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1

58-year-old woman with pancreatic neuroendocrine tumour

100%

Kolasińska-Ćwikła A.

OncoReview

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2014

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vol. 4

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issue 2

A76-82

EN

We reported a 58-year-old woman with tumor in the tail and body of pancreas measuring 70 mm in diameter who underwent distal pancreatectomy and splenectomy. Examination of a specimen of the pancreatic mass obtained histopathological features of a well-differentiated neuroendocrine carcinoma (WHO 2000 r. NECLM group 2, MIB < 2%). Immunohistochemical staining showed that the tumor cells were positive for chromogranin and synaptophysin. The tumor was radical resected; there were 9 lymph nodes without metastases. The patient was attending routine follow-up 3 years after resection, when ultrasonography detected hepatic tumor with a low echoic area, confirmed as at least 3 lesions in CT. The patient presented with symptoms of general malaise, anorexia, weight loss, diarrhea, and diabetes mellitus. The diagnosis including of the histopathological features resected specimen and symptoms suggested a somatostatinoma. The patient denied the surgery treatment so she was treated with good clinical and biochemical (normalization of chromogranin A) response to octreotide LAR. During follow-up 4 months after, Computer Tomography showed progression. The patient refused suggested chemotherapy streptozotocin combined with doxorubicin. We continued treatment with octreotide LAR, taking into consideration lack of symptoms and stabilization in chromogranin A level, with good result and stabilization in following Computer Tomography. Somatostatinoma originates from delta cells and is a rare neoplasm, accounting for about 1% of gastroenteropancreatic endocrine neoplasms. About half of somatostatinomas originate in the pancreas, and the remainders originate in other parts of the gastrointestinal tract, mainly in the duodenum. Measurement of the plasma somatostatin concentration is useful for making a diagnosis of somatostatinoma, however is very difficult to perform this examination in our country. Successful treatment with long-acting somatostatin analogues (octreotide LAR) has been reported after progression.

2

DIAGNOSTIC POTENTIAL OF SELECTED SALIVARY PROTEOMICS FOR AUTONOMIC NERVOUS SYSTEM ACTIVITY ASSESSMENT

88%

Dobrek L.

Acta Neuropsychologica

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2020

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vol. 18(2)

285-303

EN

The clinical assessment of autonomic nervous system (ANS) functioning, enabling the diagnosis of autonomic neuropathy present in the course of many diseases, is currently based on performing simple cardiovascular reflexes (Ewing tests), analyzing heart rate variability (HRV) or heart rate turbulence (HRT), examining skin sweating or recording neurophysiological tests (e.g. microneurography). Laboratory assessment of ANS function is very scarce and practically only includes the plasma assessment of noradrenaline as a surrogate for the biochemical indicator of sympathetic activity. Recently, the possibility of evaluation of selected compounds present in saliva as laboratory markers of not only oral diseases but also systemic diseases has been raised. This work focuses on a brief description of the anatomy and physiology of the salivary glands and describes the formation of saliva, its composition and the use of this bodily fluid in laboratory diagnostics. In addition, the paper specifically discusses the possibility of determining selected compounds that are considered to reflect autonomic activity. A review of the literature indicates primarily four proteomics: two neuropeptides (vasoactive intestinal peptide (VIP) and neuropeptide Y (NPY) that are co-transmitters in autonomic fibers, chromogranin A, a synaptic vesicle protein and α-amylase, a hydrolytic enzyme pre-digesting carbohydrates in the oral cavity. These are currently the most widely investigated agents for their usefulness as laboratory markers of ANS activity.

3

Diagnostyka i leczenie neuroendokrynnych raków szyjki macicy - doświadczenia własne i przegląd piśmiennictwa

63%

Bidziński M., Nasierowska-Guttmejer A., Ćwikła J., Bakuła-Zalewska E., Dańska-Bidzińska A., Panek G.

