Which other cancers test positive for INSM1 and Synaptophysin?

Hello,

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I understand your apprehension and will definitely try to help you out. Primary small cell carcinoma of the pancreas is a rare malignancy with a poor prognosis which accounts for 1 to 1.4 percent of all pancreatic malignancies. INSM1 is a nuclear marker of neuroendocrine differentiation with equivalent or better sensitivity and specificity compared to synaptophysin. It is expressed in 100 percent pancreatic neuroendocrine tumors. Positive INSM1 along with positive synaptophysin strongly indicate a small cell neuroendocrine tumor. Small cell carcinoma, by definition, are aggressive neoplasms, and around 91% have metastases at the time of initial diagnosis. An elevated serum NSE (neuron-specific enolase) level can also help you confirm the diagnosis. You can still get the Ki67 index done on the remaining tissue, and you can still get the diagnosis reviewed at another center if you have doubt. In my opinion, a thorough search for metastatic deposits should be done at this stage, and treatment (chemo/radiation) should be started as soon as possible. Take care and all the best.