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Pancreatic Neoplasms: HELP
Articles by Anna Sowa-Staszczak
Based on 13 articles published since 2008
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Between 2008 and 2019, A. Sowa-Staszczak wrote the following 13 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Guideline Diagnostic and therapeutic guidelines for gastro-entero-pancreatic neuroendocrine neoplasms (recommended by the Polish Network of Neuroendocrine Tumours). 2017

Kos-Kudła, Beata / Blicharz-Dorniak, Jolanta / Strzelczyk, Janusz / Bałdys-Waligórska, Agata / Bednarczuk, Tomasz / Bolanowski, Marek / Boratyn-Nowicka, Agnieszka / Borowska, Małgorzata / Cichocki, Andrzej / Ćwikła, Jarosław B / Falconi, Massimo / Foltyn, Wanda / Handkiewicz-Junak, Daria / Hubalewska-Dydejczyk, Alicja / Jarząb, Barbara / Junik, Roman / Kajdaniuk, Dariusz / Kamiński, Grzegorz / Kolasińska-Ćwikła, Agnieszka / Kowalska, Aldona / Król, Robert / Królicki, Leszek / Krzakowski, Maciej / Kunikowska, Jolanta / Kuśnierz, Katarzyna / Lampe, Paweł / Lange, Dariusz / Lewczuk-Myślicka, Anna / Lewiński, Andrzej / Lipiński, Michał / Londzin-Olesik, Magdalena / Marek, Bogdan / Nasierowska-Guttmejer, Anna / Nawrocki, Sergiusz / Nowakowska-Duława, Ewa / Pilch-Kowalczyk, Joanna / Rosiek, Violetta / Ruchała, Marek / Siemińska, Lucyna / Sowa-Staszczak, Anna / Starzyńska, Teresa / Steinhof-Radwańska, Katarzyna / Sworczak, Krzysztof / Syrenicz, Anhelli / Szawłowski, Andrzej / Szczepkowski, Marek / Wachuła, Ewa / Zajęcki, Wojciech / Zemczak, Anna / Zgliczyński, Wojciech / Zieniewicz, Krzysztof. ·Klinika Endokrynologii i Nowotworów Neuroendokrynnych, Katedra Patofizjologii i Endokrynologii, Śląski Uniwersytet Medyczny. endoklin@sum.edu.pl. ·Endokrynol Pol · Pubmed #28597909.

ABSTRACT: Progress in the diagnostics and therapy of gastro-entero-pancreatic (GEP) neuroendocrine neoplasms (NEN), the published results of new randomised clinical trials, and the new guidelines issued by the European Neuroendocrine Tumour Society (ENETS) have led the Polish Network of Neuroendocrine Tumours to update the 2013 guidelines regarding management of these neoplasms. We present the general recommendations for the management of NENs, developed by experts during the Third Round Table Conference - Diagnostics and therapy of gastro-entero-pancreatic neuroendocrine neoplasms: Polish recommendations in view of current European recommenda-tions, which took place in December 2016 in Żelechów near Warsaw. Drawing from the extensive experience of centres dealing with this type of neoplasms, we hope that we have managed to develop the optimal management system, applying the most recent achievements in the field of medicine, for these patients, and that it can be implemented effectively in Poland. These management guidelines have been arranged in the following order: gastric and duodenal NENs (including gastrinoma); pancreatic NENs; NENs of the small intestine and appendix, and colorectal NENs.

