1
|
Liu M, Armeni E, Navalkissoor S, Davar J, Sullivan L, Leigh C, O'Mahony LF, Hayes A, Mandair D, Chen J, Caplin M, Toumpanakis C. Cardiac Metastases in Patients with Neuroendocrine Tumours: Clinical Features, Therapy Outcomes, and Prognostic Implications. Neuroendocrinology 2021; 111:907-924. [PMID: 32717739 DOI: 10.1159/000510444] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/20/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cardiac metastases (CM) from neuroendocrine tumours (NET) are rare; however, with the introduction of new molecular imaging modalities, such as 68Ga-DOTATATE PET-CT for NET diagnosis and re-staging, they are now identified more frequently. This study presents a single-institution experience on the NET CM characteristics, management, and prognostic implications. METHODS Between January 1998 and January 2020, 25 NET patients with CM were treated in our unit. A retrospective review of electronic records was performed. Overall survival (OS) was assessed by the Kaplan-Meier method. Cox regression models were used to evaluate the association of various clinical variables with OS. RESULTS The median age in the NET CM cohort was 64 years, with small intestine being the most common primary (84%). Nearly half of the patients suffered either from shortness of breath (48%) or had palpitations (12%). Peptide receptor radionuclide therapy (PRRT) was applied in more than half of the patients (64%), who had an improved trend for a longer median OS compared to those patients who did not receive PRRT (76.0 vs. 14.0 months, p = 0.196). The multivariate analysis demonstrated that concomitant skeletal or pancreatic metastases, as well as N-terminal pro-B-type natriuretic peptide (NT pro-BNP) >2 × upper limit of normal (ULN), were independent poor prognosticators. CONCLUSIONS Clinical features of NET CM ranged from asymptomatic patients to heart failure. Concomitant bone or pancreatic metastases and NT pro-BNP levels >2 ULN predicted shorter survival time. PRRT serves as a feasible therapy with promising survival benefits; however, more data are needed.
Collapse
Affiliation(s)
- Man Liu
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
- Department of Gastroenterology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Eleni Armeni
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | | | - Joseph Davar
- Cardiology Department, Royal Free Hospital, London, United Kingdom
| | - Luke Sullivan
- Medical School, University College of London, London, United Kingdom
| | - Charlotte Leigh
- Medical School, University College of London, London, United Kingdom
| | | | - Aimee Hayes
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Dalvinder Mandair
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Jie Chen
- Department of Gastroenterology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Martyn Caplin
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Christos Toumpanakis
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom,
| |
Collapse
|
2
|
Abstract
BACKGROUND Most neuroendocrine tumours (NETs) metastasize to the liver, lymph nodes and, although less frequently, to the bone. The heart is a rare localization for NET metastases. METHODS With the introduction of the Ga-DOTATATE PET/computed tomography (CT) in our hospital as a new diagnostic method for imaging neuroendocrine tumours, more rare metastatic localizations are being found. We present six cases of patients with cardiac NET metastases detected by Ga-DOTATATE PET/CT. Also, a review of literature is presented on case reports of cardiac NET metastases in patients detected by somatostatin receptor imaging, including In-Pentetreotide single photon emission computed tomography/CT, Ga-DOTATATE PET/CT, Ga-DOTANOC PET/CT or Ga-DOTATOC PET/CT. RESULTS AND CONCLUSION Most patients with cardiac NET metastases have extensive metastatic disease. The cardiac metastases are often asymptomatic.
Collapse
|
4
|
Beaujot J, Leteurtre E, Do Cao C, Beron A, Caiazzo R, Vantyghem MC. Potential role of parasitosis in tumorigenesis: case study of heart metastasis as the only presenting symptom of an ileal neuroendocrine tumor. Presse Med 2014; 44:102-6. [PMID: 25455631 DOI: 10.1016/j.lpm.2014.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 04/19/2014] [Accepted: 05/05/2014] [Indexed: 10/24/2022] Open
Affiliation(s)
- Juliette Beaujot
- CHRU de Lille, institut de pathologie, 59037 Lille cedex, France
| | | | - Christine Do Cao
- CHRU de Lille, hôpital Claude-Huriez, service d'endocrinologie et métabolisme, 59037 Lille cedex, France
| | - Amandine Beron
- CHRU de Lille, hôpital Claude-Huriez, service de médecine nucléaire, 59037 Lille cedex, France
| | - Robert Caiazzo
- CHRU de Lille, hôpital Claude-Huriez, service de chirurgie endocrinienne, 59037 Lille cedex, France
| | - Marie-Christine Vantyghem
- CHRU de Lille, hôpital Claude-Huriez, service d'endocrinologie et métabolisme, 59037 Lille cedex, France.
| |
Collapse
|