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Pancreatic cystic neoplasm

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
February 10, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28179324/dna-cytometry-for-differentiation-between-low-and-medium-grade-dysplasia-in-intraductal-papillary-mucinous-neoplasms
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28133317/-pancreatic-adenosquamous-carcinoma-that-developed-after-resection-of-ipma-in-the-pancreatic-tail
#10
Akinao Kaneta, Takao Tsuchiya, Takahiro Saito, Satoshi Otani, Fujio Ito, Junichi Miura
Pancreatic adenosquamous carcinoma coexisting with intraductal papillary mucinous neoplasm(IPMN)is extremely rare. We report a rare case of pancreatic adenosquamous carcinoma that developed after resection of intraductal papillary mucinous adenoma(IPMA). A 67-year-old man was suspected of having a pancreatic cystic lesion. MRCP demonstrated a cystic lesion measuring 25mm in the pancreatic tail, which had an enhanced nodule. We therefore diagnosed branch duct type IPMN of the pancreas. Although pancreatic juice cytology did not indicate malignancy, we performed laparoscope-assisted distal pancreatectomy...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133201/-long-term-survival-in-response-to-multimodality-therapy-in-a-patient-with-invasive-pancreatic-cancer-with-cyst-formation
#11
Hironobu Makino, Hisashi Kametaka, Tadaomi Fukada, Kazuhiro Seike, Akio Hasegawa, Masaru Isozaki
The patient was a 61-year-old man. Computed tomography(CT)in April 2007 revealed a pancreatic cyst in the tail of the pancreas. Rapid enlargement was noted in November 2007, and the patient was referred to the surgery department. CT showed a cystic lesion containing a nodular shadow in the pancreatic tail. Tumor marker measurements yielded normal carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)levels, but the duke pancreatic monoclonal antigen type 2(DUPAN-2)level was elevated. A diagnosis of mucinous cystic neoplasm(MCN)of the pancreas was made in December 2007, and distal pancreatectomy and partial colectomy were performed...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28131327/current-controversies-in-pancreatic-cystic-neoplasms
#12
R Matthew Walsh
Pancreatic cystic neoplasms are a growing clinical challenge. They are incidentally discovered with increased frequency. The evaluation and management have evolved over time with increasing need to establish the correct type of cystic neoplasm and understand the unique natural history of each subtype. This review highlights this evolving strategy and an approach to management where treatment is guided by symptoms and features worrisome for high-risk of developing an invasive neoplasm. A thoughtful approach should be taken for an asymptomatic patient where resection needs to show a clear advantage to prevent cancer...
January 11, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28126546/management-of-undifferentiated-solitary-mucinous-cystic-lesion-of-the-pancreas-a-clinical-dilemma
#13
Alexandra M Roch, Katherine Bigelow, Christian M Schmidt, Rosalie A Carr, Andrea L Jester, Eugene P Ceppa, Michael G House, Nicholas J Zyromski, Attila Nakeeb, C Max Schmidt
BACKGROUND: Management of solitary mucinous cystic lesions of the pancreas (MCLs) relies on correct differentiation between branch-duct intraductal papillary mucinous neoplasm(BD-IPMN) and mucinous cystic neoplasm(MCN). Current international consensus guidelines recommend resection for MCN, whereas unifocal BD-IPMN may be followed in the absence of worrisome features/high-risk stigmata. We hypothesized that preoperative differentiation of solitary MCLs is suboptimal, and that all solitary MCLs should be treated similarly...
January 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28117220/pancreatic-cysts-diagnostic-accuracy-and-risk-of-inappropriate-resections
#14
N de Pretis, S Mukewar, A Aryal-Khanal, Y Bi, N Takahashi, S Chari
BACKGROUND: Pancreatic cystic neoplasms (PCN) frequently undergo surgery, given malignant potential. Pancreatic cyst surgery is associated with significant rates of morbidity and mortality. It is crucial to accurately characterize these lesions pre-operatively to avoid unnecessary surgery in patients with benign pancreatic cysts. AIM: We aimed to assess the correlation between pre-operative (pre-op) diagnosis based on imaging and clinical presentation, and post-operative (post-op) diagnosis based on histopathology in patients undergone pancreatic cyst surgery...
