A case of mixed adenoneuroendocrine carcinoma of the pancreas

Murata, Masaru; Takahashi, Hidekazu; Yamada, Mitsuko; Song, Misa; Hiratsuka, Masahiro

doi:10.1097/md.0000000000006225

Cited by 17 publications

(9 citation statements)

References 17 publications

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“…For example, one study that reported a case of mixed adenoneuroendocrine carcinoma of the pancreas, examined the two different components by immunostaining and found that the tumour protein p53 was positive in both tumour components. 15 This finding supports the hypothesis that they were derived from a single cancer stem cell. In the second hypothesis, the lesions are thought to develop as two distinct tumours derived from two different precursors.…”

Section: Discussionsupporting

confidence: 81%

Mixed adenoneuroendocrine carcinoma (MANEC) of the ampulla of Vater in a Chinese patient: A case report

Liu

Sun

et al. 2020

J Int Med Res

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Mixed adenoneuroendocrine carcinoma (MANEC) is a rare tumour of the gastrointestinal tract with both epithelial and neuroendocrine components. We describe a case of a 57-year-old man who presented with yellow sclera and dark urine. Contrast-enhanced computed tomography (CT) showed enlargement of the intra and extrahepatic bile ducts and a neoplastic lesion at the end of the common bile duct which was indistinguishable from the adjacent head of the pancreas and duodenum. A pancreaticoduodenectomy was performed and histopathological examination of resected samples showed that tumour was a complex lesion with adenocarcinoma and neuroendocrine components positive for neuroendocrine markers (chromogranin A and synaptophysin) with a Ki-67 labelling index of 40%. The patient was diagnosed with MANEC in the ampulla of Vater with a neuroendocrine carcinoma component of approximately 70%. Ampullary MANECs are highly aggressive tumours with a high risk for distant metastases and a poor prognosis. Therefore, establishing a standard therapeutic strategy is crucial.

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Section: Discussionsupporting

confidence: 81%

Mixed adenoneuroendocrine carcinoma (MANEC) of the ampulla of Vater in a Chinese patient: A case report

Liu

Sun

et al. 2020

J Int Med Res

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“…Interestingly, in a case report of a collision tumor of poorly differentiated cecal adenocarcinoma with signet ring cell and mucinous features admixed with a well differentiated neuroendocrine tumor, next generation sequencing showed BRCA2 mutation in both the adenocarcinoma and NET components, while a TP53 mutation was only found in the adenocarcinoma component, with no mutations of KRAS , NRAS or BRAF in either component[ 47 ]. Immunohistochemical studies in a case a mixed adenoneuroendocrine carcinoma of the pancreas suggests NEC as the precursor giving rise to the adenocarcinoma component, with both of them diverging from a single cancer stem cell[ 62 , 63 ]. Immunohistochemistry study of seven colorectal MANEC as part of a study of gastrointestinal MANECs by Gurzu et al [ 64 ] in 2019 reports that gastrointestinal MANEC is a microsatellite stable tumor with strong positivity to CD44 and no expression of maspin suggesting an origin from a CD44-positive stem like precursor cell.…”

Section: Discussionmentioning

confidence: 99%

Mixed epithelial endocrine neoplasms of the colon and rectum – An evolution over time: A systematic review

