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Pancreatic neoplasms

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https://www.readbyqxmd.com/read/28733926/perioperative-management-of-endocrine-insufficiency-after-total-pancreatectomy-for-neoplasia
#1
REVIEW
Ajay V Maker, Raashid Sheikh, Vinita Bhagia
PURPOSE: Indications for total pancreatectomy (TP) have increased, including for diffuse main duct intrapapillary mucinous neoplasms of the pancreas and malignancy; therefore, the need persists for surgeons to develop appropriate endocrine post-operative management strategies. The brittle diabetes after TP differs from type 1/2 diabetes in that patients have absolute deficiency of insulin and functional glucagon. This makes glucose management challenging, complicates recovery, and predisposes to hospital readmissions...
July 21, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28733877/expanding-the-spectrum-of-colonic-manifestations-in-tuberous-sclerosis-l-cell-neuroendocrine-tumor-arising-in-the-background-of-rectal-pecoma
#2
David L Kolin, Kai Duan, Bo Ngan, J Ted Gerstle, Monika K Krzyzanowska, Gino R Somers, Ozgur Mete
Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous condition that predisposes to numerous proliferative lesions, including perivascular epithelioid cell tumors (PEComas), such as lymphangioleiomyomatosis (LAM) and angiomyolipomas, and rare neuroendocrine neoplasms. We describe herein a TSC2-harboring tuberous sclerosis patient manifesting with a synchronous well-differentiated L-cell rectal neuroendocrine tumor and leiomyomatosis-like LAM of the rectum. The background large bowel wall was thickened by confluent nodular areas comprising vessels and spindle-to-epithelioid cells, which are immunoreactive for myoid (smooth muscle actin, muscle specific actin, and desmin) and melanocytic markers (HMB45, Melan-A, microphthalmia transcription factor, and CD117)...
July 21, 2017: Endocrine Pathology
https://www.readbyqxmd.com/read/28732381/lymph-node-ratio-but-not-the-total-number-of-examined-lymph-nodes-or-lymph-node-metastasis-is-a-predictor-of-overall-survival-for-pancreatic-neuroendocrine-neoplasms-after-surgical-resection
#3
Peng Liu, Xianbin Zhang, Yuru Shang, Lili Lu, Fei Cao, Min Sun, Zhaohui Tang, Brigitte Vollmar, Peng Gong
AIM: To evaluate the prognostic significance of lymph node metastasis, extent of examined lymph nodes (ELNs) and lymph node ratio (LNR) for resected pancreatic neuroendocrine neoplasms (pNENs). MATERIALS AND METHODS: Surgically resected pNENs were assimilated from the Surveillance, Epidemiology, and End Results database. Kaplan-Meier and Cox proportional hazard models were used to examine the prognostic effect of clinicopathological characteristics on overall survival; Harrell's concordance index was performed to assess the prognostic accuracy of all independent prognostic factors; and the Spearman's rank correlation was used to assess the correlation between LNR and other clinicopathological characteristics...
July 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/28730242/replaced-common-hepatic-artery-originating-from-the-superior-mesenteric-artery-and-prepancreatic-anterior-course-in-a-patient-with-cephalic-pancreaticoduodenectomy-case-report
#4
Octavian Marius CreŢu, Emil Florin Hut, Radu Gheorghe Dan, Mihnea Munteanu, Bogdan Dan Totolici, Octavian Aurel Andercou
The presence of hepatic arterial variations is particularly important for patients undergoing cephalic pancreaticoduodenectomy, because it can lead to unnecessary incidents or postoperative complications. We present the case of a patient with pancreatic head neoplasm in which the cephalic pancreaticoduodenectomy was performed and the origin of common hepatic artery from superior mesenteric artery, with an anterior, prepancreatic course.
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28728311/clinical-approach-to-incidental-pancreatic-cystic-neoplasm-in-outpatient-clinics
#5
REVIEW
Young Sik Woo, Kyu Taek Lee
Cystic lesions of the pancreas are increasingly observed due to increased use of abdominal images. The malignant rate of pancreas cystic lesion varies widely between various types. Identification of malignant or high-risk lesions is important when determining the appropriate course of management. Using these image findings, including cyst size, presence of solid components, and pancreatic duct involvement, the 2012 International Association of Pancreatology (IAP) and the 2015 American Gastroenterological Association (AGA) guidelines provide a rationale in identifying higher risk patients requiring further workups using an endoscopic ultrasound (EUS)...