Ginekologia Onkologiczna

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2007

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vol. 5

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issue 1

6-14

EN

Aim of paper: Neuroendocrine cervical cancer is a significant diagnostic and therapeutic challenge. For many years, these neoplasms were not differentiated from small-cell cancer. It was known, that these cancers were associated with poor prognosis and, in spite of combination of several therapeutic modalities, treatment outcome was far below expectations. Material and methods: Based on retrospective analysis and using synaptophysin and chromogranin A staining and assessment of cellular proliferative activity using MIB1 antibodies, out of 14 small-cell cancers 5 cases were selected, which fulfilled the criteria for neuroendocrine neoplasms and clinical course of the patients affected was analyzed. Results: In all cases, the disease has been diagnosed in FIGO stage I. Treatment consisted in extended hysterectomy m. Wertheim-Meigs and adjuvant radiochemotherapy. In two patients (40%), treatment failure was observed after a relatively short follow-up (within less than 16 months). One patient died due to liver metastases and in the other, faced with failure of chemotherapy, we instituted somatostatin receptor treatment. Conclusion: Immature or small-cell cervical cancer requires differentiation with neuroendocrine cancer and confirmation of its true nature by immunohistochemical studies. Therapy should encompass modern chemotherapy protocols and (in selected cases) isotope therapy using radio-labeled somatostatin analogs. Somatostatin analog therapy is reserved for patients featuring expression of somatostatin receptor on the surface of cancer cells.

PL

Cel badania: Neuroendokrynne raki szyjki macicy stanowią bardzo poważne wyzwanie zarówno terapeutyczne, jak i diagnostyczne. Przez wiele lat nie odróżniano tych nowotworów od raków drobnokomórkowych. Wiadomym było, że raki te gorzej rokują, a terapia, pomimo kojarzenia szeregu metod leczniczych, w efekcie nie przynosiła zamierzonego skutku. Materiał i metody: Spośród 14 raków drobnokomórkowych w wyniku retrospektywnej analizy z zastosowaniem barwień na synaptofizynę i chromograninę A oraz oceny aktywności proliferacyjnej komórek przy zastosowaniu przeciwciała MIB1 wybrano 5 guzów, które spełniały kryteria nowotworów neuroendokrynnych, i przeanalizowano przebieg kliniczny u tych chorych. Wyniki: Wszystkie pacjentki miały rozpoznaną chorobę w I stopniu zaawansowania klinicznego wg FIGO. Leczenie polegało na rozszerzonym usunięciu macicy sposobem Wertheima-Meigsa oraz zastosowaniu uzupełniającej radio-chemioterapii. U 2 chorych (40%) w krótkim okresie - do 16 miesięcy po leczeniu pierwotnym stwierdzono niepowodzenie leczenia. Jedna pacjentka zmarła z powodu przerzutów do wątroby, zaś u drugiej po nieskutecznej chemioterapii wdrożono leczenie z zastosowaniem receptorów somatostatyny. Wnioski: Niskodoj-rzałe lub drobnokomórkowe raki szyjki macicy wymagają diagnostyki w kierunku raka neuroendotoynnego i potwierdzenia tego faktu badaniami immunohistochemicznymi. W leczeniu tych nowotworów należy wykorzystywać zarówno nowoczesne techniki chemioterapii, jak i (w wybranych przypadkach) terapię izotopową znakowanymi analogami somatostatyny. Leczenie analogami somatostatyny jest zarezerwowane dla tych chorych, u których stwierdza się ekspresję receptora somatostatynowego na powierzchni komórek raka.

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58-year-old woman with pancreatic neuroendocrine tumour

DIAGNOSTIC POTENTIAL OF SELECTED SALIVARY PROTEOMICS FOR AUTONOMIC NERVOUS SYSTEM ACTIVITY ASSESSMENT

Diagnostyka i leczenie neuroendokrynnych raków szyjki macicy - doświadczenia własne i przegląd piśmiennictwa