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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
Giulio Innamorati, Thomas M Wilkie, Havish S Kantheti, Maria Teresa Valenti, Luca Dalle Carbonare, Luca Giacomello, Marco Parenti, Davide Melisi, Claudio Bassi
BACKGROUND: Mutations activating the α subunit of heterotrimeric Gs protein are associated with a number of highly specific pathological molecular phenotypes. One of the best characterized is the McCune Albright syndrome. The disease presents with an increased incidence of neoplasias in specific tissues. MAIN BODY: A similar repertoire of neoplasms can develop whether mutations occur spontaneously in somatic tissues during fetal development or after birth. Glands are the most "permissive" tissues, recently found to include the entire gastrointestinal tract...
March 15, 2018: BMC Cancer
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
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
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
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
Apostolos Gaitanidis, Michail Alevizakos, Alexandra Tsaroucha, Christos Tsalikidis, Constantinos Simopoulos, Michail Pitiakoudis
BACKGROUND: Conditional survival (CS) analysis represents a novel method that may provide more clinically relevant perspectives to cancer management compared to conventional survival analysis. The purpose of this study was to evaluate conditional survival for patients with intraductal papillary mucinous neoplasms (IPMNs) undergoing curative resection. METHODS: A retrospective search of the Surveillance Epidemiology and End Results (SEER) database was performed. Three-year conditional survival (i...
January 12, 2018: European Journal of Surgical Oncology
Annabelle L Fonseca, Kimberly Kirkwood, Michael P Kim, Anirban Maitra, Eugene J Koay
The incidence of intraductal papillary mucinous neoplasms (IPMNs) has been increasing over the past decade, mainly owing to increased awareness and the increased use of cross-sectional imaging. The Sendai and Fukuoka consensus guidelines provide us with clinical management guidelines and algorithms; however, the clinical management of IPMNs continues to be challenging. Our incomplete understanding of the natural history of the disease, and the events and pathways that permit progression to adenocarcinoma, result in difficulties predicting which tumors are high risk and will progress to invasive disease...
March 2018: Pancreas
Chiara Dal Borgo, Giampaolo Perri, Alex Borin, Giovanni Marchegiani, Roberto Salvia, Claudio Bassi
BACKGROUND: Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas comprise a heterogeneous group of intraductal mucin-producing neoplasms representing a typical adenoma-to-carcinoma sequence. The involvement of the main pancreatic duct (MPD) is a feature of paramount importance, directly related to a more aggressive biology and a higher malignancy rate. METHOD: We review and discuss the clinical management of IPMNs with a MPD involvement, recalling the different consensus guidelines and addressing recent controversies in literature, presenting the current clinical practice in Verona Pancreas Institute...
February 8, 2018: Digestive Surgery
Nicholas J Zyromski
No abstract text is available yet for this article.
February 8, 2018: Digestive Diseases and Sciences
Ye Rim Chang, Taesung Park, Sung Hyo Park, Yong Kang Kim, Kyoung Bun Lee, Sun-Whe Kim, Jin-Young Jang
There is an urgent need to investigate the genetic changes that occur in intraductal papillary mucinous neoplasm (IPMN), which is a well-known precursor of pancreatic cancer. In this study, gene expression profiling was performed by removing unwanted variation to determine the differentially expressed genes (DEGs) associated with malignant progression of IPMN. Among the identified DEGs, zinc finger E-box binding homeobox 1 (ZEB1) and E-cadherin, a crucial regulator of epithelial-to-mesenchymal transition (EMT), was validated among identified DEGs...
January 2, 2018: Oncotarget
Ji Y Park, Jae Hoon Lee, Ki-Byung Song, Dae Wook Hwang, Kyu-Rae Kim, Song Cheol Kim, Seung-Mo Hong
Microcystic, elongated, and fragmented (MELF) glandular features are associated with epithelial-mesenchymal transition, invasion, and progression in endometrioid adenocarcinoma of the uterus. Similar histological features are also observed at the periphery of pancreatic intraductal papillary mucinous neoplasms (IPMNs). However, the clinicopathological significance of MELF-like features-particularly whether they represent regenerative or truly neoplastic conditions-in IPMNs remains unclear. We assessed a total of 152 surgically resected IPMNs...
February 1, 2018: Human Pathology
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