Clinicopathological profile of neuroendocrine tumors of gastrointestinal tract

Introduction: Neuroendocrine neoplasms are derived predominately from enterochromaffin or Kulchitsky's cells. The estimated prevalence of neuroendocrine tumors (NET) is 1 to 2 cases per 100,000 people, of which gastrointestinal tract (GIT) is the most common site. And being a rare tumor, it is less studied Aim of the Study: To study the clinicopathological profile of Neuroendocrine tumors of GIT. Materials and Methods: All specimens of neuroendocrine tumors received from the Department of Surgery and Department of digestive health diseases during the period from September 2008 to September 2012 were included. Clinical details were collected from the medical records in all cases. The tumors were classified based on WHO classification 2010 using morphological findings on H&E slides. Immunohistochemistry was done in 40 cases using Synaptophysin, Chromogranin and Neuron specific enolase. Results: There were 886 neoplasms diagnosed in GIT of which 53 (5.98%) were NET. The mean age of presentation was 50 years. The male: Female ratio observed is 2:1. The most common presenting symptoms were abdominal pain followed by loss of appetite and weight. Carcinoid syndrome was seen in 2/53 (3.8%) patients .The most common site involved was Stomach followed by duodenum and ileum. NET Grade 1 was seen in 22 cases, NET Grade 2 was seen in 9cases, NET Grade3 was seen 4 cases and mixed adenocarcinoma and neuroendocrine carcinoma (MANEC) was seen in 18 cases. Metastasis to liver was seen in 3 cases Most of the NET tumors expressed the IHC markers, 95% were positive for NSE, 87.5% were positive for Synaptophysin and 82.5% cases were positive for Chromogranin. Conclusion: Neuroendocrine tumors (NETs) are uncommon malignancies of GIT. Stomach was the most common anatomical site. NET grade 1 was the most common histological subtype. IHC markers NSE, Synaptophysin and chromogranin can be used in diagnosis of NETs.