Collision lung tumor associating typical carcinoid tumor to sclerosing hemangioma

Collision tumors associating carcinoid tumor and sclerosing pneumocytoma have rarely been reported in the literature. The clinical presentation may be challenging especially in cases showing multiple and bilateral nodules. This case illustrates the association of both tumors diagnosed incidentally and illustrates a full spectrum of neuroendocrine lesions and sclerosing pneumocytoma. The authors present the case of a 52‐year‐old patient presenting an abdominal pain revealing a vesicular lithiasis and multiple pulmonary nodules. Radiologic follow‐up of the asymptomatic lung lesions revealed the stabilization of a left lobe lesion with a disappearance of the other lesions. A lobectomy with a mediastinal lymph node curettage was performed. The microscopic examination revealed both tumor components associating a typical carcinoid tumor to a sclerosing pneumocytoma in association to lesions of diffuse neuroendocrine hyperplasia present in the peri‐tumoral parenchyma. This case illustrates radiologic, gross, and microscopic features of a rare pulmonary tumor.     

Primary hepatic neuroendocrine tumor: A case report and literature review

Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare and difficult to distinguish from other liver tumors, such as hepatocellular carcinoma (HCC) and cholangiocarcinoma, based on medical imaging findings. A 70-year-old man was referred for evaluation of liver mass incidentally discovered on abdominal computed tomography. The characteristic finding from dynamic liver magnetic resonance imaging led to a diagnosis of HCC. The patient underwent right hepatectomy. Histopathological and immunohistochemical examination revealed grade 2 neuroendocrine tumor. The postoperative 24-h urinary excretion of 5-hydroxy-indolacetic acid was within the normal range. Further imaging investigations were performed. No other lesions were found making probable the diagnosis of PHNET. This case shows that the diagnosis of PHNET is a medical challenge, requiring differentiation of PHNETs other hepatic masses and exclusion of occult primary neuroendocrine tumors. The diagnosis of PHNET can be ascertained after long term follow-up to exclude another primary origin.     

Laparoscopic total pancreatectomy for multiple endocrine neoplasia type 1 syndrome‐associated multifocal,non‐functioning pancreatic neuroendocrine tumor: A case report

Pancreatic neuroendocrine tumors are rare, accounting for less than 3% of all pancreatic tumors. Although laparoscopic pancreas‐preserving surgery for managing sporadic pancreatic neuroendocrine tumors has been described in the literature, laparoscopic total pancreatectomy has rarely been reported. We present a 30‐year‐old man who was incidentally diagnosed with multiple endocrine neoplasia type 1 syndrome with parathyroid hyperplasia and a non‐functioning pancreatic neuroendocrine tumor. He underwent laparoscopic total pancreatectomy with splenectomy. This report highlights the technical details of laparoscopic total pancreatectomy, which appears to be a feasible and safe option in select cases.     

Invasion of poorly differentiated large-cell neuroendocrine tumor of the lung through right pulmonary veins into the left atrium: A very rare case report

Intracavitary cardiac metastasis is a rare manifestation of primary lung cancer which can be associated with a very poor prognosis. In this condition, the right chambers of the heart are more commonly involved and the invasion of the left atrium (LA) through the venous routes is highly exceptional. Poorly differentiated large-cell neuroendocrine tumors also include only 3% of all primary lung carcinomas which can have adverse outcomes. Therefore, in this report, a rare case of a 72-year-old male patient with poorly differentiated large-cell neuroendocrine carcinoma of the right lung spreading to the LA through the right pulmonary veins was described.     

Inflammatory myofibroblastic tumor of the pancreatic neck: A case report and review of literature

BACKGROUNDPancreatic inflammatory myofibroblastic tumor (IMT) is a relatively rare disease that is often confused with pancreatic cancer or pancreatic neuroendocrine tumors. The histological features of IMTs show that tissue from this type of tumor contains an intermingling of fibroblast and myofibroblast proliferation, accompanied by a varying degree of inflammatory cell infiltration.CASE SUMMARYThe management of an IMT occurring at the neck of the pancreas is presented in this paper. A 66-year-old female patient was diagnosed with a pancreatic neck mass after a series of tests. The patient underwent enucleation of the pancreatic neck tumor after a pathological diagnosis of IMT. Previous research on the clinical features, pathological diagnosis and treatment of pancreatic IMTs was reviewed. Compared with previous reports, this is a unique case of enucleation of a pancreatic IMT.CONCLUSIONThe enucleation of pancreatic IMTs may be a safe and efficient surgical method for managing such tumors with a better prognosis. Further cases are required to explore surgical measures for pancreatic IMTs.     

