Maria Ahmad, Felipe B Maegawa, Elizabeth De La Rosa, Brian Davis, Alan Tyroch, Ioannis T Konstantinidis
BACKGROUND: Mucinous Cystic Neoplasms are mucin producing cysts of the pancreas with malignant potential. The existing literature on treatment outcomes is limited to relatively small surgical series. METHODS: We reviewed the National Cancer Database assessing the outcomes of patients with mucinous cystic neoplasms between 2004 and 2016. Kaplan-Meier method and log rank test were used to make survival comparisons. RESULTS: A total of 707 patients were identified; 492(69...
September 6, 2020: American Journal of Surgery
Wooil Kwon, Youngmin Han, Yoonhyeong Byun, Jae Seung Kang, Yoo Jin Choi, Hongbeom Kim, Jin-Young Jang
The current guidelines on branch duct type intraductal papillary mucinous neoplasm (BD-IPMN) recommend various predictive features of malignancy as well as different treatment strategies. This study aimed to identify the risk factors for malignancy with higher level of evidence. A meta-analysis was performed on 40 literatures published between 2000 and 2019. These literatures included 6301 patients with pathologically proven IPMN. Malignancy was defined as high-grade dysplasia and invasive carcinoma. It was significantly associated with symptoms (odds ratio [OR] 1...
September 14, 2020: Cancers
Soodeh Sagheb, Ur Metser, Suzan Razaz, Ravi Menezes, Steven Gallinger, Kartik S Jhaveri
OBJECTIVES: The aim of the study was to evaluate preliminary feasibility of 18F-FDG-PET/MRI in differentiation of pancreatic serous cystic neoplasms (SCNs) from non-SCNs. METHODS: From August 2017 to June 2019, 10 patients (3 men, 7 women; mean age, 63 years) previously diagnosed with pancreatic cystic neoplasm underwent simultaneous 18F-FDG-PET/MRI prospectively on an integrated 3-Tesla hybrid PET/MRI scanner. PET images were analyzed visually and semiquantitatively measuring standardized uptake values (SUV) including lesion SUVmax and SUVmean, lesion to pancreas and lesion to liver SUVmax and SUVmean ratio independent of MRI diagnosis...
September 5, 2020: Nuclear Medicine Communications
Etsuko Hisanaga, Takaaki Sano, Norio Kubo, Norihiro Ishii, Ken Shirabe, Hitoshi Takagi, Junko Hirato, Hayato Ikota
A woman in her 70 s was diagnosed with a tumor in her duodenal wall during a routine visit for diabetes. She subsequently underwent subtotal stomach-preserving pancreatoduodenectomy. Histologically, the tumor was present mainly in the duodenal wall, and atypical cystic ducts were seen in the muscularis propria and subserosa. Invasive well-differentiated adenocarcinoma was seen in the duodenal submucosal and mucosal layers. Heterotopic pancreatic tissue was seen within the tumor, and atypical epithelium had proliferated and replaced the cystic ductal epithelium of the heterotopic pancreas...
September 10, 2020: Clinical Journal of Gastroenterology
Hiroaki Okuse, Reiko Yamada, Kyosuke Tanaka, Noriyuki Horiki, Yoshiyuki Takei
A 45-year-old woman presented with upper abdominal and back pain. A cystic lesion in the pancreas and inflammation around the splenic artery were detected by computed tomography. Although imaging studies were difficult to exclude malignancy, pathological and cytological findings of a fine-needle aspiration showed no signs of malignancy. The patient was, therefore, followed-up for 3 months, during which time the cyst increased in size and developed a cyst-in-cyst structure. She was diagnosed with mucinous cyst neoplasm and underwent distal pancreatectomy...
September 9, 2020: Clinical Journal of Gastroenterology
Catherine E Hagen, Kathleen Christians, Amanda Hopp, Tamara Giorgadze, Christopher P Hartley, Bryan Hunt, Olca Basturk, David Klimstra
We correlate the cytologic and histologic features of a squamous-lined pancreatic cystic lesion with a complex papillary architecture and an associated KRAS mutation, which to our knowledge has not been previously described. A 69 year-old woman presented with intermittent left upper quadrant pain. CT imaging revealed a 1 cm solid lesion in the pancreatic tail with peripheral calcification. Endoscopic ultrasound-guided fine needle biopsy showed a proliferation of epithelial cells with fibrovascular cores. An immunohistochemical stain for p40 was positive in the lesional cells...
August 13, 2020: Annals of Diagnostic Pathology
Rachel H S Park, Grace R S Lim, Jania J Y Wu, Ye-Xin Koh, Jin-Yao Teo, Peng-Chung Cheow, Chung-Yip Chan, London L P J Ooi, Alexander Y F Chung, Brian K P Goh
INTRODUCTION: Over the years, several guidelines have been introduced to guide management of mucinous pancreatic cystic neoplasms (mPCN). In this study, we aimed to evaluate and compare the clinically utility of the Sendai-06, Fukuoka-12, Fukuoka-17 and European-18 guidelines in predicting malignancy of mPCN. METHODS: One hundred and eighty-eight patients with mucinous cystic neoplasms (MCN) or intraductal papillary mucinous neoplasm (IPMN) who underwent surgery were retrospectively reviewed and classified under the 4 guidelines...
