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intraductal papillary mucinous neoplasms

Shinya Fujie, Hiroyuki Matsubayashi, Hirotoshi Ishiwatari, Hiromasa Hazama, Takaaki Ito, Keiko Sasaki, Hiroyuki Ono
A 70-year-old man was referred to our hospital with exacerbation of diabetes. His blood tests showed elevated levels of serum IgG4 and HbA1c. Computed tomography of the pancreatic body demonstrated a weakly enhanced mass, 2 cm in size, with indistinct borders. Magnetic resonance cholangiopancreatography revealed a narrowing of the main pancreatic duct (MPD) at the pancreatic body, a markedly dilated upstream duct, and a slightly dilated downstream duct. Endoscopic ultrasonography demonstrated an iso-hypoechoic heterogeneous mass, protruding and spreading in the pancreatic duct...
March 2018: Journal of Gastrointestinal and Liver Diseases: JGLD
Valentina Tardivo, Francesca Vincitorio, Matteo Monticelli, Luca Bertero, Francesco Zenga, Alessandro Ducati, Paola Cassoni, Diego Garbossa
BACKGROUND: Brain metastases in pancreatic cancer are a rare condition and are usually seen in case of pancreatic adenocarcinoma. Only few cases of brain metastasis in patients affected by Intraductal papillary mucinous neoplasm (IPMN) are actually reported. CASE DESCRIPTION: We report a patient diagnosed with double cystic brain lesions that the histological examination reveal to be consistent, with pancreatic metastasis. Our patient had an history shown of stable pancreatic IPMN which has never made the oncologist suspicious about neoplastic progression or degeneration into pancreatic carcinoma...
March 20, 2018: British Journal of Neurosurgery
Pablo Cortegoso Valdivia, Mauro Bruno, Silvia Gaia, Giorgio M Saracco, Claudio DE Angelis
We report a rare case of gastric fistulization in a patient with main-duct (MD) intraductal papillary mucinous neoplasm (IPMN). Fistulization to adjacent organs is a rare complication of this disease, mainly affecting the duodenum; the fact that the stomach was the only organ involved makes this case even more peculiar. The diagnosis of the fistula was made after examination with Endoscopic Ultrasound (EUS), since a previous computed tomography (CT) scan wasn't able to detect it.
March 16, 2018: Minerva Gastroenterologica e Dietologica
Ryota Matsuki, Masanori Sugiyama, Shinya Yoshiike, Junji Shibahara, Masaharu Kogure, Masaaki Yokoyama, Yutaka Suzuki, Nobutsugu Abe, Tadahiko Masaki, Toshiyuki Mori
A 72-year-old woman with advanced ascending colon cancer and an intraductal papillary mucinous neoplasm (IPMN) of the pancreatic head was treated by right hemicolectomy (RHC) and pylorus-preserving pancreaticoduodenectomy (PpPD). Adjuvant chemotherapy was not administered. Multimodal examinations at 5 months after surgery detected a solitary metastatic liver tumor derived from cancer of the ascending colon. Liver resection proceeded at 7 months after the first surgery. A pathological study of a surgical specimen of the liver identified a necrotic nodule that did not contain viable tumor cells...
March 15, 2018: Clinical Journal of Gastroenterology
Jennifer M Kolb, Pamela Argiriadi, Karen Lee, Xiaoyu Liu, Emilia Bagiella, Aimee L Lucas, Michelle Kang Kim, Nikhil A Kumta, Satish Nagula, Umut Sarpel, Christopher J DiMaio
BACKGROUND & AIMS: For patients with branch duct intraductal papillary mucinous neoplasms (BD-IPMNs, cysts), it is a challenge to identify those at high risk for malignant lesions. We sought to identify factors associated with development of pancreatic cancer, focusing on neoplasm growth rate. METHODS: We performed a retrospective study of 189 patients with BD-IPMNs who underwent at least 2 contrast-enhanced cross-sectional imaging studies, 1 year or more apart, at a tertiary referral center from January 2003 through 2013...
March 10, 2018: Clinical Gastroenterology and Hepatology
Andrew A Gumbs, Despoina Daskalaki, Luca Milone
Although minimally invasive pancreatectomy has been performed increasingly for pancreatic malignancies, many authors feel that a history of pancreatitis is a contraindication to either laparoscopic or robotic-assisted pancreatectomy. Shown here is a video (Supplemental Digital Content 1, of a laparoscopic total pancreatectomy with splenectomy for chronic pancreatitis. This patient was denied auto-islet cell transplantation because of insurance restraints. In total, 4 laparoscopic total pancreatectomies have been attempted and completed...
