Table 1.
All patients with NEN and adrenal masses (n = 16) | Patients with NEN and 68Ga-DOTATOC PET/CT (n = 12) | Patients with NEN and adrenalectomy (n = 4) | P value | |
---|---|---|---|---|
Age at NEN diagnosis (years) | 59.5 (39−80) | 62 (39−80) | 58.5 (52−75) | 0.99 |
Sex | F n = 5, M = 11 | F n = 5, M n = 7 | F n = 0, M = 4 | 0.24 |
Primary tumor | 0.038 | |||
Ileal-NET (n) | 8 (50%) | 8 (67%) | ||
Pancreatic-NET (n) | 2 (13%) | 2 (17%) | ||
Atypical bronchial-NET (n) | 2 (13%) | 1 (8%) | 1 (25%) | |
Small cell abdominal-NEC (n) | 1 (6%) | 1 (8%) | ||
Skin-NECa (n) | 1 (6%) | 1 (25%) | ||
Gastric-NET (n) | 1 (6%) | 1 (25%) | ||
Pulmonary large cell-NEC (n) | 1 (6%) | 1 (25%) | ||
Ki-67 | 7.2% (0.1−80%) | 1.9% (0.1−80%) | 47.5% (4.5−80%) | 0.091 |
Grade | 2 (1−3) | 1 (1−3) | 2.5 (2−3) | 0.077 |
Stage | 3 (2−4) | 4 (2−4) | 3 (2−3) | 0.062 |
When adrenal mass seen on PET/CT or scintigraphy | ||||
Age at diagnosis of adrenal tumor (years) | 64.5 (39−80) | 66.5 (39−80) | 60.5 (54−78) | 0.96 |
First PET/CT or scintigraphy the adrenal mass was seen (n) | 14 (88%) | 10 (83%) | 4 (100%) | 1 |
Adrenal mass known before (n) | 7 (44%) | 3 (25%) | 4 (100%) | <0.001 |
Adrenal mass strongly positive on PET/CT or scintigraphyb | 13 (81%) | 9 (75%) (68Ga-DOTATOC) | 4 (100%) (3 18F-FDG, 1 111In-pentetreotide) | 0.52 |
Bilateral | 1 (6%) | 1 (8%) | 0 (0%) | 1 |
Left n, size (mm) | 11 (69%), 18 (10−80) | 9 (75%), 15 (10−80) | 2 (50%), 35.5 (28−43) | 0.55, 0.45 |
Right n, size (mm) | 6(38%), 70 (34−90) | 4 (33%), 70 (36−85) | 2 (50%), 62 (34−90) | 0.60,0.90 |
Total size (mm) | 26.5 (10−160) | 19 (10−160) | 38.5 (28−90) | 0.68 |
Lipid rich tumor | 3 (19%) | 3 (25%) | 0 (0%) | 0.53 |
Considered to be NEN metastasesc | 13 (81%) | 9 (75%) | 4 (100%) | 0.52 |
Adrenal hormones assessedd | ||||
Any (n) | 9 (56%) | 5 (42%) | 4 (100%) | 0.089 |
All (n) | 4 (25%) | 2 (17%) | 2 (50%) | 0.24 |
Other metastasis at the time of adrenal mass discovery (n) | 11 (69%) | 9 (75%) | 2 (50%) | 0.55 |
Liver metastases (n) | 8 (50%) | 8 (67%) | ||
Abdominal lymph node metastases (n) | 7 (44%) | 7 (58%) | ||
Pancreatic metastases (n) | 1 (6%) | 1 (8%) | ||
Peritoneal carcinosis (n) | 1 (6%) | 1 (8%) | ||
Bone metastases (n) | 3 (19%) | 2 (17%) | 1 (25%) | |
Lung metastases (n) | 4 (25%) | 2 (17%) | 2 (50%) | |
Neck lymph node metastases (n) | 1 (6%) | 1 (8%) | ||
Brain metastases (n) | 1 (6%) | 1 (8%) | ||
No metastasis | 5 (31%) | 3 (25%)e | 2 (50%)f | 0.55 |
Follow-up since adrenal mass diagnosis | 2 years (0−11 years) | 1 year (0−11 years) | 3 years (2−9 years) | 0.25 |
Dead (n) | 6 (38%) | 3 (25%) | 3 (75%) | 0.11 |
Cause of death (n) |
4 (25%) metastases 1 (6%) carcinoid crisis 1 (6%) Cushing syndrome |
1 (33%) carcinoid crisis 1 (33%) metastasis 1 (33%) Cushing syndrome |
3 (100%) metastases |
aMerkel Cell Carcinoma
bAll primary tumors were strongly positive as well
cCortisol, metaneprhines, aldosterone and renin concentrations, in the any group at least the metanephrines were controlled. One patient with ileal NET develops Cushing syndrome suspected to be ectopic
dIn those not having histology this assumption was built on a combination of radiological parameters, e.g., a strong uptake on PET/CT or scintigraphy, lipid contents, growth pattern and other radiological features
e1 patient developed extensive liver metastases within 2 years. NEN, neuroendocrine neoplasia. NET, neuroendocrine tumor. NEC, neuroendocrine carcinoma
f1 patient developed a brain metastasis within 3 years