Endocrine Abstracts

Background: The incidence of neuroendocrine neoplasms (NENs) in younger populations (<50 years) is increasing and was 1.8 per 100,000 persons in 2011. There is limited data on NENs and pregnancy.

Methods: A retrospective analysis was performed on pregnant women with NENs managed in an ENETS Centre of Excellence. The objectives of the study were to describe the tumour characteristics, pregnancy outcomes, treatment and the tumour behaviour intra-pregnancy. The tumour behaviour was assessed through the comparison of images carried out at baseline pre/intra-pregnancy with the images performed post-pregnancy.

Results: A total of 15 women with 18 pregnancy encounters were included. All had well differentiated NENs. Majority 7(46.7%) had mid gut NENs. 15(83.3%) had successful pregnancy outcomes and the mean gestational age at delivery and birth weight were 36.7weeks 3.02kg respectively. 11 (61.1%) pregnancies proceeded the diagnosis of NENs. Of them, 10 (90.9%) had residual/metastatic disease at conception. Median time between the pre and post-natal imaging assessments was 13 months (range 6-25). At baseline, 2(20%) patients had progressive disease (PD) and both received Octreotide LAR throughout the antenatal/postnatal period. 5(50%) had PD at the end of the pregnancy including the 2 patients with PD at the time of conception. A total of 3 patients received Octreotide LAR during antenatal/postnatal period. Of them, 1 developed gestational diabetes while another had a preterm delivery with neonatal complications related to prematurity. 5 out of 18 (27.7%) pregnancies were diagnosed with NENs in the antenatal period. Among them, 3(60%) had metastatic disease and 1(20%) had PD on postpartum imaging compared with baseline. Furthermore, 2(11.1%) patients were discovered with NENs during the postpartum period.

Conclusion: Although most patients with NENs and pregnancy had favourable pregnancy outcomes, a significant proportion had progressive NENs at the end of the pregnancy.