2 Guideline Pancreatic neuroendocrine neoplasms - management guidelines (recommended by the Polish Network of Neuroendocrine Tumours). 2017

Kos-Kudła, Beata / Rosiek, Violetta / Borowska, Małgorzata / Bałdys-Waligórska, Agata / Bednarczuk, Tomasz / Blicharz-Dorniak, Jolanta / Bolanowski, Marek / Boratyn-Nowicka, Agnieszka / Cichocki, Andrzej / Ćwikła, Jarosław B / Falconi, Massimo / Foltyn, Wanda / Handkiewicz-Junak, Foltyn / Hubalewska-Dydejczyk, Alicja / Jarząb, Barbara / Jarząb, Michał / Junik, Roman / Kajdaniuk, Dariusz / Kamiński, Grzegorz / Kolasińska-Ćwikła, Agnieszka / Kowalska, Aldona / Król, Robert / Królicki, Leszek / Kunikowska, Jolanta / Kuśnierz, Katarzyna / Lampe, Paweł / Lange, Dariusz / Lewczuk-Myślicka, Anna / Lewiński, Andrzej / Lipiński, Michał / Londzin-Olesik, Magdalena / Marek, Bogdan / Nasierowska-Guttmejer, Anna / Nowakowska-Duława, Ewa / Pilch-Kowalczyk, Joanna / Ruchała, Marek / Siemińska, Lucyna / Sowa-Staszczak, Anna / Starzyńska, Teresa / Steinhof-Radwańska, Katarzyna / Strzelczyk, Janusz / Sworczak, Krzysztof / Syrenicz, Anhelli / Szawłowski, Andrzej / Szczepkowski, Marek / Wachuła, Ewa / Zajęcki, Wojciech / Zemczak, Anna / Zgliczyński, Wojciech. ·vml@wp.pl. ·Endokrynol Pol · Pubmed #28540973.

ABSTRACT: This article presents updated diagnostic and therapeutic guidelines for the management of pancreatic neuroendocrine tumours (PNEN), proposed by the Polish Network of Neuroendocrine Tumours. The guidelines contain new data received in the years 2013-2016, which confirm previous recommendations, and have led to modification of previous guidelines or have resulted in the formulation of new guidelines. Biochemical and imaging (anatomical and functional) tests are of great importance in diagnostics, as well as histopathological diagnosis to determine the management of PNEN patients, but they must be confirmed by an immunohistochemical examination. PNEN therapy requires collaboration among the members a multidisciplinary team of specialists experienced in the management of these neoplasms. Surgery is the basic form of treatment in many cases. Further therapy requires a multidirectional procedure; therefore, the rules of biotherapy, peptide receptor radionuclide therapy, molecular targeted therapy, and chemotherapy are discussed.

3 Guideline Gastroduodenal neuroendocrine neoplasms, including gastrinoma - management guidelines (recommended by the Polish Network of Neuroendocrine Tumours). 2017

Lipiński, Michał / Rydzewska, Grażyna / Foltyn, Wanda / Andrysiak-Mamos, Elżbieta / Bałdys-Waligórska, Agata / Bednarczuk, Tomasz / Blicharz-Dorniak, Jolanta / Bolanowski, Marek / Boratyn-Nowicka, Agnieszka / Borowska, Małgorzata / Cichocki, Andrzej / Ćwikła, Jarosław B / Falconi, Massimo / Handkiewicz-Junak, Daria / Hubalewska-Dydejczyk, Alicja / Jarząb, Barbara / Junik, Roman / Kajdaniuk, Dariusz / Kamiński, Grzegorz / Kolasińska-Ćwikła, Agnieszka / Kowalska, Aldona / Król, Robert / Królicki, Leszek / Kunikowska, Jolanta / Kuśnierz, Katarzyna / Lampe, Paweł / Lange, Dariusz / Lewczuk-Myślicka, Anna / Lewiński, Andrzej / Londzin-Olesik, Magdalena / Marek, Bogdan / Nasierowska-Guttmejer, Anna / Nowakowska-Duława, Ewa / Pilch-Kowalczyk, Joanna / Poczkaj, Karolina / Rosiek, Violetta / Ruchała, Marek / Siemińska, Lucyna / Sowa-Staszczak, Anna / Starzyńska, Teresa / Steinhof-Radwańska, Katarzyna / Strzelczyk, Janusz / Sworczak, Krzysztof / Syrenicz, Anhelli / Szawłowski, Andrzej / Szczepkowski, Marek / Wachuła, Ewa / Zajęcki, Wojciech / Zemczak, Anna / Zgliczyński, Wojciech / Kos-Kudła, Beata. ·grazka3558@yahoo.pl. ·Endokrynol Pol · Pubmed #28540972.

