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 difficult tumors to clinically and histopathologically distinguish as benign or malignant.
• Moreover, endocrine neoplasm provide an extremely important model for studying the important molecular changes that lead to carcinogenesis because of their diverse clinical behavior, even when having the same TNM stage and histologic features.
• The Endocrine Surgery Section of the Surgery Branch, NCI has a focus on studying the molecular changes that are involved in Endocrine Cancer initiation and progression. 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 identify diagnostic and predictive markers, as well as, therapeutic targets that may have significant clinical ramifications. Some of the patients enrolled in this study may be on other protocols throughout the NIH, for which our Section is consulted in order to perform their operation.

Objectives:

Primary Objective:

- To develop a genetic and epigenetic profile of endocrine neoplasm that will allow us to distinguish benign from malignant tumor 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 and epigenetic (methylation) changes.
• To obtain, when accessible, normal endocrine and other adjacent 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. or patients with a described pre or potentially malignant condition that requires surgery or biopsy as a part of the standard of care treatment and/or follow up.
• 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, and paragangliomas and or extraadrenal rests of neuroendocrine tissue.
• Tissue and blood will be processed at the time of collection, stored and then transferred to Dr. Kebebew's laboratory for further processing.
• No investigational therapy will be given.
• It is anticipated that 1350 patients will be enrolled over a period of 16 years.