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Zhang D, Kim SSR, Kelly DF, Asa SL, Movassaghi M, Mareninov S, Yong WH, Cloughesy TF, Rodriguez FJ, McKeever P, Qian J, Li JY, Mao Q, Newell KL, Green RM, Welsh CT, Xiong Z, Heaney AP. Somatostatin Receptor Ligand Therapy-A Potential Therapy for Neurocytoma. J Clin Endocrinol Metab 2019; 104:2395-2402. [PMID: 30722009 DOI: 10.1210/jc.2018-02419] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/29/2019] [Indexed: 02/13/2023]
Abstract
CONTEXT Neurocytoma (NC) is a rare, low-grade tumor of the central nervous system, with a 10-year survival rate of 90% and local control rate of 74%. However, 25% of NCs will be atypical, with an elevated Ki-67 labeling index >2%, and will exhibit a more aggressive course, with a high propensity for local recurrence and/or craniospinal dissemination. Although no standard treatment regimen exists for these atypical cases, adjuvant stereotactic or conventional radiotherapy and/or chemotherapy have been typically offered but have yielded inconsistent results. CASE DESCRIPTION We have described the case of a patient with a vasopressin-secreting atypical NC of the sellar and cavernous sinus region. After subtotal resection via endoscopic transsphenoidal surgery, the residual tumor showed increased fluorodeoxyglucose uptake and high somatostatin receptor (SSTR) expression on a 68Ga-DOTA-TATE positron emission tomography/CT scan. Somatostatin receptor ligand (SRL) therapy with lanreotide (120 mg every 28 days) was initiated. Four years later, the residual tumor was stable with decreased fluorodeoxyglucose tumor uptake. Immunocytochemical SSTR2 and SSTR5 expression >80% was further confirmed in a series of NC tissues. CONCLUSIONS To the best of our knowledge, we have described the first use of SRL therapy for an atypical NC. Our results support consideration of adjuvant SRL therapy for NC refractory to surgical removal. Our findings further raise the possibility of SSTR-directed peptide receptor radionuclide therapy as NC therapy.
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Affiliation(s)
- Dongyun Zhang
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Sarah S R Kim
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Daniel F Kelly
- Pacific Neuroscience Institute, Santa Monica, California
- Providence John Wayne Cancer Institute, Santa Monica, California
| | - Sylvia L Asa
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Masoud Movassaghi
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Sergey Mareninov
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - William H Yong
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Timothy F Cloughesy
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Fausto J Rodriguez
- Division of Neuropathology, Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Paul McKeever
- Department of Pathology and Clinical Laboratories, University of Michigan, Ann Arbor, Michigan
| | - Jiang Qian
- Department of Pathology, Albany Medical Center, Albany, New York
| | - Jian Yi Li
- Department of Pathology and Laboratory Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Manhasset, New York
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Lake Success, New York
| | - Qinwen Mao
- Department of Pathology, Feinberg School of Medicine at Northwestern University, Chicago, Illinois
| | - Kathy L Newell
- Department of Pathology and Laboratory Medicine, University of Kansas, Kansas City, Kansas
| | - Richard M Green
- Neuro-Oncology Program, Kaiser Los Angeles Medical Center, Los Angeles, California
| | - Cynthia T Welsh
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Zhenggang Xiong
- Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital, New Brunswick, New Jersey
| | - Anthony P Heaney
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, California
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