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https://www.readbyqxmd.com/read/28421458/surgical-management-of-pancreatic-cysts-a-shifting-paradigm-toward-selective-resection
#1
REVIEW
Jon M Gerry, George A Poultsides
Due to the widespread use of high-quality cross-sectional imaging, pancreatic cystic neoplasms are being diagnosed with increasing frequency. Clinicians are therefore asked to counsel a growing number of patients with pancreatic cysts diagnosed incidentally at an early, asymptomatic stage. Over the last two decades, accumulating knowledge on the biologic behavior of these neoplasms along with improved diagnostics through imaging and endoscopic cyst fluid analysis have allowed for a selective therapeutic approach toward these neoplasms...
April 18, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28416122/patients-with-a-resected-pancreatic-mucinous-cystic-neoplasm-have-a-better-prognosis-than-patients-with-an-intraductal-papillary-mucinous-neoplasm-a-large-single-institution-series
#2
James F Griffin, Andrew J Page, Georges J Samaha, Adrienne Christopher, Feriyl Bhaijee, Maryam K Pezhouh, Niek A Peters, Ralph H Hruban, Jin He, Martin A Makary, Anne Marie Lennon, John L Cameron, Christopher L Wolfgang, Matthew J Weiss
BACKGROUND/OBJECTIVES: Mucinous cystic neoplasms (MCNs) are rare pancreas tumors distinguished from intraductal papillary mucinous neoplasms (IPMNs) by the presence of ovarian-type stroma. Historical outcomes for MCNs vary due to previously ambiguous diagnostic criteria resulting in confusion with IPMNs. This study seeks to characterize and clarify the clinical features and long-term outcomes of MCNs versus IPMNs in the largest single-institution series of pathology-confirmed MCNs to date...
April 11, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28415140/imaging-modalities-for-characterising-focal-pancreatic-lesions
#3
REVIEW
Lawrence Mj Best, Vishal Rawji, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: Increasing numbers of incidental pancreatic lesions are being detected each year. Accurate characterisation of pancreatic lesions into benign, precancerous, and cancer masses is crucial in deciding whether to use treatment or surveillance. Distinguishing benign lesions from precancerous and cancerous lesions can prevent patients from undergoing unnecessary major surgery. Despite the importance of accurately classifying pancreatic lesions, there is no clear algorithm for management of focal pancreatic lesions...
April 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28413390/a-serous-cystic-neoplasm-of-the-pancreas-coexisting-with-high-grade-pancreatic-intraepithelial-neoplasia-mimicking-an-intraepithelial-papillary-mucinous-neoplasm-a-case-report
#4
Aya Kawanishi, Kenichi Hirabayashi, Hirotaka Kono, Yumi Takanashi, Atsuko Hadano, Yohei Kawashima, Masami Ogawa, Yoshiaki Kawaguchi, Misuzu Yamada, Toshio Nakagohri, Naoya Nakamura, Tetsuya Mine
Serous cystic neoplasms of the pancreas are rare exocrine pancreatic neoplasms, most of which are benign and do not communicate with the pancreatic duct. Pancreatic intraepithelial neoplasm (PanIN) is considered a precursor of ductal adenocarcinoma that is microscopically recognized in pancreatic ducts. A 67-year-old Japanese woman presented with a 10-mm multilocular cystic lesion at the pancreatic body. Magnetic resonance pancreatography showed stenosis of the main pancreatic duct at the pancreatic body and dilatation of the distal side of the main pancreatic duct...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28404017/dna-testing-of-pancreatic-cyst-fluid-is-it-ready-for-prime-time
#5
REVIEW
Aatur D Singhi, Marina N Nikiforova, Kevin McGrath
Pancreatic cysts are a clinical quandary in both diagnosis and management. Although many cysts, such as pseudocysts and serous cystadenomas, are benign and can be monitored clinically, mucinous cysts, such as intraductal papillary mucinous neoplasms and mucinous cystic neoplasms, have the potential to progress to pancreatic cancer. Considering the poor prognosis of pancreatic cancer, the detection of a pancreatic cyst can be a source of anxiety for both the patient and physician. This diagnosis in turn can lead to expensive, invasive, and even harmful surveillance and treatment options...
