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Pancreatic neoplasms

Ahmet Aslan, Ibrahim Inan, Süleyman Orman, Mine Aslan, Murat Acar
The management of cystic pancreatic neoplasm (CPN) is a clinical dilemma because of its clinical presentations and malignant potential. Surgery is the best treatment choice ; however, pancreatic surgery still has high complication rates, even in experienced centers. Imaging methods have a definitive role in the management of CPN and computed tomography, magnetic resonance imaging, and endoscopic ultrasonography are the preferred methods since they can reveal the suspicious features for malignancy. Therefore, radiologists, gastroenterologists, endoscopists, and surgeons should be aware of the common features of CPN, its discrete presentations on imaging methods, and the limitations of these modalities in the management of the disease...
April 2017: Acta Gastro-enterologica Belgica
Rym El Khoury, Christopher Kabir, Vijay K Maker, Mihaela Banulescu, Margaret Wasserman, Ajay V Maker
BACKGROUND: A subset of intraductal papillary mucinous neoplasms (IPMNs) will progress to invasive adenocarcinoma, however identifying invasive from non-invasive disease preoperatively remains challenging. The rate of malignancy in resected IPMNs in the US remains unclear. OBJECTIVE: We aimed to determine the rate of malignancy and factors associated with high-risk pathology in resected IPMNs. METHODS: The most recent annual cohort of patients undergoing pancreatectomy included in the American College of Surgeons National Surgical Quality Improvement Program were assessed, and contributions of demographics, preoperative laboratory values, and outcome data to level of IPMN dysplasia were analyzed...
March 20, 2018: Annals of Surgical Oncology
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
Stefano Francesco Crinò, Mirko D'Onofrio, Laura Bernardoni, Luca Frulloni, Michele Iannelli, Giuseppe Malleo, Salvatore Paiella, Alberto Larghi, Armando Gabbrielli
BACKGROUND AND AIMS: Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is a promising technique for the treatment of pancreatic neoplasm. We evaluated the feasibility, safety, and technical success of pancreatic EUS-RFA performed in a single center. METHODS: 9 consecutive patients (8 with pancreatic adenocarcinoma and 1 with renal cancer metastasis) were referred for EUS-RFA between November 2016 and July 2017. EUS-RFA was performed using 18-gauge internally cooled electrode with a 5 or 10 mm exposed tip...
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
Minhee Park, Ho Kyoung Hwang, Mijin Yun, Woo Jung Lee, Hoguen Kim, Chang Moo Kang
Objective: We aimed to investigate the metabolic characteristics of Solid pseudopapillary neoplasms (SPNs) in relation signal intensities on18 F-FDG PET scans. Summary Background Data: SPNs of the pancreas commonly show high uptake of 18F-FDG. However, the metabolic characteristics underlying the high18 F-FDG uptake in SPNs are not well characterized. Materials and Methods: mRNA expressions for glucose metabolism were analyzed in five SPNs, five pancreatic ductal adenocarcinomas (PCAs), and paired normal pancreatic tissues...
February 23, 2018: Oncotarget
Linda C Chu, Pamela T Johnson, Elliot K Fishman
Pancreatic cancer is the third most common cause of cancer death and CT is the most commonly used modality for the initial evaluation of suspected pancreatic cancer. Post-processing of CT data into 2D multiplanar and 3D reconstructions has been shown to improve tumor visualization and assessment of tumor resectability compared to axial slices, and is considered the standard of care. Cinematic rendering is a new 3D-rendering technique that produces photorealistic images, and it has the potential to more accurately depict anatomic detail compared to traditional 3D reconstruction techniques...
March 17, 2018: Abdominal Radiology
D Cuccurullo, G Carbone, M G Iovino, I De Rosa, M Fabozzi, F Corcione
BACKGROUND: Solid pancreatic pseudopapillary tumors are a rare neoplasms, about 1-3% of all pancreatic neoplasms. This cancer mainly affects women between the third and fourth decade of life. They are not well known; the molecular origins represent a low degree of malignancy, in which the complete resection is curative. We report our experience with a case report of SPT in a young man. PRESENTATION OF CASE: Thirty-six years old male patient with a mass about 10 cm in the pancreatic tail and splenic ilum...
