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Ovarian neuroendocrine tumor metastases can induce estrogen production in postmenopausal patients.

Author information

Affiliations

  • 1. ENETS Center of Excellence, Section of Endocrinology, Department of Internal Medicine, Erasmus Medical Center Cancer Institute, 3015 GD Rotterdam, The Netherlands.
      Authors
    • Mulders MCF 1
    • Hofland LJ 1
    • de Herder WW 1
    • Hofland J 1
    (4 authors)
  • 2. Department of Pathology, Erasmus Medical Centre, 3015 GD Rotterdam, The Netherlands.
      Authors
    • van Velthuysen MF 2
    (1 author)
  • 3. Department of Gynecologic Oncology, Erasmus Medical Centre Cancer Institute, 3015 GD Rotterdam, The Netherlands.
      Authors
    • Roes EM 3
    (1 author)
  • 4. Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8575, Japan.
      Authors
    • Sasano H 4
    (1 author)

ORCIDs linked to this article

European Journal of Endocrinology, 01 Jul 2024, 191(1):K1-K4
https://doi.org/10.1093/ejendo/lvae075 PMID: 38917055 

Abstract 

Neuroendocrine tumors (NETs) are malignant neoplasms that can be associated with specific hormonal syndromes. We describe a novel syndrome of postmenopausal vaginal bleeding and ovarian estradiol overproduction due to ovarian NET localizations. An extensive workup was performed for 2 index patients with ovarian metastases of small bowel neuroendocrine tumors and symptoms of postmenopausal vaginal bleeding. Clinically significant ovarian estrogen production was demonstrated by a combination of ovarian vein sampling and normalization of circulating estrogen levels after oophorectomy. Immunohistochemical analyses revealed marked aromatase immunoactivity in the ovarian NET cells, while CYP17A1 and SF-1 were detected in the adjacent ovarian stromal cells but not the NET cells. Ex vivo and in vivo endocrine tests were unable to identify a paracrine mechanism of ovarian estradiol overproduction by NET cells. A retrospective search of electronic medical records revealed that 21% (14/66) of postmenopausal patients with an ovarian NET localization reported symptoms of vaginal blood loss. Together, these findings support the presence of a novel NET-associated hormonal syndrome.

Full text links 

Read article at publisher's site: https://doi.org/10.1093/ejendo/lvae075

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Funding 

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Erasmus MC