Endocrine Abstracts

Endocrine cancers are defined, by European Taskforce on Endocrine Cancer, as malignant tumours arising from endocrine organs including thyroid, adrenal, parathyroid, pituitary, as well as neuroendocrine tumours in general.

Cancerous neuroendocrine tumours arise from neuroendocrine cells which can be found within the endocrine system: in the pituitary, pineal, parathyroid and (medulla of the) adrenal gland, or more scantily within the thyroid, pancreas, ovaries and testicles, or more diffusely throughout the body, being present in respiratory, urinary and digestive tracts, as well as breast, skin, prostate and gynaecological structures.

Neuroendocrine and most endocrine cancers are considered both rare and complex.

Commonalities exist in terms of gross classification, that is, designation by site, cell type and whether they are associated with excess hormone/peptide secretion – differences are revealed as this broad definition narrows.

For example: within the adrenal gland:

Endocrine – adrenocorticol carcinoma (ACC) arises within the cortex, and may be associated with excess secretion of steroidal hormones. TNM staging.

Neuroendocrine – pheochromocytoma arises within the medulla, and may be associated with the overproduction of catecholamines. No standardised staging and malignancy designation may be withheld in the absence of metastatic disease, though presentation, family history and proliferation rate will influence treatment planning and follow-up.

Both may be associated with inherited disorders such as multiple endocrine neoplasia, therefore careful history taking and consideration of genetic counselling (Table & diagram of sites, cell type and associated hormone). Accurate identification of disease site, cell type and associated hormone secretion is paramount in delivering optimal clinical care – evidence based guidelines are available for most neuro/endocrine tumours - but consideration should also be given to meeting the psychosocial and informational needs of the individual diagnosed with one of these rare cancers.

1. http://www.endocrinecancer.eu/en/pages/statement.

2. http://www.ese-hormones.org/guidelines/index.aspx.

3. http://www.enets.org/current_guidelines.html