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Pancreatic cystic neoplasm

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https://www.readbyqxmd.com/read/28321928/eus-evaluation-for-pancreatic-cysts-necessity-or-overkill
#1
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/28318763/pancreatic-carcinosarcoma-a-case-report-highlighting-computed-tomography-characteristics
#2
Steven Mszyco, Leslie Teng, Joseph Annunziata, Matthew S Hartman
Primary pancreatic carcinosarcoma is a rare and malignant neoplasm arising within the pancreas. With fewer than a dozen cases ever reported, the recognition and treatment of this rare phenomenon can be difficult. We describe the case of an 85-year-old man who presented with vague right upper quadrant and epigastric abdominal pain and was found to have a pancreatic mass on ultrasound and computed tomography. The patient underwent open pancreaticoduodenectomy and was found to have pancreatic carcinosarcoma on microscopic evaluation...
January 27, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28317015/evaluation-of-the-2015-aga-guidelines-on-pancreatic-cystic-neoplasms-in-a-large-surgically-confirmed-multicenter-cohort
#3
Phillip S Ge, V Raman Muthusamy, Srinivas Gaddam, Diana-Marie Jaiyeola, Stephen Kim, Alireza Sedarat, Timothy R Donahue, Lindsay Hosford, Robert H Wilson, David P Grande, Rajesh N Keswani, Vladimir M Kushnir, Daniel Mullady, Steven A Edmundowicz, Dayna S Early, Srinadh Komanduri, Sachin Wani, Rabindra R Watson
Background and study aims The American Gastroenterological Association (AGA) recently published guidelines for the management of asymptomatic pancreatic cystic neoplasms (PCNs). We aimed to evaluate the diagnostic characteristics of the AGA guidelines in appropriately recommending surgery for malignant PCNs. Patients and methods A retrospective multicenter study was performed of patients who underwent endoscopic ultrasound (EUS) for evaluation of PCNs who ultimately underwent surgical resection from 2004 - 2014...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28315034/natural-history-of-pancreatic-cysts
#4
REVIEW
Alexander Larson, Richard S Kwon
Pancreatic cystic neoplasms are discovered with increasing frequency. Accurate knowledge of the natural history of cystic neoplasms is crucial to develop useful and cost-effective strategies for surveillance and surgical resection. To date, the natural history of cystic neoplasms is still incomplete due to lack of adequate diagnostic accuracy in the absence of surgical pathology. Nevertheless, current evidence points to risk factors for malignant transformation to help clinical management. New biomarkers that accurately distinguish cyst neoplasms and those most likely to progress to cancer would help clarify the natural history of cystic neoplasms...
March 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28278438/diagnosis-of-autoimmune-pancreatitis-with-cholesterol-granuloma-mimicking-intraductal-papillary-mucinous-carcinoma-a-case-report
#5
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
https://www.readbyqxmd.com/read/28265400/laparoscopic-splenopancreatectomy-for-an-endocrine-tumor-with-cystic-changes-a-case-report
#6
Hideki Izumi, Naoki Yazawa, Daisuke Furukawa, Yoshihito Masuoka, Misuzu Yamada, Taro Mashiko, Yohei Kawashima, Masami Ogawa, Yoshiaki Kawaguchi, Tetsuya Mine, Kenichi Hirabayashi, Toshio Nakagohri
The biological behavior of a cystic pancreatic endocrine neoplasm is less aggressive than that of pancreatic neuroendocrine neoplasms, and its prognosis is better. Limited surgery should be considered for cystic pancreatic endocrine neoplasms that are not accompanied preoperatively by lymph node or distant metastasis.
March 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28260136/cells-of-origin-of-pancreatic-neoplasms
#7
REVIEW
Junpei Yamaguchi, Yukihiro Yokoyama, Toshio Kokuryo, Tomoki Ebata, Masato Nagino
Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignant disease associated with poor prognosis, despite recent medical advances. It is of great importance to understand the initial events and cells of origin of pancreatic cancer to prevent the development and progression of PDAC. There are three distinct precursor lesions that develop into PDAC: pancreatic intraepithelial neoplasms (PanINs), intraductal papillary mucinous neoplasms (IPMNs), and mucinous cystic neoplasms (MCNs). Studies on genetically engineered mouse models have revealed that the initiation and development of these lesions largely depend on genetic alterations...