January 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28396783/young-lady-with-a-typical-solid-cystic-abdominal-mass
#6
Saket Kumar, Rahul Rahul, Abhijit Chandra
Solid pseudopapillary tumor is a rare pancreatic neoplasm that typically affects young women. Characteristic CT appearance is that of a mixed-density lesion with solid component peripherally and cystic component centrally. Even larger tumors are well encapsulated with sharp demarcation, amenable to complete resection.
April 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28396555/heterotopic-pancreatic-tissue-associated-with-type-1-choledochal-cyst-cystolithiasis-and-gall-bladder-stones-a-rare-entity-with-review-of-literature
#7
Aditi Arora, Pradyumn Singh, Nidhi Anand, Nuzhat Husain
Choledochal cyst is a rare congenital malformation, particularly when associated with stones in cyst (cystolithiasis), gallstones and heterotopic pancreatic tissue within the cyst wall. The current case represents a 5-year-old boy with abdominal pain, pale colored stools, and jaundice. Magnetic resonance cholangiopancreatography showed a cystic lesion, arising from common bile duct with cystolithiasis and cholelithiasis. He underwent excision of choledochal cyst and gallbladder with Roux-en-Y hepaticojejunostomy...
April 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28383565/diversity-of-precursor-lesions-for-pancreatic-cancer-the-genetics-and-biology-of-intraductal-papillary-mucinous-neoplasm
#8
Krushna C Patra, Nabeel Bardeesy, Yusuke Mizukami
Pancreatic ductal adenocarcinoma (PDA), one of the most lethal cancers worldwide, is associated with two main types of morphologically distinct precursors-pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasm (IPMN). Although the progression of PanIN into invasive cancer has been well characterized, there remains an urgent need to understand the biology of IPMNs, which are larger radiographically detectable cystic tumors. IPMNs comprise a number of subtypes with heterogeneous histopathologic and clinical features...
April 6, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28379129/primary-hydatid-cyst-of-the-pancreas
#9
REVIEW
Paul Eduardo Lada, Diego Termengo, Gonzalos Cáceres, Carlos Sanchez Tacone, Fabian Caballero, Pablo Sonzini Astudillo
Hydatid cyst of the pancreas is a rare location of this disease. We study the case of a female patient with primary hydatid cyst of the pancreas coming from and endemic area and presenting pain and palpable tumor in epigastrium and right upper abdomen. The patient was studied with ultrasound scanning and CT scan in which it was interpreted as hydatid liver cyst. Pancreatic location was determined in surgery. Primary hydatid cyst of the pancreas must be taken into account as differential diagnosis with cystic lesions of the pancreas...
2017: Revista de la Facultad de Ciencias Médicas
https://www.readbyqxmd.com/read/28375947/chronic-pancreatitis-like-change-in-brca2-mutation-carriers
#10
Meir Mizrahi, Jennifer F Tseng, Daniel Wong, Nadine Tung, Mariam F Eskander, Tyler M Berzin, Douglas K Pleskow, Mandeep S Sawhney
OBJECTIVES: Pancreatic intraepithelial neoplasia lesions can appear as chronic pancreatitis-like changes on endoscopic ultrasound (EUS). The aim of our study was to determine if BRCA2 mutation carriers were more likely than noncarriers to demonstrate chronic pancreatitis-like changes on EUS. METHODS: Patients with BRCA2 mutations referred for EUS were identified (cases) from an endoscopy database. Controls were matched with cases in a 2:1 ratio for sex, date EUS was performed, endoscopist, and echoendoscope...
