Evaluation of Blood Vessel Formation in Endocrine Tumors
Evaluation of Blood Vessel Formation in Endocrine Tumors
Background:

 -  Tumors depend on blood vessels to provide the nourishment that allows them to grow.

 -  Thyroid, parathyroid, adrenal gland and pancreatic neuroendocrine tumors are among the
 tumors that contain the most blood vessels. Thus, endocrine tumors are important for the
 study of new blood vessel formation in tumors.

 Objectives:

 -To obtain tissues from endocrine tumors for examination to determine how they differ from
 normal tissue.

 Eligibility:

 -Patients who are scheduled for surgery to remove an endocrine tumor, those in or around the
 thyroid, parathyroid, adrenal gland, pancreas, or any neuroendocrine tissue.

 Design:

 -  Tissues will be obtained from patients during surgery to remove thyroid, parathyroid,
 adrenal, pancreas, or neuroendocrine tumors.

 -  About 400 patients will be enrolled in the study over a period of 5 years.
Background:

 -  Endocrine neoplasms are among the fastest growing tumors in incidence in the United
 States. Between 1995 and 2005, the incidence of thyroid carcinoma has increased 98
 percent.

 -  Tumors of the thyroid, parathyroid, adrenal gland and pancreatic neuroendocrine tumors
 are among some of the most highly vascularized tumors seen.

 -  Consequently, endocrine neoplasms provide an extremely important model for the study of
 tumor angiogenesis.

 -  The Tumor Angiogenesis Section of the Surgery Branch, NCI has a focus on studying
 neovascular formation in neoplastic tissues. In addition, this section has primary
 responsibility for providing endocrine surgery consultative services to the NIH. As
 such, our Section is uniquely positioned to acquire and perform important studies on
 endocrine tissue to help advance our knowledge of the mechanisms involved in tumor
 vessel development. The majority of the patients enrolled on this study will be patients
 on other protocols throughout the NIH, for which our Section is consulted in order to
 perform their surgery.

 Objectives:

 Primary Objective:

 -To develop a class predictor model based on gene expression patterns to distinguish benign
 from neoplastic endocrine tissue for each of the endocrine histologies under study. This
 objective will drive the statistical endpoints of the study.

 Secondary Objectives:

 -  To utilize the tissue obtained from these endocrine neoplasms for studies of gene
 expression changes, proteomic changes, and methylation changes.

 -  To perform histologic examination of these tissues including immunohistochemistry and in
 situ hybridization in order to study changes in tumor neovessel formation.

 -  To obtain, when accessible, adjacent normal endocrine tissue for comparison with the
 neoplastic tissue.

 -  To collect tissues from endocrine neoplasms arising in the thyroid, parathyroid,
 adrenal, pancreas, and extraadrenal neuroendocrine rests for future analysis and
 correlation with clinical outcome.

 Eligibility:

 -  Patients with radiographic evidence of, biochemical evidence of, or
 histologically/cytologically proven, endocrine neoplasms, including lesions of the
 thyroid, parathyroid, adrenal, extra-adrenal endocrine rests, paragangliomas,
 neuroblastomas and pancreas.

 -  Patients must have an ECOG performance score of 0-2.

 -  Patients must have laboratory and physical examination parameters within acceptable
 limits by standard of practice guidelines prior to biopsy or surgery.

 Design:

 -  A tissue acquisition trial in which tissues will be obtained at the time of surgical
 operation for the removal of neoplasms of the thyroid, parathyroid, adrenal, pancreas,
 paragangliomas and or extraadrenal rests of neuroendocrine tissue.

 -  Tissue will be processed at the time of collection, stored and then shipped to the PI's
 laboratory for further processing.

 -  No investigational therapy will be given.

 -  It is anticipated that 400 patients will be enrolled over a period of 5 years.
-  INCLUSION CRITERIA:

 -  Patients referred to the Endocrine Consult Service with radiographic evidence of,
 biochemical evidence of, or histologically/cytologically proven, endocrine neoplasms,
 including lesions of the thyroid, parathyroid, adrenal, extra-adrenal endocrine rests,
 paragangliomas, neuroblastomas and pancreas.

 -  Patients must have an ECOG performance score of 0-2.

 -  Patients must have laboratory and physical examination parameters within acceptable
 limits by standard of practice guidelines prior to biopsy or surgery.

 -  Patients undergoing treatment for their neoplasm may be eligible.