March 4, 2017: Surgery Today
https://www.readbyqxmd.com/read/28258561/a-resected-case-of-two-branch-duct-type-intraductal-papillary-mucinous-neoplasms-showing-different-clinical-courses-after-a-two-year-follow-up
#8
Hideki Shibata, Nobuyuki Ohike, Tomoko Norose, Tomohide Isobe, Reika Suzuki, Hideyuki Imai, Akira Shiokawa, Masafumi Takimoto, Akihiro Tabuchi, Yuichi Takano, Eiichi Yamamura, Masatsugu Nagahama, Nobuyuki Takeyama, Kazuaki Yokomizo, Hiroki Mizukami, Jun-Ichi Tanaka, Takeshi Aoki, Masahiko Murakami
The patient was a 60-year-old man without any particular complaints, but he underwent abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) due to a fatty liver, which revealed two similar cystic lesions regarded as branch duct-type intraductal papillary mucinous neoplasm (BD-IPMN) in the pancreatic body [BD-IPMN (b), 16 mm in size] and tail [BD-IPMN (t), 13 mm in size] without a "high-risk stigmata" or "worrisome features". He subsequently received follow-up by MRCP every 6 months...
March 3, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28255733/natural-courses-of-branch-duct-intraductal-papillary-mucinous-neoplasm
#9
Taeheon Lee, Hong Joo Kim, Soo-Kyung Park, Hyo-Joon Yang, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim, Kyu Yong Choi
PURPOSE: The study was done to elucidate the clinico-radiologic predictive factors for cancerous change detected by disease progression (PD) mainly defined by interval increase in cyst size and change of cyst morphology, for branch duct intraductal papillary mucinous neoplasm (BD-IPMN) patients with relatively long-term follow-up. METHODS: Retrospective analysis of medical records and imaging findings were performed on 107 patients with BD-IPMN enrolled from July 2005 to May 2013, in whom the communication between the cystic lesion and pancreatic duct was confirmed by either endoscopic ultrasonography (EUS), magnetic resonance cholangiopancreatography (MRCP), or endoscopic retrograde cholangiopancreatography (ERCP)...
March 2, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28246486/pancreatic-endometrial-cyst-mimics-mucinous-cystic-neoplasm-of-the-pancreas
#10
Michael A Mederos, Nicole Villafañe, Sadhna Dhingra, Carlos Farinas, Amy McElhany, William E Fisher, George Van Buren Ii
Pancreatic cysts include a variety of benign, premalignant, and malignant lesions. Endometrial cysts in the pancreas are exceedingly rare lesions that are difficult to diagnose pre-operatively. This report describes the findings in a 43-year-old patient with a recent episode of acute pancreatitis who presented with a large cyst in the tail of the pancreas. Imaging demonstrated a loculated pancreatic cyst, and cyst fluid aspiration revealed an elevated amylase and carcinoembryonic antigen. The patient experienced an interval worsening of abdominal pain, fatigue, diarrhea, and a 15-pound weight loss 3 mo after the initial episode of pancreatitis...
February 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28237644/surgery-for-pancreatic-neoplasms-how-accurate-are-our-surgical-indications
#11
David Jérémie Birnbaum, Sébastien Gaujoux, Julie Berbis, Safi Dokmak, Pascal Hammel, Marie Pierre Vullierme, Philippe Lévy, Alain Sauvanet
BACKGROUND: Accurate preoperative diagnosis is critical for the determination of appropriate surgical indications. The aim of this study was to assess the accuracy of preoperative diagnosis and indications for operative therapy for presumed pancreatic neoplasms. METHODS: From 2005 to 2013, 851 patients underwent pancreatectomies for presumed pancreatic neoplasms. A formal preoperative diagnosis was established during a multidisciplinary tumor board and compared to the final pathologic examination...