July 25, 2020: European Journal of Surgical Oncology
Yu Liu, Changxin Wang, Xiaofeng Hu, Minrui Wang, Ying Wang, Mingshan Ye, Ying Liu
INTRODUCTION: Pancreatic pseudocyst is one of the most common cystic lesions. It always occurs following pancreatitis and is rarely found in combination with pancreatic adenocarcinoma. The coexistence of exocrine and neuroendocrine tumors of the pancreas is also infrequent. We herein report a case of simultaneous occurrence of a pancreatic ductal adenocarcinoma (PDAC), pseudocyst, and neuroendocrine tumor (NET), showing a "side-by-side pattern." PATIENT CONCERN: A 74-year-old man was hospitalized for epigastric pain and poor appetite...
July 24, 2020: Medicine (Baltimore)
Keiso Matsubara, Michihiro Ishida, Toshiaki Morito, Tetsushi Kubota, Yasuhiro Choda, Masao Harano, Hiroyoshi Matsukawa, Hitoshi Idani, Shigehiro Shiozaki, Masazumi Okajima
INTRODUCTION: Gastric heterotopic pancreas (HP) is usually asymptomatic and benign; however, it may become evident when it is complicated by pathological changes such as inflammation, bleeding, and malignant transformation. PRESENTATION OF CASE: A 43-year old man was diagnosed with gastric HP 18 years prior suffered a haemorrhage from the enlarged gastric HP with multiple cystic lesions. Although endoscopic ultrasonography-guided fine needle aspiration showed no malignancy, he underwent a partial gastrectomy for diagnosis and treatment...
July 15, 2020: International Journal of Surgery Case Reports
Fernando Revoredo, José de Vinatea, Gustavo Reaño, Luis Villanueva, Fritz Kometter, José Arenas, Patricio M Polanco
RATIONALE: Although rare, pancreatic neoplasms can occur during pregnancy, both in benign and malignant forms. Mucinous cystic neoplasms (MCNs) of the pancreas, a type of these neoplasms, are precursor lesions to invasive pancreatic cancer. The presence of the ovarian-type stroma is a defining feature. PATIENT CONCERNS: The first case was a 38-year-old woman in her 18th week of pregnancy with abdominal pain that worsens a few weeks later. The second case was a 30-year-old woman in her 17th week of pregnancy with abdominal pain in the left hypochondrium...
July 31, 2020: Medicine (Baltimore)
Łukasz Liszka
Undifferentiated carcinoma of the pancreas (UC) is a carcinoma without a definitive direction of differentiation. Tumour protein p63 is a regulator of squamous phenotype, which may also be engaged in tumour development. N-terminal isoforms of p63 are TAp63 and ΔNp63. Pan-p63 antibodies are able to detect both isoforms, whereas p40 antibodies recognise the ΔNp63 isoform only. The aim of the study was to describe pan-p63/p40 immunohistochemical expression patterns in pancreatic neoplasms: UC, ductal adenocarcinomas, neuroendocrine tumours, neuroendocrine carcinomas, serous cystic neoplasms, and solid pseudopapillary neoplasms...
2020: Polish Journal of Pathology: Official Journal of the Polish Society of Pathologists
Can Cao, Max X Kong, Malathy Kapali, Koorosh Moezardalan, Qiuying Shi, Ali Azarm, Jinping Lai
BACKGROUND: The occurrence of lung adenocarcinoma metastasizing to the pancreas is overall rare and can histologically imitate primary pancreatic ductal carcinoma (PDAC). CASE REPORT: This is a case report of a 70-year-old female with a history of surgically resected right lung adenocarcinoma presenting for routine follow up without symptoms. CT scans revealed a pancreatic cystic mass with ductal dilatation that was sampled via endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and thought to be a primary pancreatic mucinous neoplasm with high grade dysplasia suspicious for carcinoma based on smear cytology...
August 2020: Anticancer Research
Mohammed Abdulrahman Alkhateeb, Deena Boqari, Nabeel Khalid Mansi
INTRODUCTION: Acinar cell cystadenoma (ACA) is very rare and benign neoplasm of the pancreas; it arises from the normal acinar parenchyma of the pancreas and may exist as solitary or diffuse lesions. PRESENTATION OF CASE: We here present a case of thirty-seven years old gentleman who incidentally was found to have multifocal cystic lesions distributed throughout the tail, body and uncinate process of the pancreas. DISCUSSION: Pre-operative diagnosis of pancreatic ACA remains very difficult and challenging despite advances in imaging techniques...