July 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28728148/the-role-of-cytotoxic-chemotherapy-in-advanced-pancreatic-neuroendocrine-tumors
#6
Sebastian Krug, Thomas M Gress, Patrick Michl, Anja Rinke
BACKGROUND: Pancreatic neuroendocrine tumors (PNETs) are rare neoplasms accounting for less than 5% of all pancreatic malignancies. These tumors are characterized by clinical and prognostical heterogeneity and are predominantly diagnosed in a metastatic stage. Cytotoxic chemotherapy, along with alkylating agents and antimetabolites as well as molecular targeted agents (everolimus, sunitinib), is used in the treatment of advanced PNETs. After the approval of lanreotide for unresectable PNETs, an additional therapeutic option has become available; however, the best sequence of therapies and patient stratification to different treatments remains challenging...
July 21, 2017: Digestion
https://www.readbyqxmd.com/read/28725064/editorial-stopping-pancreatic-cyst-surveillance
#7
James J Farrell
The management of patients with pancreatic cysts, especially presumed branch duct intraductal papillary mucinous neoplasms (BD-IPMNs), remains a challenge. BD-IPMNs carry a very low risk of malignancy and occur in predominantly older individuals who often die from causes not related to their pancreatic disease. The specific decision to stop surveillance of presumed low risk BD-IPMNs (those without either worrisome features (WF) or high risk stigmata (HRS)) is controversial, and needs to balance the real risk of malignancy or developing malignancy and IPMN-related mortality, with the patient's life expectancy, quality of life expectations, and mortality from non-pancreatic-related causes...
July 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28724304/synchronous-intraductal-papillary-mucinous-neoplasm-and-a-pancreatic-neuroendocrine-tumor-more-than-a-coincidence
#8
Juliana M Costa, Sofia Carvalho, João B Soares
Although the association between intraductal papillary mucinous neoplasm of the pancreas (IPMN) and pancreatic neuroendocrine tumor (PNET) has been increasingly reported, whether this association is real or coincidence remains unclear. We report a case of synchronous IPMN and a PNET which were diagnosed preoperatively and discuss the tumorigenesis, clinicopathological features and management of these rare tumors based on the published literature. A 56-year-old male was incidentally diagnosed with a 14 mm branch duct IPMN and a 3...
July 14, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28722124/pancreatic-undifferentiated-carcinoma-with-osteoclast-like-giant-cells-is-genetically-similar-to-but-clinically-distinct-from-conventional-ductal-adenocarcinoma
#9
Claudio Luchini, Antonio Pea, Gemma Lionheart, Andrea Mafficini, Alessia Nottegar, Nicola Veronese, Peter Chianchiano, Lodewijk A A Brosens, Michaël Noë, G Johan A Offerhaus, Raluca Yonescu, Yi Ning, Giuseppe Malleo, Giulio Riva, Paola Piccoli, Ivana Cataldo, Paola Capelli, Giuseppe Zamboni, Aldo Scarpa, Laura D Wood
Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells (UCOGC) is currently considered a morphologically and clinically distinct variant of pancreatic ductal adenocarcinoma (PDAC). In this study, we report clinical and pathological features of a series of 22 UCOGC, including the whole exome sequencing of 8 UCOGC. We observed that 60% of the UCOGC contained a well-defined epithelial component and that patients with pure UCOGC had a significantly better prognosis than did those with an UCOGC with an associated epithelial neoplasm...
July 19, 2017: Journal of Pathology
https://www.readbyqxmd.com/read/28718071/cancer-survival-in-adult-patients-in-spain-results-from-nine-population-based-cancer-registries
#10
M D Chirlaque, D Salmerón, J Galceran, A Ameijide, A Mateos, A Torrella, R Jiménez, N Larrañaga, R Marcos-Gragera, E Ardanaz, M Sant, P Minicozzi, C Navarro, M J Sánchez
INTRODUCTION: With the aim of providing cancer control indicators, this work presents cancer survival in adult (≥15 years) patients in Spain diagnosed during the period 2000-2007 from Spanish cancer registries participating in the EUROCARE project. METHODS: Cancer cases from nine Spanish population-based cancer registries were included and analysed as a whole. All primary malignant neoplasms diagnosed in adult patients were eligible for the analysis. Cancer patients were followed until 31 December 2008...
