Test Your Knowledge of Neuroendocrine Tumors
Are you up to date on staging for neuroendocrine tumors/carcinoid tumors? How about which follow-up tests are most appropriate for a patient with medullary thyroid carcinoma? Test your knowledge on these topics and more in our latest quiz.
Are you up to date on staging for neuroendocrine tumors (NETs)/carcinoid tumors? How about which follow-up tests are most appropriate for a patient with medullary thyroid carcinoma? Test your knowledge on these topics and more in our latest quiz.
Question 1
Answer and Question 2 on Next Page »
Answer
D.All of the above. In a study that included over 35,000 patients with NETs, the researchers also found that "disease stage, primary tumor site, histologic grade, sex, race, age, and year of diagnosis were predictors of outcome" among patients with well-differentiated to moderately differentiated tumors.
Question 2
Answer and Question 3 on Next Page »
Answer
D. Pancreatic NETs are staged differently than exocrine pancreatic carcinomas. Medullary thyroid carcinoma is a calcitonin-secreting tumor of the parafollicular C cells of the thyroid gland. About 25% of the cases are familial and associated with MEN2 syndrome and germline mutations of proto-oncogene RET. All of the tests are appropriate except radioactive iodine thyroid scan as this tumor does not originate from follicular or papillary cells.
Question 3
Answer and Question 4 on Next Page »
Answer
B. Repeat surgical resection with right hemicolectomy. Repeat surgical resection with right hemicolectomy. Most appendiceal NETs that are 2 cm or smaller can be treated with simple appendectomy. However tumors larger than 2 cm with poor prognostic features such as lymphovascular invasion, mesoappendiceal invasion, or atypical histologic features require a more aggressive approach with right hemicolectomy.
Question 4
Answer and Question 5 on Next Page »
Answer
B. Radioactive iodine scan. Medullary thyroid carcinoma is a calcitonin-secreting tumor of the parafollicular C cells of the thyroid gland. About 25% of the cases are familial and associated with MEN2 syndrome and germline mutations of proto-oncogene RET. All of the tests are appropriate except radioactive iodine thyroid scan as this tumor does not originate from follicular or papillary cells.
Question 5
A 54-year-old man with a history of peptic ulcer presents with epigastric pain, diarrhea, vomiting, and weight loss. He has been on proton pump inhibitors for his epigastric pain with no major improvement. An upper endoscopy reveals a partially obstructing duodenal ulcer and multiple smaller ulcers in the second part of the duodenum. Further work-up with CT abdomen pelvis shows thickening and enhancement of the small bowel and a vague pancreatic mass.
Answer
C. Fasting serum gastrin levels. Fasting serum gastrin levels would be high due to the patient’s use of proton pump inhibitors, so they should be checked at least a week after discontinuation of proton pump inhibitors. The patient most likely has a gastrinoma in his pancreas. The rest of the work-up will be helpful to diagnose this tumor as well as searching for MEN1 syndrome-related tumors of pituitary and parathyroid glands.
This study presents a male breast cancer case with a germline BRCA2 mutation and discusses the epidemiologic, pathologic, and clinical characteristics along with treatment and follow-up recommendations in view of our recent understanding of the disease.
Oncology Peer Review On-The-Go: COVID-19, Cancer, and the Potential of mRNA Vaccines
March 30th 2021Mehmet Sitki Copur, MD, discussed his article in the Journal ONCOLOGY® focusing on COVID-19, messenger RNA vaccines, and the excitement surrounding its integration into the future of cancer treatment.
ABSTRACT: Breast metastasis from extramammary malignancy is rare, with a reported incidence rate of 0.4% to 1.3% in the published literature. The primary malignancies that most commonly metastasize to the breast are leukemia, lymphoma, and malignant melanoma. Here, we report a very rare case of metastatic EGFR-mutated non–small cell lung cancer (NSCLC) in the breast detected by screening mammography. The patient had initially been diagnosed with a clinical stage IIIA NSCLC and had been treated with neoadjuvant chemoradiation followed by curative-intent surgery. Several interesting aspects of the case, along with a discussion of evolving adjuvant and frontline metastatic management options in EGFR-mutated NSCLC, will be presented.
Locally Advanced Gastrointestinal Stromal Tumor in a 33-Year-Old Woman Seeking to Conceive
ABSTRACT Gastrointestinal stromal tumors (GISTs) are rare neoplasms of the gastrointestinal tract. They commonly present with nonspecific symptoms and thus are often discovered incidentally. They are best identified by CT scan and most stain positive for CD117 (C-Kit), CD34, and/or DOG-1. Several risk stratification classification systems have been developed based on tumor size, mitotic rate, location, and perforation. Traditional chemotherapy and radiation therapy have been very ineffective, making surgery the mainstay of treatment. The discovery of mutations associated with these tumors has revolutionized the treatment approach. Imatinib mesylate, a selective tyrosine kinase receptor inhibitor, used as adjuvant or neoadjuvant therapy, has greatly improved the morbidity and mortality associated with GISTs. As the survival of patients has increased with the long-term use of targeted therapies, quality-of-life issues now have become much more relevant and have come to the forefront of care. We present a young woman who was successfully treated for GIST but now faces associated long-term adverse effects of imatinib, including the challenge of preserving fertility and the potential for childbearing.
