Resection or cryosurgery relates with pancreatic tumor type: primary pancreatic cancer with previous non-pancreatic cancer or secondary metastatic cancer within the pancreas

Endoscopic ultrasound‑guided fine‑needle aspiration for unresectable pancreatic metastasis of esophageal squamous cell carcinoma: A case report and literature review

Metastatic tumors to the pancreas are a rare subtype of pancreatic malignant tumor, particularly those that have spread from the esophagus. The diagnosis and treatment process can be complex when managing patients with tumors that have metastasized to the pancreas. Accurate differentiation between primary pancreatic and metastatic tumors is key in the use of precision therapy for these patients. The present study reports the case of a 53-year-old female patient that presented with symptoms of dysphagia and epigastric pain that had persisted for 3 months. Gastroscopy indicated the presence of a tumor in the lower esophagus, with pathology results demonstrating squamous cell carcinoma. Prior to radical esophageal cancer surgery, computed tomography (CT) scans demonstrated the presence of a tumor in the body of the pancreas. Due to the notable size of the tumor and potential involvement of the large abdominal vessels, esophageal surgery was postponed and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was performed to confirm the pathological diagnosis. EUS-FNA pathological diagnosis demonstrated that the pancreatic tumor was a result of esophageal tumor metastasis. The patient opted for radiotherapy and chemotherapy for both the esophageal and pancreatic tumors instead of undergoing surgery. The present study reports the clinical and pathological characteristics, and treatment strategies of rare metastatic tumors to the pancreas of esophageal origin.

A comprehensive analysis of renal cell carcinoma as first and second primary cancers

Objective

Second primary renal cell carcinoma (2nd RCC) refers to renal cell carcinoma (RCC) diagnosed after another unrelated malignancy. This study aims to compare the clinical manifestation, pathology, treatment, and prognostic features of patients with 2nd RCC and first primary renal cell carcinoma (1st RCC).

Materials and methods

Data of the patients with localized RCC were retrospectively collected. They were classified as 2nd RCC or 1st RCC according to a previously diagnosed cancer, including 113 cases of 2nd RCC and 749 cases of 1st RCC.

Results

The most common types of extrarenal malignancies in patients with 2nd RCC include lung, colorectal, breast, gynecological, and gastric cancers. The age and smoking rate of 2nd RCC patients were significantly higher than in those of 1st RCC patients. For 2nd RCC patients, fewer had clinical symptoms and renal masses tend to be smaller. One hundred and eight (95.6%) patients with 2nd RCC received surgical interventions. All patients with 1st RCC underwent renal surgery. More patients with 2nd RCC underwent a partial nephrectomy. Pathologically, there was no significant difference in postoperative pathological types between the 2nd and 1st RCCs. However, the 2nd RCCs were commonly identified in the early stages. The median overall survival (OS) of 2nd RCC patients was 117 months, which was shorter than that of 1st RCC patients.

Conclusions

Second RCC is not uncommon. More attention should be paid to screening for 2nd RCC in cancer survivors. There are some differences between patients with 2nd and 1st RCCs that should be viewed separately.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12957-022-02493-6.

Second Primary Renal Cell Carcinoma With Nonrenal Malignancies: An Analysis of 118 Cases and a Review of Literature

Objectives

To evaluate the nature, diagnosis, treatment and prognosis of second primary renal cell carcinoma (SPRCC).

Materials and Methods

We retrospectively collected data from 118 patients with SPRCC. Clinical characteristics, imaging features and treatments were analyzed and comparisons between SPRCC and renal metastases (RM) were made.