Synchronous but separate neuroendocrine tumor and high-grade dysplasia/adenoma of the gall bladder: A case report

BACKGROUNDGall bladder neuroendocrine tumors (GB-NETs) are rare, accounting for less than 0.5% of all NETs. They usually lack specific symptoms and are difficult to diagnose preoperatively. In most cases, GB-NETs are incidentally found after cholecystectomy for large polyps or cholelithiasis, causing acute or chronic cholecystitis. The coexistence of GB-NET and GB adenocarcinoma is very rare. CASE SUMMARYWe report a case of synchronous but separate GB-NET and adenoma with high-grade dysplasia in a patient who had undergone surgery for a progressively growing GB polypoid lesion. To the best of our knowledge, simultaneous separation of NETs and cancer in the GB has not been reported.CONCLUSIONCoexistent GB carcinoid tumor and adenocarcinoma is rare. A surveillance program is needed for these large GB polyps.     

Gastric mixed adenoma-neuroendocrine tumor: A case report

BACKGROUNDGastric mixed adenoma-neuroendocrine tumors (NETs) are quite rare. In the 2019 world health organization classification of tumors of the digestive system, these were designated as a combination of grade 1 or grade 2 NETs and adenomas or tubular adenomas. There are no treatment guidelines for these tumors, and pathological and clinical studies are ongoing. Herein, we review previous case reports and present a case of gastric mixed adenoma-NET.CASE SUMMARYA 66-year-old man underwent gastrointestinal endoscopy for the evaluation of upper abdominal pain. Histopathological examination of the biopsy specimen indicated the possibility of gastric cancer. A histopathological examination by endoscopic submucosal dissection showed a mixed adenoma-NET that was completely excised by endoscopic submucosal dissection. No recurrence was observed on gastrointestinal endoscopy at the 6-mo follow-up.CONCLUSIONClinicians'' awareness of this rare tumor is important for its timely diagnosis and treatment.     

70例胰腺肿瘤的临床病理学特征分析

目的探讨胰腺肿瘤临床病理学特征、免疫组织化学染色及鉴别诊断。方法应用形态学观察、免疫组织化学染色回顾性分析70例胰腺肿瘤的临床及病理学特点。结果①70例胰腺肿瘤中患者年龄14-84岁,平均年龄53.3岁;女性40例(57.1%),男性30例(43.9%);肿瘤位于胰头42例(60.0%),胰体10例(14.3%),胰尾18例(25.7%)。②70例胰腺肿瘤中30例导管腺癌(42.9%),17例实性假乳头状肿瘤(24.3%),12例粘液性囊性肿瘤(17.1%),3例浆液性囊腺瘤(4.3%);4例神经内分泌肿瘤(5.7%);2例导管内乳头状粘液癌(2.9%),1例胰腺低分化粘液表皮样癌(1.4%);1例继发性黑色素瘤(1.4%)。③47例(67.1%)患者有腹胀、腹痛、上腹不适症状,41例(58.5%)有黄疸。④胰腺恶性肿瘤病理分期:病理分期I期27例,II期25例,III期5例,IV期2例。⑤在17例胰腺实性假乳头状肿瘤中,男性患者1例,占5.8%,对其中6例患者进行预后随访3-36个月,均无转移及复发。⑥在12例粘液性囊性肿瘤中,男性患者4例。结论 70例胰腺肿瘤中导管腺癌发病率最高,其次是胰腺实性假乳头状肿瘤,粘液性囊性肿瘤占第3位,其中胰腺实性假乳头状肿瘤以年轻女性为主,也可发生于男性,随访无复发及死亡病例。粘液性囊性肿瘤,发生于男性患者并不罕见。发现1例胰腺原发性低分化粘液表皮样癌,属罕见病例,预后较差。     

A rare presentation of an ACTH‐producing high‐grade large cell neuroendocrine carcinoma with Cushing’s syndrome

High‐grade neuroendocrine tumors (HGNET) are rare neoplasms composed of neural and hormonal with only around 42 cases reported in the last 20 years1. Herein, we describe a rare case of pancreatic HGNET, large cell type, associated with a Cushing''s syndrome presentation.     