July 17, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28700444/multi-institutional-validation-study-of-pancreatic-cyst-fluid-protein-analysis-for-prediction-of-high-risk-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#11
Mohammad A Al Efishat, Marc F Attiyeh, Anne A Eaton, Mithat Gönen, Denise Prosser, Anna E Lokshin, Carlos Fernández-Del Castillo, Keith D Lillemoe, Cristina R Ferrone, Ilaria Pergolini, Mari Mino-Kenudson, Neda Rezaee, Marco Dal Molin, Matthew J Weiss, John L Cameron, Ralph H Hruban, Michael I D'Angelica, T Peter Kingham, Ronald P DeMatteo, William R Jarnagin, Christopher L Wolfgang, Peter J Allen
OBJECTIVE: Preliminary work by our group suggested that proteins within the pancreatic cyst fluid (CF) may discriminate degree of IPMN dysplasia. We sought to externally validate these markers and determine whether their inclusion in a preoperative clinical nomogram could increase diagnostic accuracy. SUMMARY BACKGROUND DATA: IPMN is the most common radiographically identifiable precursor to pancreatic cancer; however, the timing and frequency of its malignant progression are unknown, and there are currently no reliable preoperative tests that can determine the grade of dysplasia in IPMN...
July 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28699200/ultrasonographic-features-of-insulinoma-in-six-ferrets
#12
Ruey-Shyuan Wu, Yi-Jing Liu, Che-Chu Chu, Hock Gan Heng, Min-Yuan Chia, Hsien-Chi Wang, Kuan-Sheng Chen
Insulinoma is a functional, insulin-secreting tumor, arising from the beta islet cells of the pancreas. It is one of the most common neoplasms in ferrets and has been associated with clinical signs of hypoglycemia, such as ptyalism, pawing at the mouth, seizures, lethargy, and coma. The ultrasonographic features of insulinoma in ferrets have not been previously reported. The purpose of this retrospective case series study was to describe the ultrasonographic features of confirmed insulinoma in a group of ferrets...
July 11, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28699023/laparoscopic-uncinate-process-first-pancreatoduodenectomy-feasibility-study-of-a-modified-artery-first-approach-to-pancreatic-head-cancer
#13
Michał Pędziwiatr, Magdalena Pisarska, Piotr Małczak, Piotr Major, Mateusz Wierdak, Dorota Radkowiak, Jan Kulawik, Marcin Dembiński, Andrzej Budzyński
PURPOSE: The aim of this study was to discuss the feasibility of laparoscopic 'uncinate first' pancreatoduodenectomy. METHODS: The analysis included prospectively collected data from 12 consecutive patients undergoing elective pure laparoscopic 'uncinate process first' pancreatoduodenectomy (Group 1). They were compared with patients previously operated on with a classical laparoscopic approach (Group 2). The primary outcome was the quality of the resected specimen (lymph node (LN) yield, R0 rate, involved resection margins)...
July 11, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28697137/clinical-profile-of-pancreatic-cystic-lesions-in-von-hippel-lindau-disease-a-series-of-48-patients-seen-at-a-tertiary-institution
#14
Ayush Sharma, Saurabh Mukewar, Santhi Swaroop Vege
OBJECTIVES: Little is known about the association between pancreatic cystic lesions (PCLs) with von Hippel-Lindau disease (VHLD). In this study, we describe the clinical presentation, type of PCLs, and risk for malignancy in PCLs in VHLD. METHODS: Patients given a diagnosis of both VHLD and PCLs were identified from electronic medical records at Mayo Clinic, Rochester, MN, from January 1, 2000, to January 1, 2016. Various demographic, clinical, and radiologic variables were recorded...
August 2017: Pancreas
https://www.readbyqxmd.com/read/28697136/circulating-epithelial-cells-in-intraductal-papillary-mucinous-neoplasms-and-cystic-pancreatic-lesions
#15
Katherine E Poruk, Vicente Valero, Jin He, Nita Ahuja, John L Cameron, Matthew J Weiss, Anne Marie Lennon, Michael Goggins, Laura D Wood, Christopher L Wolfgang
OBJECTIVES: Circulating epithelial cells (CECs) are identified in the blood of patients with intraductal papillary mucinous neoplasms (IPMNs) despite the absence of malignancy. We assessed the blood of patients undergoing resection for IPMN or other benign pancreatic lesions for CECs. METHODS: Peripheral blood was collected from 26 patients prior to pancreatic resection and filtered by the ISET (Isolation by Size of Epithelial Tumor Cells) method. Circulating epithelial cells were identified with antibodies to cytokeratin and Pdx1 (pancreas and duodenal homeobox protein 1), a pancreas marker...
