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endoscopic ultrasound pancreatic cancer

Kunio Kataoka, Hiroshi Matsubara, Fumihiro Urano, Shozo Okamura, Matsuyoshi Maeda
A male patient aged over 60 years presented with abdominal pain. A solid lesion measuring 7cm was detected in the pancreatic body and tail, along with periaortic lymphadenopathy. Endoscopic ultrasound-guided fine-needle aspiration suggested squamous cell carcinoma. Nab-paclitaxel+gemcitabine therapy was effective;however, tumor progression was noted after the completion of the fourth course, and the patient died from the primary cancer 7 months after the initial consultation. Autopsy led to a definitive diagnosis of adenosquamous carcinoma of the pancreas...
2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Mišo Gostimir, Sean Bennett, Terence Moyana, Harman Sekhon, Guillaume Martel
BACKGROUND: Pancreatic cancer is among the top 5 most common cancers worldwide, but is particularly devastating due to its insidious nature. Complete surgical resection remains the only potential curative treatment, although only 20 % of patients present with a resectable tumor. Patients may alternatively present with borderline resectable pancreatic cancer or locally advanced pancreatic cancer and can be offered treatment with neoadjuvant intent. The effectiveness of these treatments is unclear and there is a paucity of data to suggest one optimal treatment approach...
October 10, 2016: BMC Cancer
Kazuya Matsumoto, Yohei Takeda, Takumi Onoyama, Soichiro Kawata, Hiroki Kurumi, Masaru Ueki, Norimasa Miura, Hajime Isomoto
Pancreatic cancer is the fifth leading cause of cancer death and has the lowest survival rate of any solid cancer. Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is currently capable of providing a cytopathological diagnosis of pancreatic malignancies with a higher diagnostic power, with a sensitivity and specificity of 85%-89% and 98%-99%, compared to pancreatic juice cytology (PJC), whose sensitivity and specificity are only 33.3%-93% and 83.3%-100%. However, EUS-FNA is not effective in the cases of carcinoma in situ and minimally invasive carcinoma because both are undetectable by endoscopic ultrasonography, although PJC is able to detect them...
September 15, 2016: World Journal of Gastrointestinal Oncology
Stergios Boussios, Ioannis Zerdes, Ourania Batsi, Vasilios P Papakostas, Esmeralda Seraj, George Pentheroudakis, George K Glantzounis
INTRODUCTION: Pancreatic metastases are uncommon and only found in a minority of patients with widespread metastatic disease at autopsy. The most common primary cancer site resulting in pancreatic metastases is the kidney, followed by colorectal cancer, melanoma, breast cancer, lung carcinoma and sarcoma. PRESENTATION OF CASE: Herein, we report a 63-year-old male patient who presented -3.5 years after radical nephrectomy performed for renal cell carcinoma (RCC)-with a well-defined lobular, round mass at the body of the pancreas demonstrated by abdominal Magnetic Resonance Imaging (MRI)...
2016: International Journal of Surgery Case Reports
Robert A Mitchell, Dylan Stanger, Constantin Shuster, Jennifer Telford, Eric Lam, Robert Enns
Background. There is a high incidence of inconclusive cytopathology at initial EUS-FNA (endoscopic ultrasound-guided fine-needle aspiration) for suspected malignant pancreatic lesions. To obtain appropriate preoperative or palliative chemotherapy for pancreatic cancer, definitive cytopathology is often required. The utility of repeat EUS-FNA is not well established. Methods. A retrospective cohort study was conducted evaluating the yield of repeat EUS-FNA in determining a cytological diagnosis in patients who had undergone a prior EUS-FNA for diagnosis of suspected malignant pancreatic lesions with inconclusive cytopathology...
2016: Canadian Journal of Gastroenterology & Hepatology
Domenico Tamburrino, Deniece Riviere, Mohammad Yaghoobi, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: Periampullary cancer includes cancer of the head and neck of the pancreas, cancer of the distal end of the bile duct, cancer of the ampulla of Vater, and cancer of the second part of the duodenum. Surgical resection is the only established potentially curative treatment for pancreatic and periampullary cancer. A considerable proportion of patients undergo unnecessary laparotomy because of underestimation of the extent of the cancer on computed tomography (CT) scanning. Other imaging methods such as magnetic resonance imaging (MRI), positron emission tomography (PET), PET-CT, and endoscopic ultrasound (EUS) have been used to detect local invasion or distant metastases not visualised on CT scanning which could prevent unnecessary laparotomy...
September 15, 2016: Cochrane Database of Systematic Reviews
Zdeněk Fryšák, David Karásek
UNLABELLED: Decrease of blood glucose levels below 3 mmol/l is in fully developed cases accompanied by neuroglycopenic symptoms that may even lead to altered state of consciousness. The treating physician frequently faces a complicated situation. This may be due to inappropriately administered drugs including cases motivated by self-harm intentions (insulin, insulin secretagogues), or alcohol abuse. Undernourished people, or those afflicted with a serious systemic infection, end-stage liver or kidney diseases or with a failing heart, belong to a risk group...
