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Pancreatic neoplasm

Kwangwoo Nam, Jun-Ho Choi
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas runs along a large spectrum from benign adenoma to invasive carcinoma.(1) Fistulas between the pancreas and adjacent organs, such as the duodenum, bile duct, and stomach, have been reported,(2-4) but benign pancreaticogastric fistulas have rarely been reported.(5) Herein, we report a patient who was diagnosed with main duct type pancreatic IPMN complicated with spontaneous pancreaticogastric fistula formation. This article is protected by copyright...
October 26, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Domenico Tamburrino, Stefano Partelli, Claudio Renzi, Stefano Crippa, Francesca Muffatti, Carolina Perali, Amilcare Parisi, Julius Randolph, Giuseppe Kito Fusai, Roberto Cirocchi, Massimo Falconi
BACKGROUND: The safety of laparoscopic resections (LPS) of pancreatic neuroendocrine neoplasms (PNENs) has been well established in the literature. METHODS: Studies conducted between January 2003 and December 2015 that reported on LPS and open surgery (OPS) were reviewed. The primary outcomes were the rate of post-operative complications and the length of hospital stay (LoS) after laparoscopic and open surgical resection. The rate of recurrence was the secondary outcome...
October 26, 2016: Expert Review of Gastroenterology & Hepatology
Kathrin Fielitz, Kristina Althoff, Katleen De Preter, Julie Nonnekens, Jasmin Ohli, Sandra Elges, Wolfgang Hartmann, Günter Klöppel, Thomas Knösel, Marc Schulte, Ludger Klein-Hitpass, Daniela Beisser, Henning Reis, Annette Eyking, Elke Cario, Johannes H Schulte, Alexander Schramm, Ulrich Schüller
Amplification or overexpression of MYCN is involved in development and maintenance of multiple malignancies. A subset of these tumors originates from neural precursors, including the most aggressive forms of the childhood tumors, neuroblastoma and medulloblastoma. In order to model the spectrum of MYCN-driven neoplasms in mice, we transgenically overexpressed MYCN under the control of the human GFAP-promoter that, among other targets, drives expression in neural progenitor cells. However, LSL-MYCN;hGFAP-Cre double transgenic mice did neither develop neural crest tumors nor tumors of the central nervous system, but presented with neuroendocrine tumors of the pancreas and, less frequently, the pituitary gland...
October 19, 2016: Oncotarget
Rahul Pannala, Karyn M Hallberg-Wallace, Amber L Smith, Aziza Nassar, Jun Zhang, Matthew Zarka, Jordan P Reynolds, Longwen Chen
INTRODUCTION: The increasing use of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) cytology to examine pancreatic neoplasms has led to an increase in the diagnosis of metastases to the pancreas. Renal cell carcinoma (RCC) is the most common metastasis to the pancreas. Our study examines 33 cases of metastatic RCC to the pancreas sampled by EUS-FNA from four large tertiary care hospitals. MATERIALS AND METHODS: We searched the cytopathology database for RCC metastatic to the pancreas diagnosed by EUS-FNA from January 2005 to January 2015...
2016: CytoJournal
Lauren M Postlewait, Cecilia G Ethun, Mia R McInnis, Nipun Merchant, Alexander Parikh, Kamran Idrees, Chelsea A Isom, William Hawkins, Ryan C Fields, Matthew Strand, Sharon M Weber, Clifford S Cho, Ahmed Salem, Robert C G Martin, Charles Scoggins, David Bentrem, Hong J Kim, Jacquelyn Carr, Syed Ahmad, Daniel E Abbott, Gregory C Wilson, David A Kooby, Shishir K Maithel
Importance: Pancreatic mucinous cystic neoplasms (MCNs) harbor malignant potential, and current guidelines recommend resection. However, data are limited on preoperative risk factors for malignancy (adenocarcinoma or high-grade dysplasia) occurring in the setting of an MCN. Objectives: To examine the preoperative risk factors for malignancy in resected MCNs and to assess outcomes of MCN-associated adenocarcinoma. Design, Setting, and Participants: Patients who underwent pancreatic resection of MCNs at the 8 academic centers of the Central Pancreas Consortium from January 1, 2000, through December 31, 2014, were retrospectively identified...