February 9, 2018: International Journal of Surgery Case Reports
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
Chungen Lan, Xin Li, Xiuchao Wang, Jihui Hao, He Ren
Objective: Cystic lesions of the pancreas have been increasingly recognized. Some lesions exhibit benign behavior, while others have unequivocal malignant potential. Thus, accurate identification of malignancy in patients diagnosed with pancreatic cystic neoplasms (PCNs) remains a major challenge. The aim of this study was to define a combined criterion to better predict malignant lesions in patients with PCNs. Methods: We retrospectively analyzed 165 patients who underwent resection of PCNs from October 2011 to May 2017...
February 2018: Cancer Biology & Medicine
D Sunjaya, J Jacobi, S Sweetser
No abstract text is available yet for this article.
April 2018: Journal of Gastroenterology and Hepatology
Uayporn Kaosombatwattana, Yoshiki Hirooka, Hiroki Kawashima, Eizaburo Ohno, Takuya Ishikawa, Hiroki Suhara, Hidemi Goto
Endoscopic ultrasound is increasingly being used for evaluation of pancreatic diseases and pancreatic tumors. Among various pancreatic cystic lesions, cystic degeneration of pancreatic neuroendocrine neoplasm is of the challenge in making diagnosis. Although unique characteristic of each type of pancreatic cystic lesions has been proposed abundantly, typical morphology of cystic degeneration of pancreatic neuroendocrine neoplasm is still unclear. We, herein, reported a case of 66-year-old woman who was incidentally found to have a cystic lesion in the tail of pancreas upon screening transabdominal ultrasonography...
March 13, 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
Vincent P Groot, Sameer S Thakker, Georgios Gemenetzis, Michaël Noë, Ammar A Javed, Richard A Burkhart, Behnoud B Noveiry, John L Cameron, Matthew J Weiss, Christopher J VandenBussche, Elliot K Fishman, Ralph H Hruban, Christopher L Wolfgang, Anne Marie Lennon, Jin He
BACKGROUND: Lymphoepithelial cysts (LECs) are rare pancreatic cystic lesions. Since LECs are benign, preoperative diagnosis is important to differentiate from a cystic neoplasm and avoid unnecessary surgery. The aim of this study was to identify clinical, radiographic and cytopathologic features associated with LECs. METHODS: A retrospective review was performed of patients diagnosed with LEC between 1995 and 2017 at our hospital. Clinicopathologic and radiographic imaging features were documented...
March 9, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Alessandra Zilli, Ilaria Fanetti, Dario Conte, Sara Massironi
Gallium-68 DOTA-peptide positron emission tomography/computed tomography (68 Ga-PET/CT) has emerged as a promising tool for the diagnosis and staging of gastro-entero-pancreatic neoplasms, thanks to its high sensitivity and specificity. Heterotopic pancreas, which is relatively rare, has never been reported as a possible cause of false positives of68 Ga-PET/CT. We report on the first case of a heterotopic pancreas showing pathological uptake at68 Ga-PET/CT, thus mimicking an intestinal neuroendocrine tumor...
March 6, 2018: Clinical Imaging
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
Riccardo Ariotti, Stefano Partelli, Francesca Muffatti, Valentina Andreasi, Francesca Della Sala, Massimo Falconi
Neuroendocrine gastro-entero-pancreatic neoplasms (GEP-NENs) constitute a heterogeneous group of tumors, whose incidence has increased over the years. The most frequent site for primary disease is the stomach followed by small and large intestine, and pancreas. In the last decade, a dramatic growing in the incidence of small, incidental GEP-NENs has been recorded. In parallel, an increasing attitude toward more conservative approaches instead of surgical management has being widely spreading. This is particularly true for small, asymptomatic, pancreatic NEN as for these tumor forms an active surveillance has proven to be safe and feasible...
March 12, 2018: Reviews in Endocrine & Metabolic Disorders
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
Hélène Neophytou, Marc Wangermez, Elise Gand, Michel Carretier, Jérôme Danion, Jean-Pierre Richer
BACKGROUND: The aim of the present study is to evaluate the risk factors of endocrine and exocrine insufficiency occurring few years after pancreatic resections in a consecutive series of patients who underwent pancreatoduodenectomy (PD), left pancreatectomy (LP) or enucleation for benign neoplasms at a referral centre. METHODS: Pancreatic exocrine insufficiency (PEI) was defined by the onset of steatorrhea associated with weight loss, and endocrine insufficiency was determinate by fasting plasma glucose...
March 8, 2018: Annales D'endocrinologie
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