May 2017: Pancreas
https://www.readbyqxmd.com/read/28374746/intracellular-hmgb1-as-a-novel-tumor-suppressor-of-pancreatic-cancer
#11
Rui Kang, Yangchun Xie, Qiuhong Zhang, Wen Hou, Qingping Jiang, Shan Zhu, Jinbao Liu, Dexing Zeng, Haichao Wang, David L Bartlett, Timothy R Billiar, Herbert J Zeh, Michael T Lotze, Daolin Tang
Pancreatic ductal adenocarcinoma (PDAC) driven by oncogenic K-Ras remains among the most lethal human cancers despite recent advances in modern medicine. The pathogenesis of PDAC is partly attributable to intrinsic chromosome instability and extrinsic inflammation activation. However, the molecular link between these two events in pancreatic tumorigenesis has not yet been fully established. Here, we show that intracellular high mobility group box 1 (HMGB1) remarkably suppresses oncogenic K-Ras-driven pancreatic tumorigenesis by inhibiting chromosome instability-mediated pro-inflammatory nucleosome release...
April 4, 2017: Cell Research
https://www.readbyqxmd.com/read/28343174/mirna-analysis-in-pancreatic-cancer-the-dartmouth-experience
#12
REVIEW
Francine B de Abreu, Xiaoying Liu, Gregory J Tsongalis
Pancreatic cancer is considered one of the most lethal cancers being the fourth leading cause of cancer deaths in adults in the United States because of the lack of early signs and symptoms and the lack of early detection. Pancreatic ductal adenocarcinoma (PDAC) is the most common histological type among pancreatic cancers, representing 80%-90% of all solid tumors of the pancreas. The majority of PDAC develops from three precursor lesions: pancreatic intraepithelial neoplasia, intraductual papillary mucinous neoplasm and mucinous cystic neoplasm...
May 1, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28331340/pancreatic-neuroendocrine-neoplasms-at-magnetic-resonance-imaging-comparison-between-grade-3-and-grade-1-2-tumors
#13
Chuangen Guo, Xiao Chen, Wenbo Xiao, Qidong Wang, Ke Sun, Zhongqiu Wang
BACKGROUND: The grading of pancreatic neuroendocrine neoplasms (PanNENs) is associated with the choice of treatment strategy. The aim of this study is to identify the magnetic resonance imaging (MRI) features in differentiating pancreatic neuroendocrine tumors (PanNETs) grade 1/2 (G1/G2) and pancreatic neuroendocrine carcinoma grade 3 (PanNEC G3). PATIENTS AND METHODS: A total of 59 patients with histologically proven PanNENs and who underwent pretreatment MRI were retrospectively analyzed...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28321928/eus-evaluation-for-pancreatic-cysts-necessity-or-overkill
#14
REVIEW
Nonthalee Pausawasdi, Thawee Ratanachu-Ek
Incidental pancreatic cysts have been gradually more recognized in clinical practice due to an increased use of transabdominal ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI). These lesions consist of inflammatory cysts (pseudocysts) and pancreatic cystic neoplasms (PCNs) which have been classified as benign, pre-malignant and malignant. The diagnosis and management strategy of incidentally discovered pancreatic cysts can be challenging as the majority of them are PCNs and CT or MRI alone may not be sufficient to provide an accurate diagnosis...
March 21, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28315508/tumor-markers-in-pancreatic-cystic-fluids-for-diagnosis-of-malignant-cysts
#15
Alexandre Levy, Theodora Popovici, Phuong-Nhi Bories
BACKGROUND AND AIM: Early diagnosis of premalignant or malignant pancreatic cysts is essential to improve prognosis. Sampling of pancreatic cyst fluid by fine-needle aspiration during endoscopic ultrasonography (EUS) enables cytopathological examination combined with biochemical analysis. This study aimed to provide an aid based on biological markers for the preoperative management of patients with pancreatic cysts. METHODS: Pancreatic fluids obtained by EUS-guided fine-needle aspiration from 115 patients with cystic lesions were assayed for amylase, lipase, carcinoembryonic antigen (CEA), CA 19-9 and CA 72-4...
