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Neuroendocrine tumors are a group of carcinomas that secrete various polypeptides with hormonal activity. A significant percentage of patients already have hepatic metastases at the time of initial diagnosis, and 80‑90% of these tumors are inoperable at the time of presentation. Transarterial chemoembolization (TACE) is the preferred approach for the management of neuroendocrine hepatic metastases. Although the technique is relatively safe, it is associated with several complications. The present study reported the case of a patient with neuroendocrine hepatic metastases who developed acute thrombocytopenia following TACE. To the best of our knowledge, acute thrombocytopenia occurring after TACE in a patient with neuroendocrine hepatic metastases has not been previously reported. In the present study, the hypothetical etiopathogenetic mechanisms were also discussed. © 2015, Spandidos Publications. All rights reserved. Source


Xie P.,Ningbo Beilun Peoples Hospital | Yang Z.,81st Hospital of the Peoples Liberation Army PLA | Yuan Z.,Shanghai PLA No. 85 Hospital
Oncology Letters | Year: 2016

In the present study, a total of 82 patients (42 men and 40 women; age range, 24-84 years), including 34 patients with lipid-poor renal angiomyolipoma (AML) and 49 with clear cell renal cell carcinoma (RCC), who had undergone multiphase contrast-enhanced computed tomography (CT) (i.e., CT with unenhanced, corticomedullary, nephrographic and 5-min delay phase scanning) were evaluated. The peak enhancement attenuation value, net enhancement attenuation value, enhancement ratio, washout value and washout ratio were calculated to compare the enhancement characteristics between the two diseases. The results revealed that the lipid-poor AMLs had a significantly higher mean attenuation value compared with that of CCRCCs on unenhanced CT scans (37.8 vs. 30.9 HU; Mann-Whitney U test, P=0.003). In addition, significant differences were found between lipid-poor AMLs and CCRCCs with regard to wash-in (Mann-Whitney U test, P=0.001) and enhancement ratios (Mann-Whitney U test, P=0.010) on contrast-enhanced CT scans. A receiver operating characteristic (ROC) analysis revealed an area under the curve (AUC) of 0.722 using wash-in for differentiation between CCRCCs and lipid-poor AMLs. Lipid-poor AMLs exhibited a reduced washout of contrast enhancement (35.8±32.7 HU washout value; 29.4±0.187% washout ratio) compared with that of CCRCCs (48.3±28.4 HU washout value; 35.7±0.148% washout ratio; Mann-Whitney U test, P=0.037 and P=0.204, respectively). The ROC analysis result yielded an AUC of 0.639 for the use of washout to differentiate CCRCCs from lipid-poor AMLs. In summary, a larger wash-in and washout of contrast enhancement is a predictor that a lesion is CCRCC. © 2016, Spandidos Publications. All rights reserved. Source

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