ABSTRACT: This paper presents the updated Polish Neuroendocrine Tumour Network expert panel recommendations on the management of neuroendocrine neoplasms (NENs) of the stomach and duodenum, including gastrinoma. The recommendations discuss the epidemiology, pathogenesis, and clinical presentation of these tumours as well as their diagnosis, including biochemical, histopathological, and localisation diagnoses. The principles of treatment are discussed, including endoscopic, surgical, pharmacological, and radionuclide treatments. Finally, there are also recommendations on patient monitoring.

4 Guideline Pancreatic neuroendocrine neoplasms - management guidelines (recommended by the Polish Network of Neuroendocrine Tumours). 2013

Kos-Kudła, Beata / Hubalewska-Dydejczyk, Alicja / Kuśnierz, Katarzyna / Lampe, Paweł / Marek, Bogdan / Nasierowska-Guttmejer, Anna / Nowakowska-Duława, Ewa / Pilch-Kowalczyk, Joanna / Sowa-Staszczak, Anna / Rosiek, Violetta / Anonymous7490781 / Anonymous7500781. ·Division of Endocrinology, Department of Pathophysiology and Endocrinology, Medical University of Silesia, Katowice, Poland. endoklin@sum.edu.pl. ·Endokrynol Pol · Pubmed #24431118.

ABSTRACT: We present revised diagnostic and therapeutic guidelines for the management of pancreatic neuroendocrine neoplasms (PNENs) proposed by the Polish Network of Neuroendocrine Tumours.These guidelines refer to biochemical (determination of specific and nonspecific neuroendocrine markers) and imaging diagnostics (EUS, CT, MR, and radioisotope examination with a 68Ga or 99Tc labelled somatostatin analogue).A histopathological diagnostic, which determines the further management of patients with PNENs, must be necessarily confirmed by immunohistochemical tests. PNENs therapy requires collaboration between a multidisciplinary team of specialists experienced in the management of these neoplasms. Surgery is the basic form of treatment. Medical therapy requires a multidirectional procedure, and therefore the rules of biotherapy, peptide receptor radionuclide therapy, chemotherapy and molecular targeted therapy are discussed.

5 Review GLP-1 and exendin-4 for imaging endocrine pancreas. A review. Labelled glucagon-like peptide-1 analogues: past, present and future. 2015

Hubalewska-Dydejczyk, A / Sowa-Staszczak, A / Tomaszuk, M / Stefańska, A. ·Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland - alahub@cm-uj.krakow.pl. ·Q J Nucl Med Mol Imaging · Pubmed #25719487.

ABSTRACT: Glucagon-like peptide 1 (GLP-1) receptors expression has been found on many types of cancer cells. In case of benign insulinoma the density of those receptors is even higher than the density of somatostatin receptors. This article presents the results of clinical trials proving the utility of GLP-1 receptors imaging. Scintigraphy or positron emission tomography with the use of GLP-1 analogues labelled with appropriate radioisotopes (111In, 99mTc, 68Ga, 18F or 64Cu) seem to be superior compared with other available techniques in diagnosis of hardly detectable benign insulinoma. While surgery is the only effective therapy for insulinoma patients, therefore proper preoperative localization of the tumor allows sparing operation. Glucagon-like peptide 1 receptors might become also a target for imaging of other tumors such as gastrinoma, pheochromocytoma and medullary thyroid cancer (MTC), which also were shown to overexpress this type of receptors. However, studies with larger groups of patients are required to prove the clinical usefulness of this indication. Moreover GLP-1 receptor imaging seems to be a potential tool to evaluate pancreatic beta cell mass (BCM). It may be useful in the early diagnosis of beta cell loss in preclinical phases of diabetes. The panceratic beta cells imaging may influence the prophylaxis of diabetes and management of diabetic patients. Presented results of clinical trials prove that glucagon-like peptide 1 receptor imaging might become helpful diagnostic strategy particularly in case of patients with benign insulinoma tumors, but also patients with gastrinoma, pheochromocytoma, medullary thyroid cancer and diabetes.