February 22, 2017: Surgery
https://www.readbyqxmd.com/read/28211072/the-diagnosis-of-pancreatic-mucinous-cystic-neoplasm-and-associated-adenocarcinoma-in-males-an-eight-institution-study-of-349-patients-over-15-years
#12
Cecilia G Ethun, Lauren M Postlewait, 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 R Scoggins, David Bentrem, Hong J Kim, Jacquelyn Carr, Syed A Ahmad, Daniel E Abbott, Gregory Wilson, David A Kooby, Shishir K Maithel
BACKGROUND: Per WHO, 2000 classification, pancreatic mucinous cystic neoplasms (MCN) are defined by presence of ovarian stroma, and are primarily located in the pancreatic body/tail of females. The incidence of MCN and associated malignancy in males, since, standardization of MCN diagnostic-criteria is unknown. METHODS: MCN resections from 2000 to 2014 at eight institutions of the Central-Pancreas-Consortium were included, and divided into early (2000-2007) and late (2008-2014) time-periods...
February 17, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28208933/a-rare-case-report-of-hepatic-subcapsular-pseudocyst-of-pancreas
#13
Noor Topno, Sandeep Ghosh, Arup Baruah
A pancreatic pseudocyst arises as a result of acute or chronic pancreatitis, pancreatic trauma, or obstruction of the pancreatic duct by a neoplasm. Most of the pseudocysts are located within the head and the body of the pancreas but 20% are extra-pancreatic. We report a case of a 33-year-old gentleman presenting with acute on chronic alcoholic pancreatitis with hepatic sub-capsular pseudocyst involving left lobe of liver, with intra-cystic bleed was successfully treated with Ultrasonography (USG) guided drainage...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28197897/middle-segment-preserving-pancreatectomy-for-metachronous-intraductal-papillary-mucinous-neoplasm-after-pancreatoduodenectomy-a-case-report
#14
Mihoko Yamada, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Yusuke Yamamoto, Ryo Ashida, Katsuhiko Uesaka
Total pancreatectomy has occasionally been performed to treat patients with multiple lesions (such as intraductal papillary mucinous neoplasm (IPMN)) or patients who have undergone repeated pancreatic resection. However, deficiencies of the exocrine and endocrine functions worsen patients' quality of life. Recently, there have been several case reports citing middle segment-preserving pancreatectomy (MSPP) as a safe procedure and beneficial with respect to preservation of the exocrine and endocrine functions...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28196020/the-prevalence-and-clinicopathological-characteristics-of-high-grade-pancreatic-intraepithelial-neoplasia-autopsy-study-evaluating-the-entire-pancreatic-parenchyma
#15
Yoko Matsuda, Toru Furukawa, Shinichi Yachida, Makoto Nishimura, Atsuko Seki, Keisuke Nonaka, Junko Aida, Kaiyo Takubo, Toshiyuki Ishiwata, Wataru Kimura, Tomio Arai, Mari Mino-Kenudson
OBJECTIVE: We sought to identify clinicopathological characteristics of high-grade pancreatic intraepithelial neoplasia (PanIN)/carcinoma in situ to facilitate screening for pancreatic ductal adenocarcinoma. METHODS: We evaluated PanIN lesions in 173 consecutive autopsy cases with no evidence of pancreatic ductal adenocarcinoma and/or intraductal papillary mucinous neoplasm (mean age, 80.5 years) by submitting the entire pancreas for microscopic examination. RESULTS: PanIN-3 was found in 4% of examined cases, whereas PanIN-1 and PanIN-2 were present in 77% and 28%, respectively...
February 14, 2017: Pancreas
https://www.readbyqxmd.com/read/28196015/genomic-characterization-of-low-and-high-grade-pancreatic-mucinous-cystic-neoplasms-reveals-recurrent-kras-alterations-in-high-risk-lesions
#16
James R Conner, Adrián Mariño-Enríquez, Mari Mino-Kenudson, Elizabeth Garcia, Martha B Pitman, Lynette M Sholl, Amitabh Srivastava, Leona A Doyle
OBJECTIVES: Pancreatic ductal adenocarcinoma arises from the following 3 distinct precursor lesions: pancreatic intraepithelial neoplasia, intraductal papillary mucinous neoplasm, and mucinous cystic neoplasm (MCN). Genetic abnormalities in the first 2 precursor lesions have been well characterized, but there are limited data on progression pathways in MCNs. This study aimed to characterize genomic differences between MCNs with low-grade (LG) and high-grade (HG) dysplasia or carcinoma...