2016: Vnitr̆ní Lékar̆ství
Francesco Puleo, Pieter Demetter, Pierre Eisendrath, Raphaël Maréchal, Laurine Verset, Emmanuel Toussaint, Jean-Baptiste Bachet, Marianna Arvanitakis, Ibrahim Mostafa, Jacques Devière, Jean-Luc Van Laethem
No abstract text is available yet for this article.
October 2016: Pancreas
Farah Adel, José Manuel Ramia, Luis Gijón, Roberto de la Plaza-Llamas, Vladimir Arteaga-Peralta, Carmen Ramiro-Perez
BACKGROUND: Cystic echinococcosis is a zoonosis caused by larvae of the parasite Echinococcus that is endemic in many countries of the Mediterranean area. It can affect any organ, with the most common sites being liver (70%) and lung (20%). Splenic hydatid disease, despite being rare, is the third most common location. Other locations such as bone, skin, or kidney are exceptional. OBJECTIVE: To present our experience in extrahepatic and extrapulmonary hydatidosis...
September 5, 2016: Cirugia y Cirujanos
Divyanshoo R Kohli, Ashwani Kapoor, Doumit BouHaidar, Ravi Vachhani
BACKGROUND AND AIMS: Endoscopic ultrasound (EUS) is widely used to evaluate pancreatic cysts. Recent American Gastroenterological Association (AGA) guideline limits EUS for evaluation of cysts with at-least two high-risk features (size ≥ 3 cm, dilated main pancreatic duct or presence of a solid component). We have investigated the impact of this guideline on sensitivity of EUS for pancreatic cancer and the reduction of EUS procedures for pancreas cysts. METHODS: EUS procedures performed between 2004 and 2015 and related patient records were retrospectively reviewed to determine the presence or absence of high-risk features, and for the results of fine needle aspiration cytology...
August 20, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Tarun Rustagi, Ferga C Gleeson, Suresh T Chari, Barham K Abu Dayyeh, Michael B Farnell, Prasad G Iyer, Michael L Kendrick, Randall K Pearson, Bret T Petersen, Elizabeth Rajan, Mark D Topazian, Mark J Truty, Santhi S Vege, Kenneth K Wang, Michael J Levy
Synchronous primary pancreatic adenocarcinoma, defined as the simultaneous presence of 2 or more newly identified and anatomically separate primary adenocarcinomas within the pancreas, is rarely reported. We compared endoscopic ultrasound (EUS) and computed tomography (CT) and magnetic resonance imaging (MRI) findings from patients with synchronous primary pancreatic adenocarcinoma and their effects on cancer staging and treatment. We performed a retrospective analysis of the EUS database at the Mayo Clinic, from September 2008 through May 2016, to collect EUS, CT, MRI, and clinical data from patients with synchronous primary pancreatic adenocarcinoma...
August 15, 2016: Clinical Gastroenterology and Hepatology
Junpei Sasajima, Jiro Uehara, Takuma Goto, Shugo Fujibayashi, Kazuya Koizumi, Yusuke Mizukami, Akemi Ishida-Yamamoto, Mikihiro Fujiya, Toshikatsu Okumura
BACKGROUND: Pancreatic involvement of angiosarcoma is extremely rare. METHODS: We herein report a rare case of angiosarcoma associated with chronic lymphedema (Stewart-Treves syndrome) with pancreatic metastasis that was diagnosed using endoscopic ultrasound (EUS)/fine needle aspiration (FNA). RESULTS: A 43-year-old woman with a history of radical hysterectomy with bilateral inguinal lymphadenectomy and chemoradiotherapy for cervical cancer 15 years prior noticed the presence of erythematous indurative plaques on her right femoral region, where chronic lymphedema had developed...
August 2016: Medicine (Baltimore)
Louis de Mestier, Jean-Baptiste Danset, Cindy Neuzillet, Vinciane Rebours, Jérôme Cros, Nadem Soufir, Pascal Hammel
Germline BRCA2 mutations are the first known cause of inherited (familial) pancreatic ductal adenocarcinoma (PDAC). This tumor is the third most frequent cancer in carriers of germline BRCA2 mutations, as it occurs in around 10% of BRCA2 families. PDAC is known as one of the most highly lethal cancers, mainly because of its chemoresistance and frequently late diagnosis. Based on recent developments in molecular biology, a subgroup of BRCA2-associated PDAC has been created, allowing screening, early surgical treatment and personalized systemic treatment...