October 19, 2016: JAMA Surgery
Nitya Raj, Emily Valentino, Marinela Capanu, Laura H Tang, Olca Basturk, Brian R Untch, Peter J Allen, David S Klimstra, Diane Reidy-Lagunes
OBJECTIVES: Emerging data suggest that not all grade 3 (G3) pancreatic neuroendocrine neoplasms (panNENs) behave the same; tumor differentiation may predict outcome. METHODS: Patients with G3 panNENs treated at our institution between 1999 and 2014 were identified. Demographics, response to therapy, and overall survival were determined. RESULTS: Forty-five patients were identified, 16 with G3 well differentiated pancreatic neuroendocrine tumors (WD-panNETs) and 29 with poorly differentiated neuroendocrine carcinomas (PDNEC)...
October 18, 2016: Pancreas
Yugang Cheng, Hanxiang Zhan, Lei Wang, Jianwei Xu, Guangyong Zhang, Zongli Zhang, Sanyuan Hu
The incidence rate of pancreatic neuroendocrine neoplasms (pNENs) has increased rapidly in recent years. However, the clinicopathological characteristics of pNENs are poorly understood. Medical records of patients who underwent surgery and were confirmed as pNENs by pathological examination from January 2003 to February 2015 in Qilu Hospital were reviewed retrospectively. A total of 100 patients, 36 males and 64 females, were included with a mean operation age of 46.26 + 13.41 years. Among the 100 cases, 76 had insulinomas and 24 had non-functional pNENs...
October 17, 2016: Frontiers of Medicine
Shinsuke Koshita, Yutaka Noda, Kei Ito, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yoshiharu Masaki, Jun Horaguchi, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Miwa Uzuki, Fumiyoshi Fujishima
BACKGROUND AND AIMS: To elucidate the efficacy of pancreatic juice cytology with the cell block method (CB-PJC) for the determination of surgery in patients with branch duct intraductal papillary mucinous neoplasm (BD-IPMN). METHODS: In 138 patients with BD-IPMN from whom pancreatic juice was collected under ERCP for CB-PJC, we retrospectively evaluated the following: (1) the rate of the CB-PJC successfully evaluated, (2) the ability of CB-PJC for the diagnosis of malignant BD-IPMNs and for the identification of pathological subtypes in resected BD-IPMNs, (3) the rate of development into invasive cancer and progression of BD-IPMNs in patients with BD-IPMN diagnosed as benignancy by CB-PJC, and (4) post-ERCP adverse events...
October 15, 2016: Gastrointestinal Endoscopy
Simon Schimmack, Ben Lawrence, Barton Kenney, Hubertus Schmitz-Winnenthal, Irvin M Modlin, Mark Kidd
BACKGROUND: Small intestinal neuroendocrine neoplasm (SI-NEN) proliferation is quantified by Ki67 measurements which capture G1-G2M phases of the cell cycle. G0 and early G1 phases, typical of slow-growing cells, can be detected by minichromosome maintenance protein (MCM) expression. We hypothesized that these replication licensing markers may provide clinically relevant information to augment Ki67 in low-grade neuroendocrine neoplasia. METHODS: Immunohistochemical staining (IHC), Western blot analysis, quantitative polymerase chain reaction, and copy number variations of MCM2, MCM3, and Ki67 were undertaken in SI-NENs (n = 22)...
October 2016: Translational Oncology
W G P Kanchana, R A A Shaminda, K B Galketiya, V Pinto, D Walisinghe, S Wijetunge, R Heendeniya
Background. Solid Pseudopapillary Tumours of the pancreas are a rare entity and more commonly seen in women than in men. These tumours have typically reached large sizes when clinically detected. Case Description. A 21-year-old male was found to have a left hypochondrial mass on physical examination following a trivial soft tissue injury. Contrast-enhanced computed topography (CT) of the abdomen showed a 10.3 × 7.6 × 10.3 cm size arising from the body and the tail of the pancreas. He underwent laparoscopic resection of distal pancreatic tumour en bloc with spleen...