March 3, 2017: International Journal of Biological Markers
https://www.readbyqxmd.com/read/28315030/endoscopic-management-of-pancreatic-cysts
#16
REVIEW
Michael J Bartel, Massimo Raimondo
Management of pancreatic cystic lesions relies on patients' clinical presentation, imaging, and endoscopic ultrasound. Current research in basic science, radiology, and endoscopy is evolving and making progress in this condition which is relatively common in the general population. This review focuses on the recent endoscopic ultrasound approaches to the diagnosis of these pancreatic disorders.
March 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28287935/heterotopic-pancreas-histopathologic-features-imaging-findings-and-complications
#17
Maryam Rezvani, Christine Menias, Kumaresan Sandrasegaran, Jeffrey D Olpin, Khaled M Elsayes, Akram M Shaaban
Heterotopic pancreas is a congenital anomaly in which pancreatic tissue is anatomically separate from the main gland. The most common locations of this displacement include the upper gastrointestinal tract-specifically, the stomach, duodenum, and proximal jejunum. Less common sites are the esophagus, ileum, Meckel diverticulum, biliary tree, mesentery, and spleen. Uncomplicated heterotopic pancreas is typically asymptomatic, with the lesion being discovered incidentally during an unrelated surgery, during an imaging examination, or at autopsy...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28286093/needle-based-confocal-laser-endomicroscopy-for-the-diagnosis-of-pancreatic-cystic-lesions-an-international-external-interobserver-and-intraobserver-study-with-videos
#18
Somashekar G Krishna, William R Brugge, John M Dewitt, Pradermchai Kongkam, Bertrand Napoleon, Carlos Robles-Medranda, Damien Tan, Samer El-Dika, Sean McCarthy, Jon Walker, Mary E Dillhoff, Andrei Manilchuk, Carl Schmidt, Benjamin Swanson, Zarine K Shah, Phil A Hart, Darwin L Conwell
BACKGROUND AND AIMS: EUS-guided nCLE characteristics of common types of PCLs have been identified; however surgical histopathology was available in a minority of subjects. We sought to assess the performance characteristics of EUS-nCLE for differentiating mucinous from non-mucinous PCLs in a larger series of subjects with a definitive diagnosis. METHODS: Six endosonographers (nCLE experience >30 cases each) blinded to all clinical data, reviewed nCLE images of PCLs from 29 subjects with surgical (n=23) or clinical (n=6) correlation...
March 9, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28281482/laparoscopic-spleen-preserving-distal-pancreatectomy-for-a-primary-hydatid-cyst-mimicking-a-mucinous-cystic-neoplasia
#19
Tugan Tezcaner, Yahya Ekici, Onur Huseyin Aydın, Gonca Barit, Gökhan Moray
Pancreatic hydatid cysts are fairly rare. The disease can be encountered concurrently with systemic involvement or as an isolated pancreatic involvement. We report the first case of spleen-preserving laparoscopic distal pancreatectomy for a pancreatic hydatid cyst. There was no complication or recurrence. A 55-year-old woman was admitted to our centre with epigastric and back pain. Upper abdominal magnetic resonance imaging revealed a solitary cystic lesion with septations at the pancreatic tail level measuring 24 mm × 18 mm, which was initially thought to be a pancreatic mucinous cystic neoplasia...
April 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28278438/diagnosis-of-autoimmune-pancreatitis-with-cholesterol-granuloma-mimicking-intraductal-papillary-mucinous-carcinoma-a-case-report
#20
Yusuke Takahashi, Naoyuki Yokoyama, Daisuke Sato, Tetsuya Otani, Koko Mitsuma, Hideki Hashidate
INTRODUCTION: Pancreatic cysts are often observed incidentally on abdominal computed tomography (CT). For cysts involving intracystic nodules, malignant neoplasms such as intraductal papillary-mucinous carcinoma (IPMC) should be suspected. In contrast, cholesterol granuloma (CG) rarely occurs in the pancreas, and CG-associated autoimmune pancreatitis (AIP) has not yet been reported. To our knowledge, this is the first reported case of AIP with CG mimicking IPMC. PRESENTATION OF CASE: A 56-year-old woman underwent abdominal CT for preoperative breast cancer screening...
March 1, 2017: International Journal of Surgery Case Reports
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