Gastric glomus tumor presenting with massive upper GI bleeding: A challenging to diagnose and treat tumor

Glomus tumors are infrequent benign tumors that originate from the glomus body and can be found anywhere in the body including the gastrointestinal tract. It is rare that gastric glomus tumors present with life‐threatening upper GI bleeding. Diagnosis of gastric glomus tumors poses a challenge due to overlapping endoscopic and endosonographic features with other gastric subepithelial lesions, and the final diagnosis may not be clear until after surgical resection and pathological examination. We report the case of a 61‐year‐old patient who presented with massive upper GI bleeding secondary to an ulcerated gastric glomus tumor that was eventually treated with surgical wedge resection of the tumor.     

Sonographic appearance of a neuroendocrine tumor arising in the axilla: Case report and literature review

Neuroendocrine tumors (NETs) are tumors that originate from neuroendocrine cells throughout the body. NETs are most commonly found in the appendix, followed by the rectum, ileum, lungs, and bronchi. NETs arising in soft tissues are rare. Here we describe the sonographic appearance of a NET in the axilla. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound 42:30–32, 2014     

The hybrid procedure of thoracoscopic and hand-assisted laparoscopic resection of an esophageal gastrointestinal stromal tumor: A case report

Esophageal gastrointestinal stromal tumors (E-GIST) are very rare tumors, and there is no consensus regarding the optimal surgical approach for E-GISTs. Here, we report a case of a large E-GIST that was resected via video-assisted thoracoscopic surgery (VATS) and hand-assisted laparoscopic surgery (HALS). When examining for comorbidities of myasthenia gravis using computed tomography, a 7-cm-sized tumor was detected in the lower esophagus of a 68-year-old woman. Further examination revealed the tumor to be an E-GIST with high malignant potential, and thus, esophagectomy was performed. The hybrid procedure for VATS and HALS techniques was safe and minimally invasive for this E-GIST that required esophagectomy. Thus, esophagectomy with VATS and HALS is thought to be a reasonable surgical option for resecting large E-GISTs, for which enucleation is not recommended.     

Combined thoracoscopic and laparoscopic approach to remove a large retroperitoneal compound paraganglioma: A case report

BACKGROUNDParagangliomas (PGLs) are rare catecholamine-secreting neuroendocrine tumors, which often present with secondary hypertension. The most common location is the retroperitoneal space. For the first time, we report a rare case of large retroperitoneal compound PGL, and we have innovatively applied a new surgical plan to completely remove the tumor.CASE SUMMARYA 55-year-old middle-aged man was admitted to the hospital for fluctuating blood pressure for more than 1 year with intermittent headache. He suffered dozens of attacks every day. Blood and urine catecholamines were elevated, somatostatin receptor imaging was positive, and the diagnosis of PGL was clear. The imaging examination revealed a large tumor on the right front of the mediastinal spine at the level of T10-L1 (the posterior space of the right phrenic foot). For the first time in our department, a combined thoracoscopic and laparoscopic operation was used to detect and remove large tumors.CONCLUSIONThis is the first reported case of using a thoracoscopic and laparoscopic approach simultaneously to remove a large retroperitoneal compound PGL, which may provide a new surgical approach for similar cases.     

Clinical manifestations of neuroendocrine tumors

A complex clinico-functional morphologic examination was carried out on 125 patients with neuroendocrine tumors (NET): carcinoids, pheochromocytoma and multiple endocrine adenomatosis (an integral part of which is pheochromocytoma, gastrinoma and medullar C-cell carcinoma of thyroid gland). There was a clinical examination using laboratory and instrumental methods in pre- and postoperative periods, morphological research of removed tumors. According to the obtained indications, selective angiography and static scintigraphy with 111Tc was carried out. Isotopes 111-In were used in 3 patients for scintigraphic research of somatostatinpositive NET. The following versions were selected: serotonin and sympathoadrenal clinical variants of monoaminoforming NET, clinical versions of multiple endocrine neoplasias, a clinical version of adenocarcinomas having in their composition cells with neuroendocrine differentiation accompanied by neuroendocrine paraneoplastic syndrome. There were offered a term and definitions of hyperproduction syndrome of regulatory peptides in case of NET.     

