UKINETS2018 Poster Presentations (1) (28 abstracts)
Chest metastases in advanced small bowel neuroendocrine neoplasms: incidence and outcome
Jasryan Birk 1 , Ben Jacobs 1 , James Bailey 1 , Besma Musaddaq 2 , Conrad Von Stempel 2 , Adam Brown 2 , Myles Furnace 3 , Dalvinder Mandair 3 , Martyn Caplin 3 , Joanne Cleverley 2 & Christos Toumpanakis 3
1Medical School, University College of London, London, UK; 2Radiology Department, Royal Free Hospital, London, London, UK; 3Neuroendocrine Tumour Unit, ENETS Centre of Excellence, Royal Free Hospital, London, UK.
Introduction: Liver is the most common site in patients with advanced small bowel neuroendocrine neoplasms (SBNEN) and distant metastases. On the contrary, lung metastases are relatively uncommon, occurring in 5–13.6% of patients. Although hepatic metastases often progress and have implications to the disease outcome, not enough data are available for lung metastases.
Aim: Our aim was to assess the incidence of chest (including lung, mediastina/hilar lymph node and pleural) soft-tissue metastases, and the outcome of lung metastases, in a series of advanced SBNEN.
Methods: A series of 236 advanced SBNEN was retrospectively reviewed. The presence of chest soft tissue metastases was confirmed by their avidity in Somatostatin Receptor Imaging. The study period was 3 years. No biopsy was performed in any of those lesions.
Results: Thirty four (34/236, 14.4%) had soft-tissue chest metastases. Seven patients (7/236, 2.9%) had lung parenchymal metastases, 23/236 (9.7%) had mediastinal/hilar lymph node (MHLN) metastases, whilst 4/236 (1.6%) had pleural deposits. Three of the patients with lung metastases had also MHLN metastases and one had also pleural metastases. Hepatic metastases were also present in 5/7 (71%) of patients with lung metastases and in 5/23 (21.7%) in patients with MHLN metastases. The mean size of lung metastases was 1.9 cm. In 28/34 (82%), the primary tumours’ grade (G) was G1. None of the patients had any symptoms associated with those lesions. Two of the patients (28%) with lung metastases had disease progression, based on size, and at the same time progression of hepatic metastases. Peptide Receptor Radionuclide Treatment (PRRT) was administered, resulting in disease stabilization. PRRT was given to another patient with progressive disease in the liver only, which resulted in partial response in her liver and lung metastatic lesions.
Conclusions: Mediastinal/hilar LN metastases seem to be the most common site of chest soft-tissue metastases in advanced SBNEN, whilst lung parenchymal metastases are quite rare and usually co-exist with hepatic metastatic disease. Lung metastases progress rather uncommonly and almost always when progression of hepatic metastases is also noted. Larger series of patients with longer follow-up are needed.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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