Clinicopathological spectrum of neuroendocrine neoplasms; retrospective study at a tertiary care centre

Abstract

Introduction: Neuroendocrine tumors are cancers that begin in specialized cells called neuroendocrine cells. Neuroendocrine cells have traits similar to those of nerve cells and hormone-producing cells. Neuroendocrine neoplasms (NENs) belong to a group of malignancies with poorly defined, confusing histology and nomenclature to match. Neuroendocrine cells (NE) are distributed throughout the body and hence NENs have been described in the central nervous system, respiratory tract, larynx, gastrointestinal (GI) tract, thyroid, skin, breast, and urogenital system. Among which gastrointestinal tract and lungs are the most common primary tumor sites.Materials and Methods: It was a retrospective cohort study conducted at the Department of General Surgery, JSS Hospitals, Mysuru from June 2014 to June 2019 (5 years). A series of 75 patients with NENs, data was collected through the administrative database, medical records, direct interview of patients. All those patients who were diagnosed to have neuroendocrine tumors incidentally detected/detected post-operatively through histopathological examination were included. All those patients diagnosed to have neuroendocrine tumors but deemed to be medically unfit for surgery were excluded from the study.
Results: There were 75 cases of NENs diagnosed in the study period which included 44 male and 31 female patients in the age range of 13 to 80 years (mean: 54 years) Majority of them (80% ) were >45 years of age. The diagnosis was made on endoscopic biopsies in 41 cases and resected surgical specimens were available in 34 patients. Biopsy diagnosis was mostly made in NENs of GI tract whereas all the pancreatic, periampullary lesions, colon, appendix, breast were diagnosed on resected specimens.Conclusion: The duodenum followed by colorectal, stomach were found to be the most common sites of NENs. The majority of tumors are NET G1 and were classified based on WHO classification and most of the G3 tumors were not amenable to surgical clearance. 87% of the NENs were completely resectable, in our study. Still, limited available studies opine differently in most of the parameters pertaining to NENs. Hence, more studies with a large number of subjects, are required in this regard.