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Krishnamurthy G, Ganesan S, Ramas J, Radhakrishna P. Ruptured Mucinous Cystadenoma Pancreas: A Case Report and Review of Literature. Euroasian J Hepatogastroenterol 2021; 11:45-48. [PMID: 34316465 PMCID: PMC8286360 DOI: 10.5005/jp-journals-10018-1337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Mucinous cystic neoplasm (MCN) of the pancreas is a rare neoplasm affecting the elderly women. They vary in their clinical presentation and biological behavior. Spontaneous rupture of MCN is very rare and only eight cases have been reported so far in the English literature. We report a case of a young woman presenting with abdominal pain following spontaneous contained rupture of MCN managed with surgical resection. How to cite this article: Krishnamurthy G, Ganesan S, Ramas J, et al. Ruptured Mucinous Cystadenoma Pancreas: A Case Report and Review of Literature. Euroasian J Hepato-Gastroenterol 2021;11(1):45–48.
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Affiliation(s)
| | - Senthil Ganesan
- Department of Surgical Gastroenterology, SIMS, Chennai, Tamil Nadu, India
| | - Jayapriya Ramas
- Department of Surgical Gastroenterology, SIMS, Chennai, Tamil Nadu, India
| | - Patta Radhakrishna
- Department of Surgical Gastroenterology, SIMS, Chennai, Tamil Nadu, India
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Revoredo F, de Vinatea J, Reaño G, Villanueva L, Kometter F, Arenas J, Polanco PM. Mucinous cystic neoplasms of the pancreas associated with pregnancy: Two case reports. Medicine (Baltimore) 2020; 99:e21471. [PMID: 32756169 PMCID: PMC7402798 DOI: 10.1097/md.0000000000021471] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
RATIONALE Although rare, pancreatic neoplasms can occur during pregnancy, both in benign and malignant forms. Mucinous cystic neoplasms (MCNs) of the pancreas, a type of these neoplasms, are precursor lesions to invasive pancreatic cancer. The presence of the ovarian-type stroma is a defining feature. PATIENT CONCERNS The first case was a 38-year-old woman in her 18th week of pregnancy with abdominal pain that worsens a few weeks later. The second case was a 30-year-old woman in her 17th week of pregnancy with abdominal pain in the left hypochondrium. DIAGNOSIS The patients were under clinical examination and laboratory test including carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA). Both patients had magnetic resonance imaging (MRI). The diagnosis of a MCNs of the pancreas was done preoperatively in the 2 cases. INTERVENTIONS Both patients underwent distal pancreatectomy during pregnancy. One of them was an emergency laparotomy because of a ruptured MCN. OUTCOMES Both patients were completely recovered from distal pancreatectomy and continued to full term, delivering a healthy baby by Caesarean section. After 6 years of follow-up, the first patient underwent a total gastrectomy, because of a gastric cancer with carcinomatosis. Currently the 2 patients are still alive after 8 years and 5 years of follow-up, respectively. LESSONS Surgical resection of MCNs during pregnancy should be considered during the second trimester given common distal pancreas location, rapid growth, risk of spontaneous rupture, and malignant potential.
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Affiliation(s)
| | | | | | | | | | - José Arenas
- Department of Pathology, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú
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Fujinaga A, Hirashita T, Iwashita Y, Nakanuma H, Tada K, Masuda T, Endo Y, Ohta M, Ono H, Murakami K, Inomata M. A case of ruptured mucinous cystadenoma of the pancreas with recurrence-free survival for 8 years. Surg Case Rep 2020; 6:52. [PMID: 32185526 PMCID: PMC7078394 DOI: 10.1186/s40792-020-00816-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 03/09/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Pancreatic mucinous cystic neoplasm (MCM) presenting with rupture is extremely rare, and very few studies have followed up patients over the long term after ruptured mucinous cystadenoma (MCA). We report a case of ruptured MCA of the pancreas with recurrence-free survival for 8 years. CASE PRESENTATION A 28-year-old Japanese woman was admitted to the emergency department of a local hospital after experiencing acute abdominal pain. Abdominal computed tomography revealed massive ascites and the presence of a cystic tumor measuring 60 mm in diameter in the pancreatic tail. Conservative therapy with antibiotics and abdominal drainage were performed to treat peritonitis that occurred secondary to the ruptured pancreatic cystic tumor, after which the patient's symptoms improved. The patient was referred to our department for further examination and treatment. We diagnosed a ruptured MCN and performed laparoscopic spleen-preserving distal pancreatectomy. Histopathological findings revealed ovarian-type stroma, which tested positive for estrogen and progesterone receptors by immunohistochemistry. The histopathological diagnosis was MCA. The postoperative course was uneventful, and the patient remains alive without any evidence of recurrence at 8 years postoperatively. CONCLUSION A good prognosis is possible even in cases of ruptured MCA. Because of the risk of peritoneal dissemination after ruptured MCA, long-term follow-up is important.
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Affiliation(s)
- Atsuro Fujinaga
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan.
| | - Teijiro Hirashita
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Yukio Iwashita
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Hiroaki Nakanuma
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Kazuhiro Tada
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Takashi Masuda
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Yuichi Endo
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Masayuki Ohta
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Hideki Ono
- Department of Gastroenterology, Oita Prefectural Hospital, Oita, Japan
| | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
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Miura S, Fujimoto K, Kokado Y, Asari K, Hasegawa H, Nishigori H, Koizumi N, Uehara T, Ishii M, Higashiyama H. Peritonitis Caused by a Ruptured Mucinous Cystadenoma of the Pancreas. ACTA ACUST UNITED AC 2014. [DOI: 10.5833/jjgs.2013.0252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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