Neuroendocrine neoplasia and bone (Review)

Ghemigian,Adina; Carsote,Mara; Sandru,Florica; Petca,Razvan-Cosmin; Oproiu,Ana-Maria; Petca,Aida; Valea,Ana

doi:10.3892/etm.2021.10653

Neuroendocrine neoplasia and bone (Review)

Authors:
- Adina Ghemigian
- Mara Carsote
- Florica Sandru
- Razvan-Cosmin Petca
- Ana-Maria Oproiu
- Aida Petca
- Ana Valea
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Affiliations: Department of Endocrinology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Department of Dermatology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Department of Urology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Department of Plastic and Reconstructive Surgery, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Department of Endocrinology, ‘I. Hatieganu’ University of Medicine and Pharmacy, 400012 Cluj‑Napoca, Romania
Published online on: August 26, 2021 https://doi.org/10.3892/etm.2021.10653
Article Number: 1219

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Abstract

This is a narrative review focusing on neuroendocrine neoplasia (NEN) and bone status, in terms of metastases and osteoporosis/fractures. One fifth of NEN have skeletal dissemination, this affinity being regulated by intrinsic tumor factors such as the C‑X‑C chemokine receptor 4 (CXCR4). Bone colonization impairs the patient quality of life, representing a surrogate of reduced survival. Patients with NEN without bone metastases may exhibit low bone mineral density, perhaps carcinoid‑related osteoporosis, yet not a standardized cause of osteoporosis. Case‑finding strategies to address bone health in NEN with a good prognosis are lacking. Contributors to fractures in NEN subjects may include: menopausal status and advanced age, different drugs, induced hypogonadism, malnutrition, malabsorption (due to intestinal resection, carcinoid syndrome), hypovitaminosis D, impaired glucose profile (due to excessive hormones such as glucagon, somatostatinoma or use of somatostatin analogues), various corticoid regimes, and high risk of fall due to sarcopenia. Pheocromocytoma/paraganglioma involve bone through malignant forms (bone is an elective site) and potential secondary osteoporosis due to excessive hormonal content and increased sympathetic activity which is a key player of bone microarchitecture/quality as reflected by low Trabecular Bone Score. Glucocorticoid osteoporosis is related to NEN‑associated ectopic Cushing syndrome. Currently, there are a lack of studies to emphasis that excessive gut‑derivate serotonin in NENs with carcinoid syndrome is a specific activator of bone loss thus a contributor to carcinoid‑related osteoporosis.

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