2016: Case Reports in Gastrointestinal Medicine
Alyssa M Krasinskas, Gerard J Oakley, Pelin Bagci, Kee-Taek Jang, Shih-Fan Kuan, Michelle D Reid, Ipek Erbarut, Volkan Adsay
Pancreatic cysts >1 cm lined by nonpapillary mucinous epithelium without ovarian-type stroma pose diagnostic challenges. The term "simple mucinous cyst" was recently proposed for this entity. Our goal was to determine the clinicopathologic characteristics of these cysts, as they have not been previously described. Of the 39 patients with pancreatic resections included in this study, the mean age was 65 years and the female-to-male ratio was 4:1. The characteristics of the cysts are as follows: 82% had elevated cyst fluid carcinoembryonic antigen levels, 67% were unilocular, 69% occurred in the body/tail, 92% did not communicate with pancreatic ducts, the mean size was 2...
October 12, 2016: American Journal of Surgical Pathology
Verena Plodeck, Ulrich Sommer, Gustavo B Baretton, Daniela E Aust, Michael Laniado, Ralf-Thorsten Hoffmann, Ivan Platzek
Pancreatic endometriosis is very rare with only a few cases reported in the literature. The imaging features are non-specific and the definitive diagnosis is usually only established after surgery. We report on a 68-year-old woman with left upper quadrant pain who demonstrated a mass in the pancreatic tail on imaging. Laboratory results showed only mildly elevated liver enzymes, tumor markers were within the normal range. A left pancreatectomy was performed, frozen section suggesting a benign lesion, and final histopathology confirmed endometriotic cysts...
September 2016: Acta Radiologica Open
Raffaele Pezzilli, Lucia Calculli, Gianvico Melzi d'Eril, Alessandra Barassi
BACKGROUND: Serum cancer antigen 19-9 (CA19-9) provides additional information about mucinous cystic pancreatic neoplasm (MPN). This study was undertaken to assess both CA19-9 and carcinoembryonic antigen (CEA) serum concentrations in consecutive patients affected by MPNs and other chronic benign and malignant pancreatic diseases. We also evaluated whether serum CA19-9 and CEA determinations provide additional information such as the presence of invasive carcinoma in MPN patients. METHODS: Serum CA19-9 and CEA from 91 patients with pancreatic diseases were tested by commercially available kits at the time of diagnosis...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Faiyaz Notta, Michelle Chan-Seng-Yue, Mathieu Lemire, Yilong Li, Gavin W Wilson, Ashton A Connor, Robert E Denroche, Sheng-Ben Liang, Andrew M K Brown, Jaeseung C Kim, Tao Wang, Jared T Simpson, Timothy Beck, Ayelet Borgida, Nicholas Buchner, Dianne Chadwick, Sara Hafezi-Bakhtiari, John E Dick, Lawrence Heisler, Michael A Hollingsworth, Emin Ibrahimov, Gun Ho Jang, Jeremy Johns, Lars G T Jorgensen, Calvin Law, Olga Ludkovski, Ilinca Lungu, Karen Ng, Danielle Pasternack, Gloria M Petersen, Liran I Shlush, Lee Timms, Ming-Sound Tsao, Julie M Wilson, Christina K Yung, George Zogopoulos, John M S Bartlett, Ludmil B Alexandrov, Francisco X Real, Sean P Cleary, Michael H Roehrl, John D McPherson, Lincoln D Stein, Thomas J Hudson, Peter J Campbell, Steven Gallinger
Pancreatic cancer, a highly aggressive tumour type with uniformly poor prognosis, exemplifies the classically held view of stepwise cancer development. The current model of tumorigenesis, based on analyses of precursor lesions, termed pancreatic intraepithelial neoplasm (PanINs) lesions, makes two predictions: first, that pancreatic cancer develops through a particular sequence of genetic alterations (KRAS, followed by CDKN2A, then TP53 and SMAD4); and second, that the evolutionary trajectory of pancreatic cancer progression is gradual because each alteration is acquired independently...
