Shanmugasundaram Rajaian, Ashwin Shekar Paulraj, Lakshman Murugesan, Premanand Sengottaiyan
Mucinous cystic neoplasms of the pancreas are the most common pancreatic cystic neoplasms. A 54-year-old female presented with an abdominal mass and was diagnosed to have a multilocular hydatid cyst from the left kidney by imaging. During surgery, a large thick-walled cyst with multiple loculi was seen arising from the upper pole of the left kidney and adherent to the distal pancreas and splenic vessels. The cyst was completely excised without hilar clamping. Histopathological examination confirmed mucinous cystadenoma arising from the pancreas...
April 2020: Urology Annals
Hamza N Gokozan, Claire W Michael
BACKGROUND: Fine needle aspiration (FNA) of the pancreas is considered the primary and least invasive diagnostic method in the evaluation of pancreatic lesions. A nondiagnostic sample may trigger repeat FNA or a more invasive diagnostic procedure. The goal of this study was to identify the root causes of nondiagnostic samples. METHODS: We performed a retrospective review of FNAs of the pancreas categorized as nondiagnostic at our institution between 2008 and 2019...
June 11, 2020: Cancer Cytopathology
Amy Sara Abraham, Betty Simon, Anu Eapen, Kirthi Sathyakumar, Anuradha Chandramohan, Ravish Sanghi Raju, Philip Joseph, Thomas Alex Kodiatte, Mahasampath Gowri
Objectives: The aim of the study was to evaluate the accuracy of computed tomography/magnetic resonance imaging (CT/MRI) in characterizing cystic lesions of the pancreas and in differentiating between benign and malignant/potentially malignant lesions. Material and Methods: A retrospective study was performed on patients with pancreatic cystic lesions who underwent pre-operative imaging and surgery between October 2004 and April 2017 at a tertiary care teaching hospital...
2020: Journal of Clinical Imaging Science
Dimitrios Massaras, Eirini V Pantiora, John Koutalas, Elias C Primetis, Georgios P Fragulidis
Serous cystadenocarcinoma of the pancreas is a rare but well-established entity. The origin and evolution of this disorder remain unclear, but even metastatic cases have an excellent prognosis. These tumors are very similar to benign serous cystic neoplasms (SCNs) of the pancreas, except that they tend to be larger, are locally invasive, and present distant metastasis. The most frequent local invasion is adjacent vessels, spleen, stomach, and duodenum. The most common site of distant metastasis is the liver...
April 17, 2020: Curēus
Rumi Matono, Mizuki Ninomiya, Kazutoyo Morita, Takahiro Tomino, Yumi Oshiro, Tomoyuki Yokota, Takashi Nishizaki
BACKGROUND: Intraductal papillary neoplasm of the bile duct (IPNB) is characterized by an intraluminal, growing papillary tumor covered by neoplastic biliary epithelial cells with a fine fibrovascular core. IPNB was introduced as a precancerous and early neoplastic lesion in the 2010 World Health Organization classification of tumors of the digestive system. IPNB eventually invades the bile duct wall and progresses to invasive cholangiocarcinoma. IPNB resembles intraductal papillary mucinous neoplasm of the pancreas (IPMN), particularly the main pancreatic duct type...
May 15, 2020: Surgical Case Reports
Jae Seung Kang, Hyo Jun Kim, Yoo Jin Choi, Yoonhyeong Byun, Jeong Min Lee, Youngmin Han, Hongbeom Kim, Wooil Kwon, Jin-Young Jang
Purpose: Serous cystic neoplasm (SCN) of the pancreas is considered benign in most cases. However, some SCN patients undergo surgical resection because lesions could not be differentiated preoperatively. This study evaluated causes of resection for SCN, investigated clinical and radiological features of surgically resected SCNs, and compared characteristics of SCNs diagnosed accurately and those misdiagnosed. Methods: One hundred patients, who underwent surgery for pancreatic cystic tumors with pathological confirmation of SCN between 2000 and 2014 were retrospectively analyzed...
May 2020: Annals of Surgical Treatment and Research
Takuya Sakamoto, Yutaka Takeda, Yoshiaki Ohmura, Yoshiteru Katsura, Ayako Imada, Koki Takase, Keisuke Toya, Yoshirou Yukawa, Kenji Kawai, Kohei Murakami, Yoshinori Kagawa, Toru Masuzawa, Atsushi Takeno, Taishi Hata, Kohei Murata
Although accessory spleens are often found in clinical practice, it is rare to identify cystic disease in an intrapancreatic accessory spleen. Here, we report a case of an epithelial cyst that occurred in the intrapancreatic accessory spleen. The patient was a 54-year-old male. Liver dysfunction was identified by the primary care doctor, and abdominal CT showed a tumorous lesion in the pancreatic tail. The patient was then referred to our hospital. Contrast-enhanced CT revealed a multilocular cystic lesion in the pancreatic tail...