August 2017: Pancreas
https://www.readbyqxmd.com/read/28694837/metastatic-neoplasms-to-the-thyroid-diagnosed-by-fine-needle-aspiration-core-needle-biopsy-clinicopathologic-and-cytomorphologic-correlation
#16
Mobeen Rahman, Ashley Rae Okada, Kevin Guan, Pamela Tauchi-Nishi
BACKGROUND: Although thyroid fine-needle aspiration (FNA) and core needle biopsy (CNB) are commonly utilized modalities in the evaluation of thyroid nodules, metastatic tumors to the thyroid are only rarely encountered. We aspired to determine the incidence and primary origin of metastases to the thyroid at our institution and to examine their clinicopathologic and cytomorphologic features. MATERIALS AND METHODS: A search of our database was undertaken to review all thyroid FNA and/or CNB examined between January 2004 and December 2013...
2017: CytoJournal
https://www.readbyqxmd.com/read/28693619/successful-pregnancy-after-mucinous-cystic-neoplasm-with-invasive-carcinoma-of-the-pancreas-in-a-patient-with-polycystic-ovarian-syndrome-a-case-report
#17
Conisha Holloman, S J Carlan, Lohini Sundharkrishnan, Angela Guzman, Mario Madruga
BACKGROUND: The incidence of invasive cancer within a mucinous cystic neoplasm of the pancreas varies between 6 and 36%. Polycystic ovarian syndrome is a disorder characterized by hyperandrogenism and anovulatory infertility. One surgical treatment that can restore endocrine balance and ovulation in polycystic ovarian syndrome is partial ovarian destruction. Successful pregnancies following preconception pancreaticoduodenectomies (Whipple procedures) and chemoradiation to treat pancreatic neoplasms have been reported rarely but none were diagnosed with pre-cancer polycystic ovarian syndrome-associated infertility...
July 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28693147/pancreatic-intraductal-tubulopapillary-neoplasm-with-associated-invasive-cancer-successfully-treated-by-total-pancreatectomy-a-case-report
#18
Yuji Fujimoto, Yoshito Tomimaru, Hiromi Tamura, Kozo Noguchi, Hirotsugu Nagase, Atsushi Hamabe, Masashi Hirota, Kazuteru Oshima, Tsukasa Tanida, Tomono Kawase, Shunji Morita, Hiroshi Imamura, Takashi Iwazawa, Kenzo Akagi, Masashi Yamamoto, Tsutomu Nishida, Shiro Adachi, Keizo Dono
A 74-year-old male was admitted to Departments of Surgery, Toyonaka Municipal Hospital (Osaka, Japan) for treatment of a pancreatic tumor. Contrast enhanced computed tomography (CT) revealed a mass with small cystic lesions in the pancreatic head and body. Fluorodeoxyglucose-positron emission tomography/CT revealed an abnormal uptake of fluorodeoxyglucose, corresponding to the mass lesions. Upper gastrointestinal endoscopy revealed rough mucosa near the opening of the accessory pancreatic duct, and the mucosa biopsy exhibited adenocarcinoma with no mucin observed...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28688966/surgical-outcomes-of-pancreaticoduodenectomy-in-young-patients-a%C3%A2-case-series
#19
Ayman El Nakeeb, Mohamed El Sorogy, Ali Salem, Rami Said, Mohamed El Dosoky, Ahmed Moneer, Mahmoud Abdelwahab Ali, Youssef Mahdy
BACKGROUND: Pancreaticoduodenectomy (PD) is a complex procedure for management periampullary neoplasms The aim of our work is to report the surgical outcomes after PD in young adult (YA) (<35 years) and to compare it to a adult patients who underwent PD. METHODS: We retrospectively analyzed the data of all patients who underwent PD in the period from January 1993 to December 2016. The primary outcome was the rate of total postoperative complications. Secondary outcomes included postoperative pathology, exocrine and endocrine function and survival rate...
July 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28687431/resectable-invasive-ipmn-versus-sporadic-pancreatic-adenocarcinoma-of-the-head-of-the-pancreas-should-these-two-different-diseases-receive-the-same-treatment-a-matched-comparison-study-of-the-french-surgical-association-afc
#20
P Duconseil, J Périnel, A Autret, M Adham, A Sauvanet, L Chiche, J-Y Mabrut, J-J Tuech, C Mariette, N Régenet, J-M Fabre, P Bachellier, J-R Delpéro, F Paye, O Turrini
PURPOSE: To compare survival and impact of adjuvant chemotherapy in patients who underwent pancreaticoduodenectomy (PD) for invasive intraductal papillary mucinous neoplasm (IIPMN) and sporadic pancreatic ductal adenocarcinoma (PDAC). METHODS: From 2005 to 2012, 240 patients underwent pancreatectomy for IIPMN and 1327 for PDAC. Exclusion criteria included neoadjuvant treatment, pancreatic resection other than PD, vascular resection, carcinoma in situ, or <11 examined lymph nodes...
June 29, 2017: European Journal of Surgical Oncology
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