October 12, 2016: Nature
Lester J Layfield, Robert L Schmidt, Jack Campbell, Magda Esebua
BACKGROUND: Papanicolaou Society of Cytopathology guidelines place low- and intermediate-grade pancreatic endocrine tumors into the "neoplastic, other" category whereas high-grade pancreatic endocrine tumors are placed in the "malignant" category. No attempt was made to stratify pancreatic endocrine tumors in the "neoplastic, other" category by likelihood for metastases. Histologically, pancreatic endocrine tumors are divided into well, intermediate, and poorly differentiated examples based on mitotic count and Ki-67 proliferation index (PI)...
2016: CytoJournal
Hazem M Zakaria, John A Stauffer, Massimo Raimondo, Timothy A Woodward, Michael B Wallace, Horacio J Asbun
AIM: To identify the current indications and outcomes of total pancreatectomy at a high-volume center. METHODS: A single institutional retrospective study of patients undergoing total pancreatectomy from 1995 to 2014 was performed. RESULTS: One hundred and three patients underwent total pancreatectomy for indications including: Pancreatic ductal adenocarcinoma (n = 42, 40.8%), intraductal papillary mucinous neoplasms (n = 40, 38.8%), chronic pancreatitis (n = 8, 7...
September 27, 2016: World Journal of Gastrointestinal Surgery
Jason R Audlin, Gaurav Khullar, Eric M Deshaies, Swamy Kurra, William F Lavelle
BACKGROUND: Carcinoid tumors are rare neoplasms that often arise from the gastrointestinal or respiratory tracts. They often metastasize to bone tissue, as well as pancreatic and hepatic sites. The central nervous system and most specifically the spinal cord are rarely involved. Primary Carcinoid tumors of the CNS are even rarer. CASE DESCRIPTION: A 58 year-old man presented with progressive bilateral lower extremity weakness and a negative history of cancer. Imaging revealed an intradural mass at the L1 and L2 spinal levels...
October 3, 2016: World Neurosurgery
Łukasz Michalak, Magdalena Bulska, Katarzyna Kudłacz, Piotr Szcześniak
Neutrophil gelatinase-associated lipocalin, known also as 24p3 lipocalin, lipocalin-2 or uterocalin (in mouse), is a small secretory protein binding small molecular weight ligands which takes part in numerous processes including apoptosis induction in leukocytes, iron transport, smell, and prostaglandins and retinol transport [19]. It was discovered in activated neutrophils as a covalent peptide associated with human gelatinase neutrophils [7]. Neutrophil lipocalin is secreted physiologically in the digestive system, respiratory tract, renal tubular cells, liver or immunity system...
January 4, 2016: Postȩpy Higieny i Medycyny Doświadczalnej
S Partelli, R Cirocchi, S Crippa, L Cardinali, V Fendrich, D K Bartsch, M Falconi
BACKGROUND: The incidence of asymptomatic, sporadic, small non-functioning pancreatic neuroendocrine neoplasms (NF-PNENs) has increased in recent decades. Conservative treatment has been advocated for these tumours. The aim of this study was systematically to evaluate the literature on active surveillance and to compare this with surgical management for asymptomatic sporadic small NF-PNENs. METHODS: PubMed, Embase and the Cochrane Library were searched systematically for studies that compared the active surveillance of asymptomatic, sporadic, small NF-PNENs with surgical management...
October 5, 2016: British Journal of Surgery
Shuji Suzuki, Hideki Kajiyama, Akira Takemura, Jiro Shimazaki, Kiyotaka Nishida, Mitsugi Shimoda
BACKGROUND: Total pancreatectomy (TP) is not more beneficial than less aggressive resection techniques for the treatment of pancreatic neoplasms and is associated with high morbidity and mortality. However, with advances in surgical techniques and glycemic monitoring, and the development of synthetic insulin and pancreatic enzymes for postoperative treatment, TP has been increasingly indicated. This is a review of the recent literature reporting the clinical outcomes after TP. METHODS: We reviewed the publications reporting the use of TP starting 2007...
October 5, 2016: Digestive Surgery
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