6 Article Coexistence of neurofibromatosis type 1 with multiple malignant neoplasia. 2018

Przybylik-Mazurek, Elwira / Palen, Joanna / Pasternak-Pietrzak, Katarzyna / Sowa-Staszczak, Anna / Brzozowska-Czarnek, Agata / Hubalewska-Dydejczyk, Alicja. ·Clinical Department of Endocrinology, Jagiellonian University in Krakow, Poland. · Department of Radiology, Jagiellonian University, Krakow, Poland. ·Neuro Endocrinol Lett · Pubmed #30431740.

ABSTRACT: Neurofibromatosis type 1 (NF1, von Recklinghausen disease) is inherited in autosomal dominant way genetic disorder, with an incidence at birth 1:3000. It is one of the most common congenital disorders. It is characterized by café-au-lait spots, neurofibromas, and less common MPTST and gliomas of the optic nerve. It is caused by germline mutations of the NF1 gene, which acts as tumor suppressor. Inactivation of the gene leads to increased activation of the kinase pathways, and in consequence, uncontrolled proliferation of cells. The disease predisposes to the development of both benign and malignant tumors. Malignant tumors, but not related to the nervous system occur in neurofibromatosis quite rare. The aim of the study is a literature review of NF1, with presentation of a patient with NF1 and coexisting numerous tumors: synchronous somatostatinoma and gastrointestinal stromal tumor with metachronous prostate adenocarcinoma and non-small cell lung carcinoma. And attempt to answer the question if there is a common pathway for oncogenesis of these four tumors.

7 Article Epidemiology of gastroenteropancreatic neuroendocrine neoplasms in Krakow and Krakow district in 2007-2011. 2017

Trofimiuk-Müldner, Małgorzata / Lewkowicz, Ewelina / Wysocka, Katarzyna / Pach, Dorota / Kiełtyka, Agnieszka / Stefańska, Agnieszka / Sowa-Staszczak, Anna / Tomaszewska, Romana / Hubalewska-Dydejczyk, Alicja. ·Department of Endocrinology, University Hospital in Krakow, Krakow, Poland. baczynskae@yahoo.com. ·Endokrynol Pol · Pubmed #28255979.

ABSTRACT: INTRODUCTION: Gastroenteropancreatic neuroendocrine neoplasms (GEPNEN) are rare and heterogeneous tumours with variable biology. The aim of this study was to evaluate the epidemiology of GEPNEN in the population of Krakow and Krakow district in 2007-2011. MATERIAL AND METHODS: The Database of the Chair and Department of Endocrinology, Jagiellonian University Medical College, comprising the data on NEN cases collected from the Endocrinology Department, University Hospital in Krakow and from independent sources: surgery, pathology, and endocrinology departments located in the Krakow area, was searched for cases of GEPNEN patients living in Krakow and Krakow district, diagnosed between 2007 and 2011. Eighty-eight such patients (39 males, 49 females, median age at diagnosis 59 ± 17 years) were identified and characterised. RESULTS: The mean follow-up time was 2.67 ± 1.6 years. The most frequent primary location of GEPNEN was small intestine (20%), followed by the appendix (18%), stomach (16%), pancreas (16%), rectum (15%), and colon (15%). NENG1 predominated (64%) in the analysed group. Most well-differentiated GEPNEN (63%) were diagnosed at stage I; however, 18% of them were diagnosed at stage IV. Metastases at diagnosis were found in 31% of patients. The GEPNEN incidence rate in 2007-2011 was 2.1/100000 inhabitants/year, without significant increase during the studied period. CONCLUSIONS: GEPNEN incidence and epidemiology in the population of Krakow and Krakow district is similar to the incidence observed in most European countries. Registers are important tools to evaluate GEPNEN epidemiology. (Endokrynol Pol 2017; 68 (1): 42-46).