March 8, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Naoto Imagawa, Mitsuharu Fukasawa, Ei Takahashi, Hiroko Shindo, Shinichi Takano, Tadashi Sato, Hiromitsu Kawaida, Hideki Fujii, Tadao Nakazawa, Nobuyuki Enomoto
A 77-year-old woman with mild dilatation (4mm) of the main pancreatic duct was referred to our hospital. Contrast-enhanced computed tomography revealed segmental dilatation of the main pancreatic duct in the pancreatic tail, but no mass was noted in the pancreas. Endoscopic ultrasonography showed low papillary lesions in the dilated pancreatic duct. Cytological analysis of the pancreatic juice revealed adenocarcinoma. Distal pancreatectomy was performed for a diagnosis of main duct-intraductal papillary mucinous cancer (MD-IPMC) of the pancreatic tail...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Wanglong Qiu, Helen E Remotti, Sophia M Tang, Elizabeth Wang, Lily Dobberteen, Ayman Lee Youssof, Joo Hee Lee, Edwin C Cheung, Gloria H Su
PanINs and IPMNs are the two most common precursor lesions that can progress to invasive pancreatic ductal adenocarcinoma (PDA). DCLK1 has been identified as a biomarker of progenitor cells in PDA progressed from PanINs. To explore the potential role of DCLK1-expressing cells in the genesis of IPMNs, we compared the incidence of DCLK1-positive cells in pancreatic tissue samples from genetically-engineered mouse models (GEMMs) for IPMNs, PanINs, and acinar to ductal metaplasia by immunohistochemistry and immunofluorescence...
March 8, 2018: Cancer Letters
Valerie Gausman, Pujan Kandel, Priscilla A Van Riet, Maria Moris, Maia Kayal, Catherine Do, John M Poneros, Amrita Sethi, Frank G Gress, Beth A Schrope, Lyndon Luk, Elizabeth Hecht, Manol Jovani, Marco J Bruno, Djuna L Cahen, Michael B Wallace, Tamas A Gonda
OBJECTIVES: Our aim was to identify baseline characteristics associated with disease progression and malignant transformation in low-risk suspected intraductal papillary mucinous neoplasms (IPMNs). METHODS: This is a retrospective cohort study of prospectively maintained databases of pancreatic cysts at 3 international, academic institutions. Five hundred fifty-nine adult patients with clinically suspected asymptomatic IPMN evaluated by radiologic studies or endoscopic ultrasound between 2003 and 2013 without worrisome features and under surveillance for 12 months or longer were included...
April 2018: Pancreas
Matthäus Felsenstein, Michaël Noë, David L Masica, Waki Hosoda, Peter Chianchiano, Catherine G Fischer, Gemma Lionheart, Lodewijk A A Brosens, Antonio Pea, Jun Yu, Georgios Gemenetzis, Vincent P Groot, Martin A Makary, Jin He, Matthew J Weiss, John L Cameron, Christopher L Wolfgang, Ralph H Hruban, Nicholas J Roberts, Rachel Karchin, Michael G Goggins, Laura D Wood
OBJECTIVE: Intraductal papillary mucinous neoplasms (IPMNs) are precursor lesions that can give rise to invasive pancreatic carcinoma. Although approximately 8% of patients with resected pancreatic ductal adenocarcinoma have a co-occurring IPMN, the precise genetic relationship between these two lesions has not been systematically investigated. DESIGN: We analysed all available patients with co-occurring IPMN and invasive intrapancreatic carcinoma over a 10-year period at a single institution...
March 2, 2018: Gut
Hyunsung Kim, Jae Y Ro
Intraductal tubulopapillary neoplasm is a rare tumor that the World Health Organization recognized in 2010 as a subtype of premalignant pancreatic neoplasms. It is important to distinguish it from other intraductal neoplasms, including intraductal papillary mucinous neoplasm, pancreatic ductal adenocarcinoma, and intraductal variant of acinar cell carcinoma, because intraductal tubulopapillary neoplasm has a favorable prognosis. Histopathologically, intraductal tubulopapillary neoplasms are characterized by tubulopapillary growth, uniform high-grade cytologic atypia, frequent necrotic foci, evident ductal differentiation, and absence of mucin...
March 2018: Archives of Pathology & Laboratory Medicine
Nandhini Srinivasan, Jin-Yao Teo, Yung-Ka Chin, Tiffany Hennedige, Damien M Tan, Albert S Low, Choon Hua Thng, Brian K P Goh
BACKGROUND: This systematic review was performed to assess the clinical utility of the Sendai Consensus Guidelines (SCG) and Fukuoka Consensus Guidelines (FCG) for intraductal papillary mucinous neoplasm (IPMN). METHODS: A computerized search of PubMed was performed to identify all the studies which evaluated the SCG and FCG in surgically resected, histologically confirmed IPMNs. RESULTS: Ten studies evaluating the FCG, 8 evaluating the SCG and 4 evaluating both guidelines were included...
February 24, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Hiroaki Seki, Nobutaka Yasui, Akihiko Shimada, Hidetoshi Matsumoto
We herein report a 75-year-old woman who presented with an intraductal papillary mucinous carcinoma(IPMC)who was treated with surgical resection 4 years after the initial diagnosis was made. She previously underwent a high anterior resection of the rectum for rectal cancer at 71 years of age. Preoperative CT revealed a multilocular cystic mass measuring 6 cm in size in the body of the pancreas, which was considered benign. We followed up the intraductal papillary mucinous neoplasm(IPMN) by using annual CT imaging for 4 years...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
C Vanbrugghe, N Tabchouri, G Louis, J Del Grande, X Lagrange, O Turrini, M Ouaissi
No abstract text is available yet for this article.