April 2020: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Kyoko Sakaguchi, Yu Kuroda, Hiroyuki Sugo, Ikuo Watanobe, Michio Machida, Kuniaki Kojima, Shunsuke Nagase, Kanako Ogura
Spindle cell type anaplastic carcinoma of the pancreas is extremely rare and has a very poor prognosis. A previously healthy 68-year-old woman was referred to our hospital due to a large tumor in the body of the pancreas. Abdominal computed tomography revealed an irregular, well-enhanced 140-mm tumor containing a cystic component. The patient underwent distal pancreatectomy for a possible malignant tumor (e.g., mucinous cystic neoplasms). Histological examination showed that the tumor contained spindle-shaped cells and adenocarcinoma with nuclear atypia, and a definitive diagnosis of anaplastic carcinoma spindle cell type was made...
2020: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Yangzom D Bhutia, Jiro Ogura, Paul J Grippo, Carolina Torres, Toshihiro Sato, Mitchell Wachtel, Sabarish Ramachandran, Ellappan Babu, Sathish Sivaprakasam, Devaraja Rajasekaran, Bradley Schniers, Nhu On, Logan Smoot, Muthusamy Thangaraju, Jaya P Gnana-Prakasam, Vadivel Ganapathy
Based on the evidence that hemochromatosis, an iron-overload disease, drives hepatocellular carcinoma, we hypothesized that chronic exposure to excess iron, either due to genetic or environmental causes, predisposes an individual to cancer. Using pancreatic cancer as our primary focus, we employed cell culture studies to interrogate the connection between excess iron and cancer, and combined in vitro and in vivo studies to explore the connection further. Ferric ammonium citrate was used as an exogenous iron source...
March 2020: Asian journal of pharmaceutical sciences
Naohisa Kuriyama, Tomohide Hatanaka, Kazuaki Gyoten, Aoi Hayasaki, Takehiro Fujii, Yusuke Iizawa, Hiroyuki Kato, Yasuhiro Murata, Akihiro Tanemura, Masashi Kishiwada, Hiroyuki Sakurai, Shugo Mizuno
BACKGROUND: Portal annular pancreas (PAP) is a rare pancreatic anomaly in which the uncinate process wraps annularly around the portal vein and fuses to the body of the pancreas. PAP is highly relevant to the development of postoperative pancreatic fistula (POPF) in pancreatic surgery. Here, we describe our experience and surgical technique of laparoscopic spleen-preserving distal pancreatectomy using Warshaw's procedure for patients with the PAP. CASE PRESENTATION: A 49-year-old woman with PAP was referred to our hospital for a suspicious mucinous cystic neoplasms 1...
May 1, 2020: Surgical Case Reports
Takashi Muraki, Michelle D Reid, Burcin Pehlivanoglu, Raul S Gonzalez, Aarti Sekhar, Bahar Memis, Yue Xue, Jeanette Cheng, Kee-Taek Jang, Pardeep Mittal, Kenneth Cardona, David A Kooby, Shishir Maithel, Juan M Sarmiento, Bassel El-Rayes, Gwen Lomberk, Raul A Urrutia, Kathleen Christians, Susan Tsai, Douglas B Evans, Volkan Adsay
BACKGROUND: The cause of most pancreatic and periampullary cancers (PAC) is unknown. Recently, anatomic variations such as pancreatobiliary maljunction have been recognized as risk factors, similar to Barrett-related gastro-esophageal cancers. METHODS: Pre-operative MRI from 860 pancreatic/biliary resections, including 322 PACs, were evaluated for low-union (cystic duct joining the common hepatic duct inside of the pancreas or within 5 mm of the pancreatic border) RESULTS: Low-union, seen <10% of the population, was present in 44% of PACs (73% distal bile duct/cholangiocarcinoma, 42% pancreatic head, and 34% ampullary)...
April 23, 2020: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Margaret G Keane, Hannah R Dadds, Ghassan El Sayed, Tu Vinh Luong, Brian R Davidson, Guiseppe K Fusai, Douglas Thorburn, Stephen P Pereira
Background: Pancreatic cystic lesions (PCL) are being detected with increasing frequency. Current methods of stratifying risk of malignant transformation are imperfect. This study aimed to determine the frequency of pancreatic malignancy in patients with PCL and define clinical and radiological features that predict malignant transformation in patients managed by surgery and/or surveillance. Methods: A retrospective cohort of adults who were evaluated in a tertiary hepatopancreaticobiliary centre between January 2000 - December 2013 with a confirmed PCL and followed up for at least 5 years...
January 16, 2020: AMRC open research
A Bararia, S Dey, S Gulati, S Ghatak, S Ghosh, S Banerjee, N Sikdar
BACKGROUND: Pancreatic cancer is one of the most lethal diseases with an incidence almost equal to the mortality. In addition to having genetic causes, cancer can also be considered an epigenetic disease. DNA methylation is the premier epigenetic modification and patterns of aberrant DNA methylation are recognized to be a common hallmark of human tumor. In the multistage carcinogenesis of pancreas starting from precancerous lesions to pancreatic ductal adenocarcinoma (PDAC), the epigenetic changes play a significant role...