8 Article 99mTc Labeled Glucagon-Like Peptide-1-Analogue (99mTc-GLP1) Scintigraphy in the Management of Patients with Occult Insulinoma. 2016

Sowa-Staszczak, Anna / Trofimiuk-Müldner, Małgorzata / Stefańska, Agnieszka / Tomaszuk, Monika / Buziak-Bereza, Monika / Gilis-Januszewska, Aleksandra / Jabrocka-Hybel, Agata / Głowa, Bogusław / Małecki, Maciej / Bednarczuk, Tomasz / Kamiński, Grzegorz / Kowalska, Aldona / Mikołajczak, Renata / Janota, Barbara / Hubalewska-Dydejczyk, Alicja. ·Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland. · Department of Endocrinology, University Hospital, Kraków, Poland. · Department of Metabolic Diseases, Jagiellonian University Medical College, Kraków, Poland. · Department of Endocrinology, Medical University of Warsaw, Warszawa, Poland. · Department of Endocrinology and Radioisotopic Therapy, Military Institute of Medicine, Warszawa, Poland. · Department of Endocrinology and Nuclear Medicine, Holycross Cancer Center, Kielce, Poland. · Radioisotope Center POLATOM, National Centre for Nuclear Research, Otwock, Poland. ·PLoS One · Pubmed #27526057.

ABSTRACT: INTRODUCTION: The aim of this study was to assess the utility of [Lys40(Ahx-HYNIC-99mTc/EDDA)NH2]-exendin-4 scintigraphy in the management of patients with hypoglycemia, particularly in the detection of occult insulinoma. MATERIALS AND METHODS: Forty patients with hypoglycemia and increased/confusing results of serum insulin and C-peptide concentration and negative/inconclusive results of other imaging examinations were enrolled in the study. In all patients GLP-1 receptor imaging was performed to localise potential pancreatic lesions. RESULTS: Positive results of GLP-1 scintigraphy were observed in 28 patients. In 18 patients postsurgical histopathological examination confirmed diagnosis of insulinoma. Two patients had contraindications to the surgery, one patient did not want to be operated. One patient, who presented with postprandial hypoglycemia, with positive result of GLP-1 imaging was not qualified for surgery and is in the observational group. Eight patients were lost for follow up, among them 6 patients with positive GLP-1 scintigraphy result. One patient with negative scintigraphy was diagnosed with malignant insulinoma. In two patients with negative scintigraphy Munchausen syndrome was diagnosed (patients were taking insulin). Other seven patients with negative results of 99mTcGLP-1 scintigraphy and postprandial hypoglycemia with C-peptide and insulin levels within the limits of normal ranges are in the observational group. We would like to mention that 99mTc-GLP1-SPECT/CT was also performed in 3 pts with nesidioblastosis (revealing diffuse tracer uptake in two and a focal lesion in one case) and in two patients with malignant insulinoma (with the a focal uptake in the localization of a removed pancreatic headin one case and negative GLP-1 1 scintigraphy in the other patient). CONCLUSIONS: 99mTc-GLP1-SPECT/CT could be helpful examination in the management of patients with hypoglycemia enabling proper localization of the pancreatic lesion and effective surgical treatment. This imaging technique may eliminate the need to perform invasive procedures in case of occult insulinoma.

9 Article Gastroenteropancreatic neuroendocrine neoplasms: a 10-year experience of a single center. 2015

Lewkowicz, Ewelina / Trofimiuk-Müldner, Małgorzata / Wysocka, Katarzyna / Pach, Dorota / Kiełtyka, Agnieszka / Stefańska, Agnieszka / Sowa-Staszczak, Anna / Tomaszewska, Romana / Hubalewska-Dydejczyk, Alicja. · ·Pol Arch Med Wewn · Pubmed #25924181.