Incidental discovery of a Hodgkin lymphoma synchronous to a papillary thyroid carcinoma

Papillary thyroid carcinoma is the most common type of thyroid cancer and accounts for almost 89.4% of all thyroid carcinomas. Hodgkin lymphoma is a heterogeneous group of neoplasms and represents 10% of lymphomas. These two cancers do not share the same risk factors. Some studies have reported the association of thyroid papillary carcinoma with lymphomas, mainly Hodgkin''s lymphoma, treated with radiotherapy. However, to our knowledge less than 10 cases have illustrated synchronous papillary thyroid carcinoma and Hodgkin lymphoma with no history of radiotherapy. We present the case of a 49‐year‐old female patient, with no history of past exposure to radiation, who was incidentally diagnosed with Hodgkin lymphoma during the work up for papillary thyroid carcinoma. Our patient had total thyroïdectomy with cervical lymphadenectomy. The histopathologic examination concluded to a papillary thyroid carcinoma of classical variant. And the lymph node dissection enabled us to diagnose not only papillary thyroid carcinoma''s lymph node metastasis, but also Hodgkin Lymphoma. This discovery of the Hodgkin lymphoma was totally incidental. The discovery of synchronous tumors in patients with papillary thyroid carcinoma has been reported in the literature. However, the diagnosis of Hodgkin through lymph node dissection for papillary thyroid carcinoma is extremely rare. This underlines the singularity and the importance of our case. The synchronous papillary thyroid carcinoma and Hodgkin lymphoma is a rare condition, which may pose significant diagnostic and treatment dilemmas. To date, there is no standardized approach due to lack of experience. The molecular mechanisms of this link are poorly understood and yet remain to be elucidated.     

Gastric glomus tumor resection using laparoscopic endoscopic cooperative surgery: A case report

Gastric glomus tumors are rare submucosal mesenchymal neoplasms that are difficult to diagnose preoperatively. We present a case of a 60-year-old woman who was diagnosed with a gastric glomus tumor using endoscopic ultrasonography-guided fine-needle aspiration biopsy. The tumor was successfully resected with laparoscopic endoscopic cooperative surgery (LECS). LECS could be an effective method for the resection of gastric glomus tumors.     

Carcinoid tumor of the thymus: a clinicopathologic report of seven cases with a review of the literature

Carcinoid tumor of the thymus is a rare neoplasm. Formerly confused with thymoma, a tumor of thymic epithelial cells, carcinoid tumor of the thymus has recently been shown to arise from cells of neuroendocrine origin that are normally present in the thymus. About half of the tumors are either functionally active (usually producing Cushing's syndrome) or are found in association with other endocrine tumors, as part of a multiple endocrine neoplasia syndrome. The remainder occur as symptomatic or asymptomatic anterior mediastinal masses, clinically indistinguishable from thymoma. At least 30% of thymic carcinoids are malignant on the basis of local invasion or metastasis or both. A protracted course, with late recurrence of tumor, is not uncommon. Aggressive surgical extirpation, followed by radiotherapy, offers the best hope for cure.     

A case of amyloid tumor of the stomach

A 68-year-old female was admitted to hospital with a 5 month history of epigastric distress. Radiological and gastrofiberscopic examinations revealed a tumor of the stomach which was strongly suggestive of gastric carcinoma. Microscopic examination of the removed stomach, however, revealed no tumors in the stomach, but instead, there a localized amyloidosis was found in the antrum, the patient died of hepatic failure 10 months after the operation. Autopsy demonstrated no evidence of systemic deposit of amyloid substance. The amyloid tumor of the stomach is rare, and the present case is believed to be the fifth of the reported cases of this lesion and, at the same time, the first case in which the solitary nature of amyloidosis was verified at autopsy.     

Juvenile granulosal cell tumor of the testicle

This is a case of a newborn with a rare testicular tumor-a juvenile granulosal cell tumor. This is a tumor of stromal origin, which is similar histologically to granulosal cell tumors of the ovaries. The authors present the imaging characteristics and differential diagnoses in this patient.