Open AccessRectal Carcinoid Tumor Metastasizing to the Thyroid and Pancreas: An Autopsy Case Exploiting Immunohistochemistry for Differentiation from Tumors Involving Multiple Endocrine Organs
Author(s) -
Lertprasertsuke Nirush,
Kakudo Kennichi,
Satoh Shinkichi,
Tada Nobuhiko,
Osamura Yoshiyuki
Publication year - 1990
Publication title -
acta patholigica japonica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
ISSN - 0001-6632
DOI - 10.1111/j.1440-1827.1990.tb01572.x
Subject(s) - pancreas , pathology , thyroid , calcitonin , endocrine system , medicine , thyroglobulin , pancreatic polypeptide , carcinoembryonic antigen , neuroendocrine tumors , carcinoid tumors , enteroendocrine cell , metastasis , multiple endocrine neoplasia , carcinoid syndrome , glucagon , cancer , hormone , biology , biochemistry , gene
A 58‐year‐old male patient with rectal carcinoid tumor is presented. The tumor extensively involved the lymph nodes and liver, and multiple tumors were also recognized in the pancreas and thyroid. Grossly, it was uncertain whether the latter were metastases from the rectal carcinoid or all were coincident primary tumors involving multiple endocrine organs, so‐called multiple endocrine neoplasia (MEN) syndrome. Histologic, histochemical and electron microscopic examinations of the tumors in both the pancreas and thyroid showed similar features to those of the rectal carcinoid. The neoplastic cells in all involved organs commonly expressed positive immunoreactivity for somatostatin, but negativity for carcinoembryonic antigen, calcitonin, calcitonin gene‐related peptide, thyroglobulin, insulin, glucagon and pancreatic polypeptide. These immunohistochemicai results confirmed that the tumors observed in multiple endocrine organs were indeed metastatic from the rectal carcinoid, rather than being a new combination of MEN syndrome. Some neuroendocrine tumors may develop widespread metastasis, sometimes creating problems with differentiation from multiple primary endocrine tumors. lmmunohistochemistry may be of great help in setting this issue.