A short report of 50 patients with gastroenteropancreatic mixed neuroendocrine–non-neuroendocrine neoplasms (MiNEN)

Laenkholm, Isak T.; Langer, Seppo W.; Andreassen, Mikkel; Holmager, Pernille; Kjær, Andreas; Klose, Marianne; Federspiel, Birgitte; Hansen, Carsten P.; Knigge, Ulrich

doi:10.1080/0284186x.2021.1903077

Cited by 10 publications

(9 citation statements)

References 12 publications

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“…Laenkholm et al. ( 18 ) suggested that regardless of the tumor composition, patients should be evaluated for surgical treatment, as it is related to the best prognosis. Patients with disseminated mixed tumors have a very poor prognosis and usually need adjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Case report: Coexistence of sigmoid tumor with unusual pathological features and multiple colorectal neuroendocrine tumors with lymph node metastases

Pang

Song²,

Zhang³

et al. 2023

Front. Oncol.

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The coexistence of adenocarcinoma and neuroendocrine neoplasm (NEN) in the same tumor is rare. What is rarer is that the neuroendocrine component is a well-differentiated neuroendocrine tumor (NET) Grade (G) 1. Most colorectal NETs are single, but multiple neuroendocrine tumors (M-NETs) are rare. Well-differentiated NETs rarely metastasize. Here, we present a unique case of a synchronous sigmoid tumor and multiple colorectal NETs with lymph node metastases. The sigmoid tumor consisted of adenocarcinoma and NET G1. The metastatic component was NET G1. A 64-year-old man underwent a colonoscopy for persistent changes in bowel habits and positive fecal occult blood for 1 year. An ulcerative lesion, which was diagnosed as colon cancer, was seen in the sigmoid colon. In addition, scattered lesions could be seen in the colon and rectum. Surgical resection was performed. Pathological findings suggested that the ulcerative lesion was composed of 80% adenocarcinoma and 20% neuroendocrine component (NET G1), while the remaining lesions were consistent with NET G1. At the same time, 11 lymph nodes around the resected intestinal segment were invaded by NET G1. The prognosis of the patient was good. After 13 months of follow-up, no recurrence and no metastasis were found. We hope to provide a reference and improve our understanding of the clinicopathological features and biological behavior of these unique tumors. We also aim to emphasize the importance of radical surgery and individualized treatment.

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Section: Discussionmentioning

confidence: 99%

Case report: Coexistence of sigmoid tumor with unusual pathological features and multiple colorectal neuroendocrine tumors with lymph node metastases

Pang

Song²,

Zhang³

et al. 2023

Front. Oncol.

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“…In the study by Laenkholm et al [ 62 ], in 50 patients with GEP-MiNEN, significant prognostic factors were disease stage, surgical resection and performance status at diagnosis. Further analysis of this study reveals that MiNEN had a median overall survival (OS) of 30 months compared with NET (50 months, P < 0.001), GEP-NEC (14 months, P = 0.001) and poorly differentiated ADC (18 months, P = 0.45)[ 21 ].…”

Section: Prognosticmentioning

confidence: 99%

Mixed neuroendocrine non-neuroendocrine neoplasms in gastroenteropancreatic tract

Díaz-López,

Jiménez-Castro,

Robles-Barraza

et al. 2024

World J Gastrointest Oncol

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Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) are a heterogeneous group of malignant neoplasms that can settle in the gastroenteropancreatic tract. They are composed of a neuroendocrine (NE) and a non-NE component in at least 30% of each tumour. The non-NE component can include different histological combinations of glandular, squamous, mucinous and sarcomatoid phenotypes, and one or both of the components can be low-or high grade malignant. Recent changes in the nomenclature of these neoplasms might lead to great deal of confusion, and the lack of specific clinical trials is the main reason why their management is difficult. The review aims to clarify the definition of MiNEN and analyze available evidence about their diagnosis and treatment options according to their location and extension through careful analysis of the available data. It would be important to reach a general consensus on their diagnosis in order to construct a classification that remains stable over time and facilitates the design of clinical trials that, due to their low incidence, will require long recruitment periods.

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“…Unfortunately, their lower metastatic capacity (25% vs 54%) and longer survival time (28 vs 15 mo) relative to pure PDNEC do not change their poor prognosis[ 65 ]. Another important finding is the predictive role of the Ki-67 proliferation index of NEC for prognosis[ 15 , 66 ]. More recently, any statistically significant difference in OS between gastroesophageal GEP MiNEN vs colorectal MiNEN was detected[ 66 ].…”

Section: Organ-specific Clinicopathological Findingsmentioning

confidence: 99%

“…Another important finding is the predictive role of the Ki-67 proliferation index of NEC for prognosis[ 15 , 66 ]. More recently, any statistically significant difference in OS between gastroesophageal GEP MiNEN vs colorectal MiNEN was detected[ 66 ].…”

Section: Organ-specific Clinicopathological Findingsmentioning

confidence: 99%

Mixed neuroendocrine–nonneuroendocrine neoplasms of the gastrointestinal system: An update

Elpek¹

2022

WJG

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Mixed neuroendocrine-nonneuroendocrine neoplasms (MiNENs) of the digestive tract are a rare heterogeneous group of tumors that present many challenges in terms of diagnosis and treatment. Over the years, the diagnostic criteria, classification, and clinical behavior of these tumors have been the subjects of ongoing debate, and the various changes in their nomenclature have strengthened the challenges associated with MiNENs. This review is performed to provide an understanding of the key factors involved in the evolution of the designation of these tumors as MiNEN, highlight the current diagnostic criteria, summarize the latest data on pathogenesis and provide information on available treatments. Moreover, this work seeks to increase the awareness about these rare neoplasms by presenting the clinicopathological features and prognostic factors that play important roles in their behavior and discussing their different regions of origin in the gastrointestinal system (GIS). Currently, the MiNEN category also includes tumors in the GIS with a nonneuroendocrine component and epithelial tumors other than adenocarcinoma, depending on the organ of origin. Diagnosis is based on the presence of both morphological components in more than 30% of the tumor. However, this value needs to be reconfirmed with further studies and may be a limiting factor in the diagnosis of MiNEN by biopsy. Furthermore, available clinicopathological data suggest that the inclusion of amphicrine tumors in the definition of MiNEN is not supportive and warrants further investigation. The diagnosis of these tumors is not solely based on immunohistochemical findings. They are not hybrid tumors and both components can act independently; thus, careful grading of each component separately is required. In addition to parameters such as the metastatic state of the tumor at the time of diagnosis and the feasibility of surgical resection, the aggressive potential of both components has paramount importance in the choice of treatment. Regardless of the organ of origin within the GIS, almost MiNENs are tumors with poor prognosis and are frequently encountered in the elderly and men. They are most frequently reported in the colorectum, where data from molecular studies indicate a monoclonal origin; however, further studies are required to provide additional support for this origin.

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A short report of 50 patients with gastroenteropancreatic mixed neuroendocrine–non-neuroendocrine neoplasms (MiNEN)

Cited by 10 publications

References 12 publications

Case report: Coexistence of sigmoid tumor with unusual pathological features and multiple colorectal neuroendocrine tumors with lymph node metastases

Case report: Coexistence of sigmoid tumor with unusual pathological features and multiple colorectal neuroendocrine tumors with lymph node metastases

Mixed neuroendocrine non-neuroendocrine neoplasms in gastroenteropancreatic tract

Mixed neuroendocrine–nonneuroendocrine neoplasms of the gastrointestinal system: An update

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