October 2016: Endocrine-related Cancer
Félix I Téllez-Ávila, Jorge Adolfo Martínez-Lozano, Anamaría Rosales-Salinas, Ambrosio Rafael Bernal-Méndez, Camilo Guerrero-Velásquez, Miguel Ángel Ramírez-Luna, Francisco Valdovinos-Andraca
BACKGROUND AND OBJECTIVES: There is no consensus about the ideal method for diagnosis in patients who have already undergone endoscopic ultrasound fine needle aspiration (EUS-FNA), and the inconclusive material is often obtained. The aim was to evaluate the diagnostic yield of the second EUS-FNA of pancreatic lesions. MATERIALS AND METHODS: A retrospective analysis of prospectively collected data of patients with EUS-FNA of pancreatic lesions is performed. All patients who underwent more than one EUS-FNA for the evaluation of suspected pancreatic cancer over a 7-year period were included in the analysis...
July 2016: Endoscopic Ultrasound
Stefano Crippa, Alessandra Piccioli, Maria Chiara Salandini, Chiara Cova, Francesca Aleotti, Massimo Falconi
The diagnosis of branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) has been dramatically increased. BD-IPMNs are frequently discovered as incidental findings in asymptomatic individuals, mainly in elderly patients. An accurate evaluation of BD-IPMNs with high-resolution imaging techniques and endoscopic ultrasound is necessary. Patients with high-risk stigmata (HRS, obstructive jaundice, enhanced solid component) should undergo resection. Patients with worrisome features (WF, cyst size ≥3 cm, thickened enhanced cyst walls, non-enhanced mural nodules, and clinical acute pancreatitis) may undergo either a strict surveillance based on patients' characteristics (age, comorbidities) or surgical resection...
August 8, 2016: Updates in Surgery
Michele Diana, Luigi Schiraldi, Yu-Yin Liu, Riccardo Memeo, Didier Mutter, Patrick Pessaux, Jacques Marescaux
BACKGROUND: High intensity focused ultrasound (HIFU) is emerging as a valid minimally-invasive image-guided treatment of malignancies. We aimed to review to current state of the art of HIFU therapy applied to the digestive system and discuss some promising avenues of the technology. METHODS: Pertinent studies were identified through PubMed and Embase search engines using the following keywords, combined in different ways: HIFU, esophagus, stomach, liver, pancreas, gallbladder, colon, rectum, and cancer...
August 2016: Hepatobiliary Surgery and Nutrition
Kinesh Changela, Rashmee Patil, Sushil Duddempudi, Vinaya Gaduputi
Objective. Radiofrequency ablation is a well-established antitumor treatment and is recognized as one of the least invasive therapeutic modalities for pancreatic neoplasm. Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) delivery can be used to treat both pancreatic cancer and asymptomatic premalignant pancreatic neoplasms and may serve as a less invasive alternative to surgical resection. This is an appealing option that may result in less morbidity and mortality. The aim of this review was to summarize and evaluate the clinical and technical effectiveness of EUS-guided RFA of pancreatic neoplasms...
2016: Canadian Journal of Gastroenterology & Hepatology
Alexander M Sarkisian, Iman Andalib, Nikhil A Kumta, Reem Z Sharaiha
PURPOSE OF REVIEW: Radiofrequency ablation (RFA) has been recognized for its potential in palliative treatment for pancreatic cancer as well as malignant biliary strictures. The purpose of this review is to describe the technology, endoscopic technique, and reported outcomes of endoscopic RFA in the management of malignant biliary strictures and unresectable pancreatic cancer. RECENT FINDINGS: Intraductal biliary RFA is safe and feasible and appears to confer a survival advantage...
July 21, 2016: Current Opinion in Gastroenterology
Ramin Shakeri, Farin Kamangar, Mehdi Mohamadnejad, Reza Tabrizi, Farhad Zamani, Ashraf Mohamadkhani, Sepideh Nikfam, Arash Nikmanesh, Masoud Sotoudeh, Rasoul Sotoudehmanesh, Bijan Shahbazkhani, Mohammad Reza Ostovaneh, Farhad Islami, Hossein Poustchi, Paolo Boffetta, Reza Malekzadeh, Akram Pourshams
BACKGROUND AND AIMS: Although several studies have suggested opium as a risk factor for cancers of the esophagus, stomach, larynx, lung, and bladder, no previous study has examined the association of opium with pancreatic cancer. We aimed to study the association between opium use and risk of pancreatic cancer in Iran, using a case-control design. We also studied the association of cigarette smoking and alcohol consumption with pancreatic cancer, for which little information was available from this population...
July 2016: Medicine (Baltimore)
Isaura S Ibrahim, Bert A Bonsing, Rutger-Jan Swijnenburg, Lieke Welling, Roeland A Veenendaal, Martin N J M Wasser, Hans Morreau, Akin Inderson, Hans F A Vasen
In 3-5 % of all cases of pancreatic ductal adenocarcinoma (PDAC), hereditary factors influence etiology. While surveillance of high-risk individuals may improve the prognosis, this study describes two very different outcomes in patients with screen-detected lesions. In 2000, a surveillance program of carriers of a CDKN2A/p16-Leiden-mutation consisting of annual MRI was initiated. Patients with a suspected pancreatic lesion undergo CT-scan and Endoscopic Ultrasound, and surgery is offered when a lesion is confirmed...
July 12, 2016: Familial Cancer
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