ABSTRACT: INTRODUCTION: Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) constitute a rare and heterogeneous group of tumors with varied biology. OBJECTIVES: The aim of this study was to establish the clinical characteristics of patients with GEP-NEN and identify factors influencing their 5-year survival. PATIENTS AND METHODS: The study included 122 patients living in Kraków or its administrative region, who were diagnosed with GEP-NEN between 2002 and 2011. RESULTS: The mean follow-up period was 4.9 ±2.8 years. The most frequent primary site of the tumor was the small intestine (n = 25; 20%), followed by pancreas (n = 23; 19%), rectum (n = 23; 19%), stomach (n = 21; 17%), appendix (n = 19; 16%), and colon (n = 11; 9%). There were 84 tumors classified as NEN G1; 31, as NEN G2; 5, as neuroendocrine carcinoma; and 1, as mixed adenoneuroendocrine carcinoma. Most well-differentiated GEP-NENs (n = 57; 57%) were diagnosed at stage I according to the American Joint Committee on Cancer / Union for International Cancer Control (AJCC/UICC) classification; 77% of NEN G1 (n = 64) were diagnosed at stage I, but the majority of NEN G2—at stage IV (n = 18; 58%). Metastases at diagnosis were found in 38 patients (34%). In 90% of the cases (n = 101), tumors were hormonally nonfunctional. The overall 5-year survival was 85%. In the univariate analysis, NEN G2 (P = 0.003), higher stage according to the AJCC/UICC classification (P <0.001), and metastases at diagnosis (P <0.001) were associated with poorer prognosis. In standardized multivariate models, higher stage (P = 0.02) and metastases at diagnosis (P = 0.02) were independent risk factors for death. CONCLUSIONS: The most important factors affecting survival of patients with GEP-NENs are tumor stage and the presence of metastases at diagnosis. The analysis of single-center data improves identification of patients with poorer prognosis requiring a more aggressive approach.

10 Article Glucagon-like peptide-1 receptor imaging with [Lys40(Ahx-HYNIC- 99mTc/EDDA)NH2]-exendin-4 for the detection of insulinoma. 2013

Sowa-Staszczak, Anna / Pach, Dorota / Mikołajczak, Renata / Mäcke, Helmut / Jabrocka-Hybel, Agata / Stefańska, Agnieszka / Tomaszuk, Monika / Janota, Barbara / Gilis-Januszewska, Aleksandra / Małecki, Maciej / Kamiński, Grzegorz / Kowalska, Aldona / Kulig, Jan / Matyja, Andrzej / Osuch, Czesław / Hubalewska-Dydejczyk, Alicja. ·Department of Endocrinology, Jagiellonian University Medical College, Cracow, Poland. sowiana@gmail.com ·Eur J Nucl Med Mol Imaging · Pubmed #23224740.

ABSTRACT: PURPOSE: The objective of this article is to present a new method for the diagnosis of insulinoma with the use of [Lys(40)(Ahx-HYNIC-(99m)Tc/EDDA)NH2]-exendin-4. METHODS: Studies were performed in 11 patients with negative results of all available non-isotopic diagnostic methods (8 with symptoms of insulinoma, 2 with malignant insulinoma and 1 with nesidioblastosis). In all patients glucagon-like peptide-1 (GLP-1) receptor imaging (whole-body and single photon emission computed tomography/CT examinations) after the injection of 740 MBq of the tracer was performed. RESULTS: Both sensitivity and specificity of GLP-1 receptor imaging were assessed to be 100 % in patients with benign insulinoma. In all eight cases with suspicion of insulinoma a focal uptake in the pancreas was found. In six patients surgical excision of the tumour was performed (type G1 tumours were confirmed histopathologically). In one patient surgical treatment is planned. One patient was disqualified from surgery. In one case with malignant insulinoma pathological accumulation of the tracer was found only in the region of local recurrence. The GLP-1 study was negative in the other malignant insulinoma patient. In one case with suspicion of nesidioblastosis, a focal accumulation of the tracer was observed and histopathology revealed coexistence of insulinoma and nesidioblastosis. CONCLUSION: [Lys(40)(Ahx-HYNIC-(99m)Tc/EDDA)NH2]-exendin-4 seems to be a promising diagnostic tool in the localization of small insulinoma tumours, but requires verification in a larger series of patients.