January 12, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28116593/fukuoka-and-aga-criteria-have-superior-diagnostic-accuracy-for-advanced-cystic-neoplasms-than-sendai-criteria
#15
Michael Sighinolfi, Susan Y Quan, Yvonne Lee, Alvaro Ibaseta, Kimberly Pham, Monica M Dua, George A Poultsides, Brendan C Visser, Jeffery A Norton, Walter G Park
BACKGROUND: The aim of this study was to compare the American Gastroenterological Association guidelines (AGA criteria), the 2012 (Fukuoka criteria), and 2006 (Sendai criteria) International Consensus Guidelines for the diagnosis of advanced pancreatic cystic neoplasms. METHODS: All patients who underwent surgical resection of a pancreatic cyst from August 2007 through January 2016 were retrospectively analyzed at a single tertiary academic center. Relevant clinical and imaging variables along with pathology results were collected to determine appropriate classification for each guideline...
January 23, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28112959/intraductal-papillary-mucinous-neoplasms-and-mucinous-cystadenomas-current-status-and-recommendations
#16
Maria Moris, Michael B Wallace
The real prevalence of pancreatic cystic lesions remains unknown. The malignant potential of some of these lesions remains a cause for significant concern. Thus, it is mandatory to develop a strategy to clearly discriminate those cysts with a potential for malignant transformation from those that do not carry any significant risk. Intraductal papillary mucinous neoplasms and mucinous cystadenomas are mucinous cystic neoplasms with a known malignant potential that have gained greater recognition in recent years...
January 23, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28109714/biliary-tumors-with-pancreatic-counterparts
#17
Yasuni Nakanuma, Yoshiko Sudo
Some biliary diseases mimic pancreatic diseases pathologically as well as pathogenetically. Such diseases can be called "biliary diseases with pancreatic counterparts". Biliary intraepithelial neoplasm (BilIN), intraductal papillary neoplasm of bile ducts (IPNB), hepatobiliary mucinous cystic neoplasm (hMCN), and IgG4-inflammatory pseudotumor represent the biliary counterparts of pancreatic intraepithelial neoplasm (PanIN), intraductal papillary mucinous neoplasm of pancreas (IPMN), pancreatic MCN, and mass forming type 1 autoimmune pancreatitis (AIP), respectively...
December 20, 2016: Seminars in Diagnostic Pathology
https://www.readbyqxmd.com/read/28107092/a-solid-pseudopapillary-neoplasm-of-the-pancreas-associated-with-igg4-related-pancreatitis
#18
Yuichiro Hatano, Keisuke Kawashima, Takuji Iwashita, Masaki Kimura, Masahito Shimizu, Akira Hara
A solid and cystic pancreatic lesion was incidentally found in a 62-year-old woman on abdominal computed tomography. The lesion was diagnosed as a solid pseudopapillary neoplasm by using endoscopic ultrasound-guided fine needle aspiration, and the tumor was resected. Histologically, the tumor cells had relatively small, round nuclei and papillary-like architecture in a hemorrhagic background. On immunohistochemical examination, the tumor cells were diffusely positive for nuclear β-catenin and cytoplasmic CD10...
November 1, 2016: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28104978/maximizing-the-endosonography-the-role-of-contrast-harmonics-elastography-and-confocal-endomicroscopy
#19
REVIEW
Andrada Seicean, Ofelia Mosteanu, Radu Seicean
New technologies in endoscopic ultrasound (EUS) evaluation have been developed because of the need to improve the EUS and EUS-fine needle aspiration (EUS-FNA) diagnostic rate. This paper reviews the principle, indications, main literature results, limitations and future expectations for each of the methods presented. Contrast-enhanced harmonic EUS uses a low mechanical index and highlights slow-flow vascularization. This technique is useful for differentiating solid and cystic pancreatic lesions and assessing biliary neoplasms, submucosal neoplasms and lymph nodes...
January 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28099258/patient-preferences-for-management-of-cystic-neoplasms-of-the-pancreas-a-cross-sectional-survey-study
#20
Dhruv Verma, Karl K Kwok, Bechien U Wu
OBJECTIVE: The aim of this study was to determine how patient anxiety, knowledge, and cancer worry influence preferences for management of pancreatic cysts. METHODS: We performed a prospective, cross-sectional study using a disease-specific survey instrument. We included patients older than 18 years who were diagnosed with a pancreatic cyst. A telephone survey instrument was developed to assess baseline anxiety using the Hospital Anxiety and Depression Scale (HADS), knowledge regarding pancreatic cysts, cancer worry, and patient preferences using a standard gamble...
March 2017: Pancreas
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