Malignancies of the gallbladder, including neuroendocrine tumors, are uncommon, mostly found incidentally after cholecystectomy and are frequently asymptomatic in the early stages, but highly fatal. Limited data is av...Malignancies of the gallbladder, including neuroendocrine tumors, are uncommon, mostly found incidentally after cholecystectomy and are frequently asymptomatic in the early stages, but highly fatal. Limited data is available on adrenocorticotropic hormone (ACTH) producing neuroendocrine tumors specifically originating from the gallbladder. We report the clinical and radiographic findings, which included positron emission tomography and computed tomography, of a patient with a gallbladder mass who presented with Cushing’s syndrome. Subsequently, a diagnosis of ACTH-producing large cell neuroendocrine carcinoma of the gallbladder was made. Despite being rare and having a poor prognosis, hormone-producing neuroendocrine tumors should be part of the differential diagnosis in the approach of patients with Cushing’s syndrome.展开更多
Clinical management of advanced unresectable HCC has indelibly changed with the advent of immune checkpoint inhibitor(ICI)antibody therapy.The CheckMate-040 multi-cohort trial first demonstrated the effectiveness of a...Clinical management of advanced unresectable HCC has indelibly changed with the advent of immune checkpoint inhibitor(ICI)antibody therapy.The CheckMate-040 multi-cohort trial first demonstrated the effectiveness of an anti-PD1 antibody(nivolumab)in patients with clinically advanced HCC previously treated with sorafenib,reporting an approximately 20% overall objective response rate in such patients[1].Another anti-PD1 agent,pembrolizumab,demonstrated similar response rates in its phase 2 trial[2],and both agents subsequently received accelerated regulatory approval for second-line systemic treatment of HCC.展开更多
Aim:To describe demographic,clinical,and outcome differences in Pacific Island-born(PI-born)compared to US-born hepatocellular carcinoma(HCC)patients of Pacific Island ancestry within a clinical cohort in Hawaii.Metho...Aim:To describe demographic,clinical,and outcome differences in Pacific Island-born(PI-born)compared to US-born hepatocellular carcinoma(HCC)patients of Pacific Island ancestry within a clinical cohort in Hawaii.Methods:A prospectively collected database of 1608 patients diagnosed with HCC over a 30-year period(1993-2022)identified 252 patients of Pacific Islander ethnicity.Data collected:demographics,medical history,laboratory data,tumor characteristics,treatment,and survival.Patients were divided into two groups:PI-born and US-born.Categorical variables were analyzed using ANOVA and chi-square analysis.Odds ratios with 95%confidence intervals were calculated using univariate and multivariate logistic regression.Overall survival was evaluated using Kaplan-Meier analysis.Results:PI-born patients were younger(57.3 vs.61.8 years,P=0.002)and more likely to have hepatitis B(OR 14.10,7.50-26.50)and underlying cirrhosis(OR 2.28,1.17-4.45).In comparison,US-born patients had a significantly higher likelihood of Hepatitis C,nonalcoholic steatohepatitis/nonalcoholic fatty liver disease,history of non-HCC cancer,and positive smoking history compared to PI-born patients.PI-born patients were more likely to forego treatment(OR 3.22,1.77-5.87)and be lost to follow-up(OR 9.21,1.97-43.03).Both groups were equally likely to have the opportunity for curative surgical treatment(liver resection or transplant).US-born status was associated with higher mortality risk,while transplantation was associated with lower mortality risk.The PI-born cohort demonstrated higher overall survival at 3 and 5 years compared to US-born.Conclusion:HBV remains the primary risk factor for HCC in PI-born patients,whereas HCC in US-born patients is more associated with the adoption of a Westernized lifestyle.展开更多
文摘Malignancies of the gallbladder, including neuroendocrine tumors, are uncommon, mostly found incidentally after cholecystectomy and are frequently asymptomatic in the early stages, but highly fatal. Limited data is available on adrenocorticotropic hormone (ACTH) producing neuroendocrine tumors specifically originating from the gallbladder. We report the clinical and radiographic findings, which included positron emission tomography and computed tomography, of a patient with a gallbladder mass who presented with Cushing’s syndrome. Subsequently, a diagnosis of ACTH-producing large cell neuroendocrine carcinoma of the gallbladder was made. Despite being rare and having a poor prognosis, hormone-producing neuroendocrine tumors should be part of the differential diagnosis in the approach of patients with Cushing’s syndrome.
文摘Clinical management of advanced unresectable HCC has indelibly changed with the advent of immune checkpoint inhibitor(ICI)antibody therapy.The CheckMate-040 multi-cohort trial first demonstrated the effectiveness of an anti-PD1 antibody(nivolumab)in patients with clinically advanced HCC previously treated with sorafenib,reporting an approximately 20% overall objective response rate in such patients[1].Another anti-PD1 agent,pembrolizumab,demonstrated similar response rates in its phase 2 trial[2],and both agents subsequently received accelerated regulatory approval for second-line systemic treatment of HCC.
基金supported by National Institutes of Health(1U01CA230690-01).
文摘Aim:To describe demographic,clinical,and outcome differences in Pacific Island-born(PI-born)compared to US-born hepatocellular carcinoma(HCC)patients of Pacific Island ancestry within a clinical cohort in Hawaii.Methods:A prospectively collected database of 1608 patients diagnosed with HCC over a 30-year period(1993-2022)identified 252 patients of Pacific Islander ethnicity.Data collected:demographics,medical history,laboratory data,tumor characteristics,treatment,and survival.Patients were divided into two groups:PI-born and US-born.Categorical variables were analyzed using ANOVA and chi-square analysis.Odds ratios with 95%confidence intervals were calculated using univariate and multivariate logistic regression.Overall survival was evaluated using Kaplan-Meier analysis.Results:PI-born patients were younger(57.3 vs.61.8 years,P=0.002)and more likely to have hepatitis B(OR 14.10,7.50-26.50)and underlying cirrhosis(OR 2.28,1.17-4.45).In comparison,US-born patients had a significantly higher likelihood of Hepatitis C,nonalcoholic steatohepatitis/nonalcoholic fatty liver disease,history of non-HCC cancer,and positive smoking history compared to PI-born patients.PI-born patients were more likely to forego treatment(OR 3.22,1.77-5.87)and be lost to follow-up(OR 9.21,1.97-43.03).Both groups were equally likely to have the opportunity for curative surgical treatment(liver resection or transplant).US-born status was associated with higher mortality risk,while transplantation was associated with lower mortality risk.The PI-born cohort demonstrated higher overall survival at 3 and 5 years compared to US-born.Conclusion:HBV remains the primary risk factor for HCC in PI-born patients,whereas HCC in US-born patients is more associated with the adoption of a Westernized lifestyle.