11 Article [Symptoms and early diagnostic possibilities of pancreatic endocrine cells hyperplasia (nesidioblastosis)]. 2012

Przybylik-Mazurek, Elwira / Pach, Dorota / Hubalewska-Dydejczyk, Alicja / Sowa-Staszczak, Anna / Gilis-Januszewska, Aleksandra / Kulig, Jan / Matyja, Andrzej / Chrapczyński, Paweł. ·Katedra i Klinika Endokrynologii UJ CM w Krakowie. eprzybyl@cm-uj.krakow.pl ·Przegl Lek · Pubmed #22764512.

ABSTRACT: Nesidioplastosis in adults is one of a rare causes of hyperinsulinemic hypoglycemia. Symptoms include chronic or recurrent hypoglycemias, often with neurological signs. Due to the looses of consciousness with coexisting seizures, in many cases patients are treated on epilepsy. Right diagnosis is usually late established, when the damages in the central nervous system (CNS) are irreversible. Early diagnosis of the disease and appropriate treatment might help to avoid serious disability in these patients. The aim of the study was to asses modern diagnostics of the nesidioblastosis with an emphasis on the biochemical and hormonal tests and imaging modalities. Patients enrolled to the study were aged between 18 and 72 years of age, and had chronic or recurrent hypoglycemia caused by hyperinsulinemia. In all patients fasting glucose and fasting insulinemia tests were performed, as well as the fasting blood test or in the 24-hour profile tests. Several techniques were used including ultrasound (US), abdominal computer tomography (CT), in two patients magnetic resonance imaging, scintigraphy of somatostatin receptors in seven patients, and in two patients scintigraphy with glucagone-like peptide-1 (GLP-1) analogue-labeled marker was done. In the performed tests low values of the blood glucose were found, whereas insulin levels, however not adequate to the blood glucose, were nearly always within the normal range. In the standard imaging only in one patient tumor lesion in the pancreatic tail was revealed, though not confirmed in the intraoperative histology. In the scintigraphy examination with the somatostatin analogue in one patient slightly increased collection of the marker in whole pancreas was reported and in the other patient focal collection in the pancreatic tail was observed. Scintigraphy with GLP-1 analogue revealed focal collection of the marker in one case. Five patients were underwent surgical treatment. In the histopathology in all operated patients hyperplasia of the endocrine pancreatic cells with positive immuno. histochemic reaction on the insulin was found. In the three cases despite hyperplasia of pancreatic islets, small sizes insulinomas were detected as well. 1. The diagnosis of nesidioblastosis should be taken into consideration in all patients with unclear-cause hypoglycemias, in whom simultaneously insulin blood level is inadequate to the level of glucose. 2. Widely available imaging examinations: US, CT, MRI are useless in the diagnosis of nesidioblastosis. 3. Among the imaging methods in preoperative diagnostics of hypoglycemia with concomitant hyperinsulinemia somatostatin receptor scintigraphy seems to have specific, though limited role - it is valuable only in the severe, diffused lesions. 4. Recurrent hypoglycemias after 70% excision of the pancreas may indicate the possibility of coexistence of pancreatic islets hyperplasia and insulin secreting insulinoma.

12 Article Can treatment using radiolabelled somatostatin analogue increase the survival rate in patients with non-functioning neuroendocrine pancreatic tumours? 2011

Sowa-Staszczak, Anna / Pach, Dorota / Stefańska, Agnieszka / Tomaszuk, Monika / Lenda-Tracz, Wioletta / Mikołajczak, Renata / Pawlak, Dariusz / Chrzan, Robert / Gilis-Januszewska, Aleksandra / Przybylik-Mazurek, Elwira / Hubalewska-Dydejczyk, Alicja. ·Department of Endocrinology, Jagiellonian University, Medical College, Krakow, Poland. ·Nucl Med Rev Cent East Eur · Pubmed #22219146.