Results

SPRCC accounts for 11.4% of all RCC. The most common types of extrarenal malignancies included lung, colorectal, breast and gynecological cancers. The median age was 58.5 years old, and 61.0% (72/118) of the patients were male. About 5.1% of the patients presented with symptoms. The average tumor diameter was 4.4 cm (1-8.4 cm). The diagnostic specificity of enhanced computed tomography (CT) was 80.1%. When comparing with RM, more patients with stage I–II extrarenal malignancy and less patients with bilateral, multiple, and endogenic renal masses on computed tomography were found in the SPRCC group. A total of 110 SPRCC patients underwent surgery, including 48 radical nephrectomies and 62 partial nephrectomies. The median overall survival time was 117 months. Female, asymptomatic status, no distant metastasis, and surgical treatment predicted a better survival.

Conclusions

SPRCC are not uncommon, and it should be considered during the follow-up of patients with nonrenal malignancy. The differential diagnosis between SPRCC and RM was mainly based on imaging and puncture biopsy.

Translation of Cryobiological Techniques to Socially Economically Deprived Populations—Part 2: Cryosurgery

Cold and cryogenic temperatures are used for treating cancer and other pathological conditions in various fields of medicine. Cryosurgery, which resides at the interface of medicine and engineering, has attracted the interest of engineers, scientists, and medical doctors. Recently, particularly since the end of the 1980s, technological developments in cryotherapy equipment and enormous advances in imaging techniques, such as computed tomography and ultrasonography, have allowed surgeons and interventional radiologists to precisely guide cryogenic probes into tumors while avoiding damage to surrounding tissues. Extensive studies have allowed us to conclude that the use of cryogenics facilitates the successful treatment of solid tumors in various organs such as lung, liver, bones, kidneys, prostate, etc. Its simplicity of use, effectiveness, low cost, and limited demand on hospital infrastructure and personnel have made cryosurgery particularly suitable for the treatment of patients of socio-economically deprived populations.

Prevention of pancreatic acinar cell carcinoma by Roux-en-Y Gastric Bypass Surgery

Roux-en-Y Gastric Bypass Surgery (RYGB) prevents the occurrence of pancreatic cell acinar carcinoma (ACC) in male and female Ngn3-Tsc1-/- mice. Ngn3 directed Cre deletion of Tsc1 gene induced the development of pancreatic ACC. The transgenic mice with sham surgery demonstrated a cancer incidence of 96.7 ± 3.35% and survival rate of 67.0 ± 1.4% at the age of 300 days. Metastasis to liver and kidney was observed in 69.7 ± 9.7% and 44.3 ± 8.01% of these animals, respectively. All animals with RYGB performed at the age of 16 weeks survived free of pancreatic ACC up to the age of 300 days. RYGB significantly attenuated the activation of mTORC1 signaling and inhibition of tumor suppressor genes: p21, p27, and p53 in pancreatic ACC. Our studies demonstrate that bariatric surgery may limit the occurrence and growth of pancreatic ACC through the suppression of mTORC1 signaling in pancreas. RYGB shows promise for intervention of both metabolic dysfunction and organ cancer.

Laparotomy Cryoablation in Rabbit VX2 Pancreatic Carcinoma

OBJECTIVE

The aim of this study was to establish a suitable rabbit model and select the optimal protocol for laparotomy cryoablation of pancreatic carcinoma.

METHODS

VX2 tumor tissues were inoculated into rabbit pancreases to build the pancreatic carcinoma model; then, the tumor-bearing rabbits were randomly divided into 4 groups: control, treatment A (the cryoablated-iceball diameter was bigger than the tumor), treatment B (iceball was as big as the tumor), and treatment C (iceball was smaller than the tumor). Related laboratory tests were conducted, and survival time was recorded.

RESULTS

The VX2 pancreatic carcinoma model was successfully established, and serum neuron-specific enolase levels increased continuously after inoculation. Compared with controls, rabbits in treatments A and C groups had no significant survival benefit (P > 0.05), but treatment B significantly prolonged the survival time (P < 0.01).

CONCLUSIONS

VX2 pancreatic cancer model was successfully established with neuron-specific enolase as biomarker. Treatment B may be the optimal protocol for pancreatic carcinoma and a new treatment option for patients with unresectable pancreatic cancer.