April 8, 2020: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Sabrina Gloria Giulia Testoni, Andrew James Healey, Christoph F Dietrich, Paolo Giorgio Arcidiacono
The development of curvilinear-array EUS and EUS-guided fine-needle aspiration (EUS-FNA) has led these approaches to become interventional procedures rather than purely diagnostic, as a minimally invasive antitumor therapeutic alternative to radiological and surgical treatments. The possibility to accurately position needle devices and to reach a deep target like the pancreas gland under real-time imaging guidance has expanded the use of EUS to ablate tumors. Currently, a variety of probes specifically designed for EUS ablation are available, including radiofrequency, hybrid cryothermal ablation (combining radiofrequency with cryotechnology), photodynamic therapy, and laser ablation...
March 2020: Endoscopic Ultrasound
Li Lian Kuan, Ashley R Dennison, Giuseppe Garcea
Intraductal tubulopapillary neoplasms (ITPNs) of the pancreas and bile duct are contemporary entities. It is unclear on how to best manage patients with this diagnosis because little is known about its progression to cancer. This review provides an update on the current knowledge of ITPN of the pancreas and bile duct with an overview of clinical, radiological, histopathological, and molecular features, as well as the prognosis and management. Embase and Medline databases search were performed to identify studies that evaluated ITPN of the pancreas and bile duct...
April 2020: Pancreas
Oshan Basnayake, Pradeep Wijerathne, Umesh Jayarajah, Nilesh Fernandopulle, Sivasuriya Sivaganesh
Background: Intraductal papillary mucinous neoplasms (IPMN) of the pancreas complicated by fistula formation to adjacent organs are an uncommon phenomenon. We present an IPMN of the pancreas with malignant transformation and multiple fistulae to the stomach and duodenum. Case Presentation . A 50-year-old female was referred for investigation of recent epigastric pain and a past history of recurrent pancreatitis. Imaging with computed tomography showed a gross dilatation of the entire pancreatic duct with a heterogeneous enhancement of the periductal parenchyma...
2020: Case Reports in Surgery
Ben-Jian Gao, Jia Luo, Ying Liu, Fu-Rui Zhong, Qing-Xi Guo, Fang-Yi Peng, Xiao-Li Yang, Song Su, Bo Li
INTRODUCTION: Solid pseudopapillary neoplasm (SPN) is a rare pancreatic tumor that mainly affects young women. It is a low-grade malignant neoplasm, with an excellent prognosis after surgical treatment. We report herein a case of SPN presenting with ascites that was misdiagnosed as pancreatic tuberculosis (TB). CASE REPORT: A 16-year-old female initially presented with a large volume of ascites. Contrast-enhanced ultrasound and computed tomography found a heterogeneous lesion in the pancreatic body, which had slight contrast enhancement on the arterial phase...
2020: International Journal of Clinical and Experimental Pathology
Jiyoung Wang, Won Jun Kang, Hojin Cho
A 33-year-old man was evaluated because of an incidentally found cyst in the pancreatic tail, which was first seen 6 years ago. The cyst was a unilocular cystic mass, 13.0 cm in diameter, and had increased in size in last 2 months. On F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), the cystic wall showed increased FDG uptake. The patient underwent distal pancreatectomy with suspicion of mucinous cystic neoplasm of the pancreas. The mass turned out to be a squamous carcinoma arising from an epidermoid cyst in an intrapancreatic accessory spleen (ECIPAS)...
February 2020: Nuclear Medicine and Molecular Imaging
W L Li, Y D Xu, X Han, W C Wu, W H Lou
Objective: To examine clinic pathological features of mucinous cystic neoplasms (MCN) of the pancreas and explore the prognosis factors associated with malignant transformation of MCN of the pancreas. Methods: This multicenter retrospective study included all patients with pancreatic MCN underwent surgery at Department of Pancreatic Surgery, Zhongshan Hospital of Fudan University between January 2008 and December 2018 and patients with MCN who confirmed by postoperative pathology from Multicenter Pancreatic Cystic Tumor Database...
March 1, 2020: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Atsuro Fujinaga, Teijiro Hirashita, Yukio Iwashita, Hiroaki Nakanuma, Kazuhiro Tada, Takashi Masuda, Yuichi Endo, Masayuki Ohta, Hideki Ono, Kazunari Murakami, Masafumi Inomata
BACKGROUND: Pancreatic mucinous cystic neoplasm (MCM) presenting with rupture is extremely rare, and very few studies have followed up patients over the long term after ruptured mucinous cystadenoma (MCA). We report a case of ruptured MCA of the pancreas with recurrence-free survival for 8 years. CASE PRESENTATION: A 28-year-old Japanese woman was admitted to the emergency department of a local hospital after experiencing acute abdominal pain. Abdominal computed tomography revealed massive ascites and the presence of a cystic tumor measuring 60 mm in diameter in the pancreatic tail...
March 16, 2020: Surgical Case Reports
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