ABSTRACT: BACKGROUND: The aim of the study was to assess the effectiveness of peptide receptor radionuclide therapy (PRRT) in patients with non-functioning neuroendocrine pancreatic tumours (NFPNTs) and to compare survival rates in patients with NFPNTs and in patients with other neuroendocrine tumours (NETs) treated using radiolabelled somatostatin analogue in our Department. We would like to analyze factors potentially determining the effectiveness of the therapy and also to assess the myelo- and nephrotoxicity. MATERIAL AND METHODS: Fourteen patients with disseminated disease and/or inoperable NFPNT were qualified to PRRT based on positive SRS (somatostatin receptor scintigraphy). There were 5 men and 9 women, with Karnofsky's index>70%. RESULTS: In the whole group of patients, partial response was observed in 21.4%, stabilization of the disease in 42.9%, and progression of the disease in 35.7% of patients. Mean observation time was 19±13 months, mean time to progression was 12±9 months, and mean time to death was 16±9 months. Six patients died--four of them due to progression of the disease, two due to myocardial infarction. After PRRT we did not observe clinically significant haemotoxicity and/or nephrotoxicity. CONCLUSIONS: 1. Peptide receptor radionuclide therapy may be a safe and effective treatment option in patients with NFPNTs, leading to stabilization or regression of the disease in the majority of patients. 2. There is no statistically significant difference in survival rate between patients with NFPNTs and NETs of other localization treated with PRRT.

13 Article Efficacy and safety of 90Y-DOTATATE therapy in neuroendocrine tumours. 2011

Sowa-Staszczak, Anna / Pach, Dorota / Kunikowska, Jolanta / Krolicki, Leszek / Stefanska, Agnieszka / Tomaszuk, Monika / Buziak-Bereza, Monika / Mikolajczak, Renata / Matyja, Marta / Gilis-Januszewska, Aleksandra / Jabrocka-Hybel, Agata / Trofimiuk, Malgorzata / Hubalewska-Dydejczyk, Alicja. ·Endocrinology Department, Jagiellonian University Medical College, Krakow, Poland. ·Endokrynol Pol · Pubmed #22069099.

ABSTRACT: BACKGROUND: The aim of this study was to assess the efficacy and toxicity of peptide receptor radionuclide therapy (PRRT) with the use of the high affinity somatostatin receptor subtype 2 analogue, (90)Y labelled Tyr3-octreotate, ((90)Y-DOTATATE) in neuroendocrine tumours (NETs). MATERIAL AND METHODS: 46 patients with disseminated or non-operable NET were enrolled in this study. The (90)Y-DOTATATE therapeutic activity was calculated per total body surface area up to a total of 7.4 GBq/m(2) administered in three to five cycles, repeated every four to nine weeks. Before and after the therapy, blood tests for haematology, kidney and liver function, and chromogranin A were performed. RESULTS: Out of 46 (90)Y-DOTATATE treated patients, one died before completing the therapy and 16 died after completing the therapy, among them one due to myocardial infarction. After 12 month follow-up, stabilisation of disease was observed in 47%, partial remission in 31%, and progression in 9% of the 45 patients who completed the therapy. Five patients died before completion of 12 months of follow-up. One of the patients died due to myocardial infarction. In one case, the information after 12 months is incomplete. The progression free survival was 37.4 months. During 12 months follow-up, transient decrease of PLT, WBC and haemoglobin values was observed. A transient increase of creatinine level (within normal ranges) and decrease of GFR values were found. CONCLUSIONS: NETs (90)Y-DOTATATE therapy results in symptomatic relief and tumour mass reduction. The mild critical organ toxicity does not limit the PRRT of NETs.