Kanthan¹,

Tharmaradinam²,

Asif³

et al. 2020

WJG

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BACKGROUND Mixed tumors of the colon and rectum, composed of a combination of epithelial and endocrine elements of benign and malignant potential are rare neoplasms. These can occur anywhere in the gastrointestinal tract and are often diagnosed incidentally. Though they have been a well-documented entity in the pancreas, where the exocrine-endocrine mixed tumors have been known for a while, recognition and accurate diagnosis of these tumors in the colon and rectum, to date, remains a challenge. This is further compounded by the different terminologies that have been attributed to these lesions over the years adding to increased confusion and misclassification. Therefore, dedicated literature reviews of these lesions in the colon and rectum are inconsistent and are predominantly limited to case reports and case series of limited case numbers. Though, most of these tumors are high grade and of advanced stage, intermediate and low grade lesions of these mixed tumors are also increasingly been reported. There are no established independent consensus based guidelines for the therapeutic patient management of these unique lesions. AIM To provide a comprehensive targeted literature review of these complex mixed tumors in the colon and rectum that chronicles the evolution over time with summarization of historical perspectives of terminology and to further our understanding regarding their pathogenesis including genomic landscape, clinicoradiological features, pathology, treatment, prognosis, the current status of the management of the primary lesions, their recurrences and metastases. METHODS A comprehensive review of the published English literature was conducted using the search engines PubMed, MEDLINE and GOOGLE scholar. The following search terms [“mixed tumors colon” OR mixed endocrine/neuroendocrine tumor/neoplasm/lesion colon OR adenocarcinoma and endocrine/neuroendocrine tumor colon OR mixed adenocarcinoma and endocrine/neuroendocrine carcinoma colon OR Amphicrine tumors OR Collision tumors] were used. Eligibility criteria were defined and all potential relevant items, including full articles and/or abstracts were independently reviewed, assessed and agreed upon items were selected for in-depth analysis. RESULTS In total 237 full articles/abstracts documents were considered for eligibility of which 45 articles were illegible resulting in a total of 192 articles that were assessed for eligibility of which 139 have been selected for reference in this current review. This seminal manuscript is a one stop article that provides a detailed outlook on the evolution over time with summarization of historical perspectives, nomenclature, clinicoradiological features, pathology, treatment, prognosis and the current status of the management of both the primary lesions, their recurrences and metastases. Gaps in knowledge have also been identified and discussed. An important outcome of this manuscript is the justified prop...

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“…Due to the lack of any specific radiologic or symptomatic predictors of the tumor, the diagnosis is made based on the histopathological findings. Although the etiopathogenesis of the tumor is completely unclear, immunohistochemical studies have confirmed that the NEC component may give rise to the adenocarcinoma component, with both of them deriving from a single stem cell ( 16 ). Till date, in the published literature, MANECs have been identified in various localizations, with the colon ( 7 ) and the stomach ( 6 ) being the most common.…”

Section: Discussionmentioning

confidence: 99%

Mixed Adeno-Neuroendocrine Carcinoma; Case Series of Ten Patients with Review of the Literature

et al. 2018

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Aims:Mixed adeno-neuroendocrine carcinoma is a rare entity, diagnosed with immunohistochemical studies. Literature mainly includes case reports and series which are very few. In our study, we aimed to report a case series from a tertiary hospital with demographics of the patients, detailed tumor and clinical findings and follow-up plus survival conditions.Methods:Pathology database was explored for patients with the pathological diagnosis of ‘mixed adeno-neuroendocrine carcinoma’ and patients were identified retrospectively and evaluated in means of demographics, histopathological examination, tumor properties.Results:Ten patients had been diagnosed with mixed adeno-neuroendocrine carcinoma in our center, diagnosed at a mean age of 64.7. Stomach was found to be the most common localization. Five patients (50%) were diagnosed as grade 3. Following surgery, median follow-up was 15 months with a median survival time of 20.6 months.Conclusion:This case series may contribute to the literature on the pathological and clinical aspects of the mixed adenoneuroendocrine carcinoma of the gastrointestinal system.

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A case of mixed adenoneuroendocrine carcinoma of the pancreas

Cited by 17 publications

References 17 publications

Mixed adenoneuroendocrine carcinoma (MANEC) of the ampulla of Vater in a Chinese patient: A case report

Mixed adenoneuroendocrine carcinoma (MANEC) of the ampulla of Vater in a Chinese patient: A case report

Mixed epithelial endocrine neoplasms of the colon and rectum – An evolution over time: A systematic review

Mixed Adeno-Neuroendocrine Carcinoma; Case Series of Ten Patients with Review of the Literature

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