, Medical University, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
5
Institute of Pathology, University of Bern, Murtenstrasse 31, CH-3012, Bern, Switzerland.

Abstract

BACKGROUND:

Patients with multiple endocrine neoplasia type 1 (MEN-1) develop multiple pancreatic neuroendocrine neoplasias (PNENs). Size at diagnosis and growth during follow-up are crucial parameters. According to the WHO 2017, grading is another important parameter. The impact of grading compared to size (WHO 2000) on the clinical course needs to be evaluated.

METHODS:

Sixty PNENs of six patients with MEN-1 were retrospectively evaluated.

RESULTS:

Fifty-one tumors with a diameter of < 20 mm were graded as G1. Two of 9 tumors with diameters of ≥20 mm were graded as G2. Tumor size of ≥20 mm correlated significantly with higher proliferation (p = 0.000617). Lymph node metastases were documented in two patients with a total of 19 tumors. In one patient, all 13 tumors (diameter: 0.4 to 100 mm) were classified as G1. However, metastases were documented in 9/29 lymph nodes. In the other patient, 5 tumors (3.5 to 20 mm) were classified as G1. The sixth tumor (30 mm) was classified as G2 (Ki-67: 8%). Metastases were revealed in 2/20 lymph nodes.

CONCLUSIONS:

Tumor size of ≥20 mm seems to correlate with more aggressive MEN-1 related pancreatic disease, regardless of individual proliferation. Tumors ≥20 mm and tumors graded as G2 should be treated surgically regardless of their size.

KEYWORDS:

Intertumor heterogeneity; MEN-1; Multiple endocrine neoplasia; NET; Pancreatic neuroendocrine tumors

PMID:
30795813
PMCID:
PMC6387504
DOI:
10.1186/s13023-019-1034-4
[Indexed for MEDLINE]
Free PMC Article

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