February 14, 2017: Pancreas
https://www.readbyqxmd.com/read/28185442/the-role-of-ancillary-tests-in-the-evaluation-and-management-of-patients-with-negative-and-non-diagnostic-pancreatic-cyst-aspirates
#17
Suzanne M Selvaggi
BACKGROUND: Fine needle aspiration of pancreatic cystic lesions has its limitations as the cytology is often paucicellular to acellular. This study reports on the value of ancillary tests, amylase and carcinoembryonic, in the evaluation and management of patients with negative and non-diagnostic pancreatic cysts. METHODS: From January 1, 2010 through December 31, 2015, the Cytopathology Laboratory processed 119 pancreatic cyst aspirates of which 51(43%) were negative and 52(44%) were non-diagnostic and form the basis of this study...
April 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28179324/dna-cytometry-for-differentiation-between-low-and-medium-grade-dysplasia-in-intraductal-papillary-mucinous-neoplasms
#18
Fritz Klein, Timm Denecke, Wladimir Faber, Christian Jürgensen, Anja Schirmeier, Hussein Al-Abadi, Thula C Walter, Nadine Al-Abadi, Thomas Malinka, Johann Pratschke, Marcus Bahra
BACKGROUND/AIM: The indication for resection of cystic pancreatic lesions is usually performed by sectional imaging criteria, such as the Sendai criteria. The aim of this study was to analyze a possible correlation between DNA cytometry and Sendai criteria for the differentiation between low-grade intraductal papillary mucinous neoplasms (IPMN-A) and medium-grade dysplasia (IPMN-B). MATERIALS AND METHODS: Histopathological analysis, DNA index and preoperative Sendai criteria were determined in 16 patients who underwent pancreatic resection for IPMN...
2017: Anticancer Research
https://www.readbyqxmd.com/read/28176217/can-mdct-or-eus-features-predict-the-histopathological-grading-scheme-of-pancreatic-neuroendocrine-neoplasms
#19
Hui Zhu, Lang Ying, Wei Tang, Xiujiang Yang, Bo Sun
PURPOSE: To identify whether the features of preoperative MDCT or EUS could predict the histopathological grading scheme of pancreatic neuroendocrine neoplasms (pNENs). METHODS: A total of 25 patients with pNENs were enrolled in the present study. The qualitative and quantitative variables were reviewed. The qualitative variables included location, contour, border, necrosis, intratumoral vessel, homogeneity, calcification, peripancreatic fat/vessel infiltration, pancreatic duct dilatation, mass within pancreas, lymphadenopathy and hepatic metastasis on MDCT and border, echogenicity, cystic/solid and blood flow on EUS...
February 7, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28148542/predicting-the-grade-of-dysplasia-of-pancreatic-cystic-neoplasms-using-cyst-fluid-dna-methylation-markers
#20
Tatsuo Hata, Marco Dal Molin, Seung-Mo Hong, Koji Tamura, Masaya Suenaga, Jun Yu, Hiraku Sedogawa, Matthew J Weiss, Christopher L Wolfgang, Anne Marie Lennon, Ralph H Hruban, Michael G Goggins
PURPOSE: Pancreatic cysts are common and pose diagnostic and management challenges. Pancreatic cyst fluid markers have the potential to aid in the management of cysts with concerning imaging findings. Our aim was to evaluate cyst fluid methylated DNA markers for their accuracy for predicting the histologic grade of neoplastic pancreatic cysts. EXPERIMENTAL DESIGN: Pancreatic cyst fluid samples from 183 patients (29 discovery, 154 validation) aspirated after surgical resection were analyzed for methylated DNA at selected genes (SOX17, BNIP3, FOXE1, PTCHD2, SLIT2, EYA4 and SFRP1) using methylation-specific droplet-digital PCR (dd-QMSP)...
February 1, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
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