March 2018: Journal of Gastroenterology and Hepatology
Yosuke Inoue, Akio Saiura, Yu Takahashi
BACKGROUND: In recent decades, there have been enthusiastic discussions of, and active proposals for, new approaches to dissection around the superior mesenteric artery during pancreaticoduodenectomy (PD). In contrast, dissection along the celiac axis (CA) and hepatic artery (HA) and in the hepatoduodenal ligament has rarely been systematically discussed. In this report, we propose and describe a three-level classification of dissection along the CA-HA system which is applicable to a variety of diseases for which PD is indicated...
February 20, 2018: World Journal of Surgery
Takahiro Einama, Hirofumi Kamachi, Toshihiro Sakata, Kengo Shibata, Kazuki Wakizaka, Ko Sugiyama, Kazuaki Shibuya, Shingo Shimada, Kenji Wakayama, Tatsuya Orimo, Hideki Yokoo, Toshiya Kamiyama, Tomoko Mitsuhashi, Akinobu Taketomi
Intraductal papillary mucinous neoplasms (IPMNs) are characterized by the papillary proliferation of atypical mucinous epithelial cells in the pancreatic ductal system. There are two recurrence patterns following resection of IPMNs: Metachronous multifocal occurrence of IPMNs, and distinct pancreatic ductal adenocarcinoma (PDAC) in the remnant pancreas. Several recent studies investigated the development of distinct PDAC during follow-up evaluation of IPMNs and the incidence rate ranged from 4.5 to 8%. Thus, IMPNs may be a good predictor for the early detection of PDAC during observation or after the resection of IPMNs...
March 2018: Molecular and Clinical Oncology
Giovanni Marchegiani, Stefano Andrianello, Alex Borin, Chiara Dal Borgo, Giampaolo Perri, Tommaso Pollini, Giorgia Romanò, Mirko D'Onofrio, Armando Gabbrielli, Aldo Scarpa, Giuseppe Malleo, Claudio Bassi, Roberto Salvia
BACKGROUND: Mural nodules (MNs) have a predominant role in the 2016 revision of the international guidelines on intraductal papillary mucinous neoplasms (IPMN) of the pancreas. The aim of this study was to evaluate MNs as predictors of invasive cancer (iCa) or high-grade dysplasia (HGD) in IPMNs and to investigate the role of MN size in risk prediction. METHODS: A PRISMA-compliant systematic review of the literature and meta-analysis on selected studies were conducted...
February 14, 2018: Surgery
Yoji Kukita, Kazuyoshi Ohkawa, Ryoji Takada, Hiroyuki Uehara, Kazuhiro Katayama, Kikuya Kato
The accuracy of next-generation sequencing (NGS) for detecting tumor-specific mutations in plasma DNA is hindered by errors introduced during PCR/sequencing, base substitutions caused by DNA damage, and pre-existing mutations in normal cells that are present at a low frequency. Here, we performed NGS of genes related to pancreatic cancer (comprising 2.8 kb of genomic DNA) in plasma DNA (average 4.5 ng) using molecular barcodes. The average number of sequenced molecules was 900, and the sequencing depth per molecule was 100 or more...
2018: PloS One
Stefan Fritz, Regina Küper-Steffen, Katharina Feilhauer, Christoph M Sommer, Götz M Richter, René Hennig, Jörg Köninger
RATIONALE: Intraductal papillary mucinous neoplasms of the pancreas (IPMNs) are benign cystic tumors with a relevant risk of malignant transformation over time. Currently, follow-up after surgical resection of benign IPMNs remains controversial. PATIENT CONCERNS: This is a case report of a 68-year-old male who underwent pancreatic head resection for a multicystic side-branch IPMN with low-grade epithelial dysplasia in March 2009 at the Katharinenhospital Stuttgart, Germany...
February 2018: Medicine (Baltimore)
Hideki Mori, Keiji Hanada, Tomoyuki Minami, Shigeki Yano, Motomitsu Fukuhara, Hirotsugu Maruyama, Akinori Shimizu, Naomichi Hirano, Fumiaki Hino, Hironobu Amano, Shuji Yonehara
A previously healthy 52-year-old man was referred to our hospital for further evaluation of main pancreatic duct dilatation. The preoperative work-up was consistent with intraductal papillary mucinous carcinoma (IPMC) derived from a mixed type intraductal papillary mucinous neoplasm (IPMN), because multilocular cysts with enhancing thickened pancreatic head walls and dilated pancreatic ducts lined with dysplastic mucinous epithelium, with papillary proliferation from the pancreatic body to the tail, were observed; in addition, the pancreatic juice cytology was class V, which is suggestive of adenocarcinoma...
February 13, 2018: Clinical Journal of Gastroenterology
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