Appendiceal neuroendocrine neoplasia: analysis of 50 patients.

OBJECTIVE: The objective of this study was to investigate the clinical, surgical, and pathological findings of appendiceal neuroendocrine neoplasms (ANNs). MATERIALS AND METHODS: The demographic, clinical, surgical, and pathological characteristics of 50 patients with ANN were analyzed. The patients were also classified as Group 1 (< 40 years, n = 37) and Group 2 (≥ 40 years, n = 13), and compared each other in terms of all parameters. RESULTS: Acute appendicitis was the pre-operative clinical presentation in 48 (96%) patients. Appendectomy (94%) was the most common surgical procedure. Mean tumor size was 8.6 mm (1-70 mm). Approximately half of the tumors (46%) were T1. There was no lymphatic and distant metastasis. The patients in Group 2 (15.4 mm) had a higher mean tumor size than patients in Group 1 (6.3 mm) (p < 0.001). The two groups were similar in other characteristics (p > 0.05). CONCLUSIONS: ANNs are usually diagnosed after histopathological evaluation due to the lack of specific clinicoradiological signs. Therefore, carefull intraoperative examination of appendectomy specimens may increase the possibility of suspecting these tumors. The results also showed that ANNs were bigger in patients above 40-years-old. Although not statistically significant, ANNs tended to have higher grade and to be more located at the base of the appendix in this group of patients.

OBJETIVO: Investigar los hallazgos clínicos, quirúrgicos y patológicos de las neoplasias neuroendocrinas (RNA) apendiculares. MÉTODO: Se analizaron las características demográficas, clínicas, quirúrgicas y patológicas de 50 pacientes con RNA. Los pacientes también fueron clasificados como Grupo 1 (< 40 años, n = 37) y Grupo 2 (≥ 40 años, n = 13), y se compararon entre sí en términos de todos los parámetros. RESULTADOS: La apendicitis aguda fue la presentación clínica preoperatoria en 48 (96%) pacientes. La apendicectomía (94%) fue el procedimiento quirúrgico más común. El tamaño medio del tumor fue de 8,6 mm (1-70 mm). Aproximadamente la mitad de los tumores (46%) eran T1. No hubo metástasis linfáticas ya distancia. Los pacientes del Grupo 2 (15.4 mm) tenían un tamaño tumoral medio mayor que los pacientes del Grupo 1 (6.3 mm) (p < 0.001). Los dos grupos fueron similares en otras características (p > 0.05). CONCLUSIONES: Las RNA suelen diagnosticarse tras evaluación histopatológica debido a la falta de signos clínico-radiológicos específicos. Por lo tanto, el examen intraoperatorio cuidadoso de las muestras de apendicectomía puede aumentar la posibilidad de sospechar estos tumores. Los resultados también mostraron que las ANN eran más grandes en pacientes mayores de 40 años. Aunque no estadísticamente significativas, las ANN tendieron a tener mayor grado y estar más ubicadas en la base del apéndice en este grupo de pacientes.

Hypoxia-Inducible Factor 1α and AT-Rich Interactive Domain-Containing Protein 1A Expression in Pituitary Adenomas: Association with Pathological, Clinical, and Radiological Features.

BACKGROUND: Hypoxia-inducible factor (HIF) plays a major role in tumorigenesis and cancer progression. In hypoxic conditions, HIF is upregulated and has been shown to activate multiple genes required for cells to adapt to hypoxia. AT-rich interactive domain-containing protein 1A (ARID1A), a SWI/SNF (switch/sucrose nonfermentable) chromatin remodeling gene has context-dependent tumor-suppressive and oncogenic roles in cancer. We assessed the correlations between the expression and mutations of HIF1A and ARID1A in histopathologically confirmed pituitary adenomas. METHODS: We performed a retrospective analysis of 71 patients who had undergone surgery for pituitary adenoma. Patient demographic, radiological, and histopathological features were correlated with HIF1A and ARID1A expression. RESULTS: Most cases were HIF1A positive (62%). No significant correlation was found between HIF1A expression and age, gender, tumor size, bone erosion, hemorrhage, or Ki-67 index. An inverse correlation was demonstrated between HIF1A and cavernous sinus invasion (P = 0.035). ARID1A loss was found in 28.2% of pituitary adenomas. No significant correlation was found between ARID1A and any of the assessed variables. CONCLUSIONS: In our patient cohort, we found that most pituitary adenomas expressed HIF1A. To the best of our knowledge, we are the first to assess the presence of ARID1A loss in pituitary adenomas, which occurred in 28.2% of cases. No individual demographic, imaging, or histopathological feature was predictive of ARID1A. Likewise, with the exception of an increased incidence of cavernous sinus invasion, no correlation was found with HIF1A. Given the prognostic value of these markers in other malignancies, their frequency in pituitary adenomas warrants further exploration of their potential role in pituitary adenoma treatment and outcome.