2020: International Journal of Surgery Case Reports
Guang-Xian Wang, Zhi-Ping Wang, Hai-Ling Chen, Dong Zhang, Li Wen
PURPOSE: The imaging features of serous cystadenomas (SCAs) overlap with those of mucinous cystic neoplasms (MCNs) and branch duct intraductal papillary mucinous neoplasms (BD-IPMNs), and an accurate preoperative diagnosis is important for clinical treatment due to their different biological behaviors. The aim of this study was to provide a computed tomographic (CT) feature for the diagnosis of SCAs and estimate whether the "circumvascular sign" can contribute to the discrimination of SCAs from MCNs and BD-IPMNs...
July 23, 2020: Abdominal Radiology
Zhi-Ming Zhao, Nan Jiang, Yuan-Xing Gao, Zhu-Zeng Yin, Guo-Dong Zhao, Xiang-Long Tan, Yong Xu, Rong Liu
BACKGROUND: Mucinous cystic neoplasm (MCN) of the pancreas is characterized by mucin-producing columnar epithelium and dense ovarian-type stroma and at risk for malignant transformation. Early diagnosis and treatment of MCN are particularly important. AIM: To investigate the clinical characteristics of and management strategies for pancreatic mucinous cystadenoma (MCA) and mucinous cystadenocarcinoma (MCC). METHODS: The clinical and pathological data of 82 patients with pancreatic MCA and MCC who underwent surgical resection at our department between April 2015 and March 2019 were retrospectively analyzed...
June 15, 2020: World Journal of Gastrointestinal Oncology
Lúcia Carvalho, Tiago Ferreira, Luísa Frutuoso, Leonor Matos, Tiago Castro, Domingos Rodrigues, Vera Oliveira, Gil Gonçalves, Mário Nora, Horácio Scigliano
Mucinous cystic neoplasms (MCNs) of the pancreas occurring during pregnancy constitute a rare condition requiring special management due to its large size, malignant potential and the risk of fetal growth restriction. The key points to manage MCNs are to perform a correct diagnosis, accurately evaluate the grade of malignant potential in order to establish the right time for pancreatic surgery and to choose the most appropriate fetal mode of delivery. We describe a case of an incidental abdominal mass detected in a third-trimester pregnant woman...
July 2020: Journal of Surgical Case Reports
B W Renz, M Ilmer, J G D'Haese, J Werner
Cystic tumors of the pancreas (PCN) have increasingly gained importance in the clinical routine as they are frequently diagnosed as an incidental finding due to the continuous improvement in cross-sectional imaging. A differentiation is made between non-neoplastic and neoplastic cysts, whereby the latter has a tendency to malignant transformation to a varying extent. Therefore, they can be considered as precursor lesions of pancreatic cancer (PDAC). In addition to a detailed patient history and examination, imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS) with fine needle aspiration (FNA) are used for the differential diagnosis...
July 8, 2020: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
H F Kuang, X Q Yan, X F Duan, H Q Bian, J Yang, Z C Zhu
Objective: To investigate the clinical characteristics of pancreatic cystic neoplasms in pediatric patients. Methods: The clinical data of 13 patients with pancreatic cystic neoplasm at Wuhan Children's Hospital from July 2007 to November 2019 were collected.There were 5 males and 8 females, with a mean age of 133 months(range: 9 to 170 months). Eleven patients presented with abdominal pain, vomiting, and a palpable mass. Tumors were located in the pancreatic head( n= 7), body( n= 2) and tail( n= 4), respectively...
July 1, 2020: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Keisuke Noda, Tamotsu Kuroki, Mampei Yamashita, Takanori Hirayama, Koji Natsuda, Shinichiro Kobayashi, Takayuki Tokunaga, Kosho Yamanouchi, Hiroaki Takeshita, Shiro Miura, Shigeto Maeda
BACKGROUND: Pancreatic neuroendocrine tumors (PNETs) are typically solid neoplasms but, in very rare cases, present as cystic lesions. We describe a case of a cystic neuroendocrine tumor that developed as a small cystic lesion. CASE PRESENTATION: In 2011, a 66-year-old Japanese woman underwent computed tomography (CT) that revealed a cystic lesion in the tail of the pancreas measuring 9 mm. She did not have any symptoms. She underwent a CT scan every year thereafter...
June 29, 2020: Surgical Case Reports
Syed M Gilani, Adebowale J Adeniran, Guoping Cai
OBJECTIVES: To evaluate the role of endoscopic ultrasound-guided fine needle aspiration cytology in identifying mucinous cystic lesions (MCLs) in histologically proven cases of intraductal papillary mucinous neoplasm (IPMN) or mucinous cystic neoplasm (MCN) and risk of malignancy associated with each cytologic category based on the Papanicolaou Society of Cytopathology (PSC) guidelines. METHODS: All resected cases with histologic diagnosis of IPMN or MCN at our institution from January 1, 2004, to August 31, 2019, with associated cytology were included...
June 26, 2020: American Journal of Clinical Pathology
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