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Chatterjee T, Reddy Y, Badshah M, Puli S. An Unusual Case of Dual Pancreatic Tumors. ACG Case Rep J 2023; 10:e01190. [PMID: 37860811 PMCID: PMC10584299 DOI: 10.14309/crj.0000000000001190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/25/2023] [Indexed: 10/21/2023] Open
Abstract
We report a simultaneous occurrence of pancreatic adenocarcinoma and pancreatic neuroendocrine tumor. A 64-year-old woman presented with abdominal pain and weight loss. Abdominal computed tomography revealed a pancreatic head mass with a mesenteric artery encasement. Endoscopic ultrasound revealed a second mass in the tail of the pancreas. Pathology reported adenocarcinoma of the head of the pancreas and a neuroendocrine tumor in the tail of the pancreas. The neuroendocrine tumor was nonfunctional, with no symptoms or signs present on assessment. The patient had advanced unresectable carcinoma, so she was treated with chemotherapy.
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Affiliation(s)
- Tulika Chatterjee
- Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL
| | - Yeshaswini Reddy
- Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL
| | - Maaz Badshah
- Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL
| | - Srinivas Puli
- Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL
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Hirai R, Omae KI, Yodoya M, Fujie S, Fujii M, Iwata K, Imanishi K, Kurihara E, Yoshida K, Jida M, Kobayashi K, Kanaya Y, Maruyama S. A case report of a collision tumor composed of pancreatic ductal adenocarcinoma and peri-pancreatic mucosa-associated lymphoid tissue lymphoma. World J Surg Oncol 2023; 21:110. [PMID: 36973717 PMCID: PMC10045193 DOI: 10.1186/s12957-023-02981-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/08/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Collision tumors are composed of two distinct tumor components. Collision tumors composed of pancreatic ductal adenocarcinoma and malignant lymphoma occurring in the pancreas have not been previously described in the scientific literature. In this case report, we describe a unique patient with a collision tumor composed of pancreatic ductal adenocarcinoma and peri-pancreatic mucosa-associated lymphoid tissue (MALT) lymphoma occurring in the pancreas. CASE PRESENTATION An 82-year-old woman presented to our hospital complaining of dizziness. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large lymphoid lesion spreading from the peri-pancreatic tissue heading to the hepatic hilar plate, involving the hepatoduodenal ligament and the entire duodenum, also showing a hard tumor in the pancreas head. We performed echo-guided needle biopsies for each tumor and diagnosed a collision tumor composed of pancreatic ductal adenocarcinoma and low-grade B cell lymphoma. The patient underwent pancreaticoduodenectomy. The resected specimen showed an elastic hard tumor, 90 × 75 mm in size, located in the pancreatic head, and a whitish-yellow hard tumor involving the lower bile duct, 31 mm in size, located in the center of the pancreatic head. Pathological and immunohistochemical examination proved that pancreatic ductal adenocarcinoma and MALT lymphoma originating from the peri-pancreatic head collided in the pancreatic head. CONCLUSIONS To best of our knowledge, this is the first report of a surgically resected collision tumor of pancreatic ductal adenocarcinoma and MALT lymphoma originating from the peri-pancreatic head. A needle biopsy is useful when inconsistent findings are observed on diagnostic CT and MRI of tumor lesions since there is the possibility of a collision tumor.
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Affiliation(s)
- Ryuji Hirai
- Department of Surgery, Himeji St. Mary's Hospital, 650, Nibuno, Himeji, Hyogo, 670-0801, Japan.
| | - Ken-Ichi Omae
- Department of Radiology, Himeji St. Mary's Hospital, 650, Nibuno, Himeji, Hyogo, 670-0801, Japan
| | - Mitsuko Yodoya
- Department of Radiology, Himeji St. Mary's Hospital, 650, Nibuno, Himeji, Hyogo, 670-0801, Japan
| | - Syunji Fujie
- Department of Radiology, Himeji St. Mary's Hospital, 650, Nibuno, Himeji, Hyogo, 670-0801, Japan
| | - Masayoshi Fujii
- Department of Pathology, Himeji St. Mary's Hospital, 650, Nibuno, Himeji, Hyogo, 670-0801, Japan
| | - Kazuma Iwata
- Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University, 2-5-1, Shikata-Cho, Kita-Ku, Okayama City, Okayama, 700-8558, Japan
| | - Kentaro Imanishi
- Department of Surgery, Himeji St. Mary's Hospital, 650, Nibuno, Himeji, Hyogo, 670-0801, Japan
| | - Eisuke Kurihara
- Department of Surgery, Himeji St. Mary's Hospital, 650, Nibuno, Himeji, Hyogo, 670-0801, Japan
| | - Kazuhiro Yoshida
- Department of Surgery, Himeji St. Mary's Hospital, 650, Nibuno, Himeji, Hyogo, 670-0801, Japan
| | - Masaru Jida
- Department of Surgery, Himeji St. Mary's Hospital, 650, Nibuno, Himeji, Hyogo, 670-0801, Japan
| | - Kazuyasu Kobayashi
- Department of Surgery, Himeji St. Mary's Hospital, 650, Nibuno, Himeji, Hyogo, 670-0801, Japan
| | - Yoshiaki Kanaya
- Department of Surgery, Himeji St. Mary's Hospital, 650, Nibuno, Himeji, Hyogo, 670-0801, Japan
| | - Syuichiro Maruyama
- Department of Surgery, Himeji St. Mary's Hospital, 650, Nibuno, Himeji, Hyogo, 670-0801, Japan
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Somatostatin Analogue Therapy in MEN1-Related Pancreatic Neuroendocrine Tumors from Evidence to Clinical Practice: A Systematic Review. Pharmaceuticals (Basel) 2021; 14:ph14101039. [PMID: 34681263 PMCID: PMC8538402 DOI: 10.3390/ph14101039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 12/20/2022] Open
Abstract
Neuroendocrine neoplasms (NENs) are relatively rare and complex tumors that can be sporadic or hereditary, as in the context of multiple endocrine neoplasia type 1 (MEN1) where patients display a 70% lifelong risk of developing a pancreatic NENs (pNENs). To date, specific personalized treatment for pNENs in patients with MEN1 are lacking. The aim of this study was to systematically analyze the efficacy and safety of somatostatin analogue (SSA) treatment in patients affected by MEN1-related pNENs. We performed a systematic review of the literature, searching for peer-reviewed articles on SSA (octreotide or lanreotide) treatment in MEN1 associated with pNENs. We selected 20 studies with a pooled population of 105 MEN1 patients with pNENs. Females were 58.5%, median age was 44 years (18-73). TNM stage at diagnosis was stage I-II in 84.8% and stage IV in 15.2%. The overall response rate (SD+PR+CR) was achieved in 88.3% of cases, with stable disease in 75.6% and objective response in 12.7% of patients. The safety profile was favorable with both SSA agents. SSAs appear to be an effective and safe treatment option for MEN1-related pNEN, either at localized or advanced stages.
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