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Möller K, Batali A, Jenssen C, Braden B, Hocke M, On W, Everett SM, Dong Y, Ge N, Sun S, Gerber M, Faiss S, Srivastava D, de Robertis R, D´Onofrio M, Misselwitz B, Dietrich CF. Comments and illustrations of the European Federation of Societies for Ultrasound in Medicine contrast-enhanced ultrasound guidelines: Multiparametric imaging and EUS-guided sampling in rare pancreatic tumors. Benign mesenchymal pancreatic tumors. Endosc Ultrasound 2024; 13:218-231. [PMID: 39318747 PMCID: PMC11419432 DOI: 10.1097/eus.0000000000000070] [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: 02/19/2024] [Accepted: 03/14/2024] [Indexed: 09/26/2024] Open
Abstract
The focus of the review is on primary benign mesenchymal pancreatic tumors and their imaging appearance. These tumors are extremely rare. Usually, they are not diagnosed until postoperative histology is available, and so even benign tumors have undergone extensive pancreatic resection. The very limited data on abdominal and EUS findings including contrast-enhanced techniques of these pancreatic lesions are summarized here. Case reports will be presented for some of these rare tumors with application of modern ultrasound and endosonographic techniques.
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Affiliation(s)
- Kathleen Möller
- Sana Hospital Lichtenberg, Medical Department I/Gastroenterology, Berlin, Germany
| | - Alina Batali
- Department Allgemeine Innere Medizin der Kliniken (DAIM) Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Christian Jenssen
- Krankenhaus Märkisch-Oderland, Department of Internal Medicine, Strausberg, Germany; Brandenburg Institute for Clinical Ultrasound (BICUS) at Medical University Brandenburg, Neuruppin, Germany
| | - Barbara Braden
- Translational Gastroenterology Unit, Oxford University Hospitals, Oxford, United Kingdom; and Medical Department B, University Muenster, Germany
| | - Michael Hocke
- Medical Department, Helios Klinikum Meiningen, Germany
| | - Wei On
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | | | - Yi Dong
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Nan Ge
- Department of Endoscopy Center, Shengjing Hospital of China Medical University, Liaoning Province, China
| | - Siyu Sun
- Department of Endoscopy Center, Shengjing Hospital of China Medical University, Liaoning Province, China
| | - Michael Gerber
- Sana Hospital Lichtenberg, Medical Department I/Gastroenterology, Berlin, Germany
| | - Siegbert Faiss
- Sana Hospital Lichtenberg, Medical Department I/Gastroenterology, Berlin, Germany
| | | | | | - Mirko D´Onofrio
- Department of Radiology, University of Verona, Verona, Italy
| | | | - Christoph F. Dietrich
- Department Allgemeine Innere Medizin der Kliniken (DAIM) Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
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2
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Möller K, Holz T, Jenssen C, Braden B, Hocke M, On W, Everett SM, Dong Y, Ge N, Sun S, Gerber M, Faiss S, Schlag C, Srivastava D, Dietrich CF. Comments and illustrations of the European Federation of Societies for Ultrasound in Medicine contrast-enhanced ultrasonography guidelines: multiparametric imaging and EUS-guided sampling in rare pancreatic tumors. Mesenchymal pancreatic tumors of intermediate biological behaviour. Endosc Ultrasound 2024; 13:145-153. [PMID: 39318650 PMCID: PMC11419476 DOI: 10.1097/eus.0000000000000071] [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: 02/19/2024] [Accepted: 03/14/2024] [Indexed: 09/26/2024] Open
Abstract
The focus of the review is on mesenchymal pancreatic tumors with intermediate biological behavior and their imaging appearance. Similar to benign and malignant mesenchymal pancreatic tumors, these tumors are extremely rare. The diagnosis is often confirmed only by postoperative histology. The very limited data on abdominal ultrasound and EUS findings including contrast-enhanced techniques of these pancreatic lesions are summarized here.
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Affiliation(s)
- Kathleen Möller
- Medical Department I/Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany
| | - Tamara Holz
- Department Allgemeine Innere Medizin der Kliniken (DAIM) Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Christian Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch-Oderland, Strausberg, Germany; Brandenburg Institute for Clinical Ultrasound (BICUS) at Medical University Brandenburg, Neuruppin, Germany
| | - Barbara Braden
- Translational Gastroenterology Unit, Oxford University Hospitals, Oxford, UK; Medical Department B, University Muenster, Muenster, Germany
| | - Michael Hocke
- Medical Department, Helios Klinikum Meiningen, Meiningen, Germany
| | - Wei On
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | | | - Yi Dong
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Nan Ge
- Department of Endoscopy Center, Shengjing Hospital of China Medical University, Liaoning Province, China
| | - Siyu Sun
- Department of Endoscopy Center, Shengjing Hospital of China Medical University, Liaoning Province, China
| | - Michael Gerber
- Medical Department I/Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany
| | - Siegbert Faiss
- Medical Department I/Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany
| | - Christoph Schlag
- Klinik für Gastroenterologie und Hepatologie, Universitätsspital Zürich, Zürich, Switzerland
| | | | - Christoph F. Dietrich
- Department Allgemeine Innere Medizin der Kliniken (DAIM) Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
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Nogueira Sixto M, Carracedo Iglesias R, Estévez Fernández S, Rodríguez Pereira C, Sánchez Santos R. Pancreatic PEComa, a not so uncommon neoplasm? Systematic review and therapeutic update. GASTROENTEROLOGIA Y HEPATOLOGIA 2024; 47:93-100. [PMID: 37230381 DOI: 10.1016/j.gastrohep.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/12/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
Pancreatic PEComas are extremely rare neoplasms with malignant potential, which mostly affect middle-aged women and are characterized by presenting melanocytic and myogenic markers in immunohistochemical analysis. There are no symptoms or pathognomonic imaging tests, so the diagnosis is established with the analysis of the surgical specimen or the FNA obtained with preoperative endoscopic ultrasound. The mean treatment consists on radical excision, adapting the intervention to the location of the tumor. To date, 34 cases have been described; however, more than 80% of them have been reported in the last decade, which suggests that it is a more frequent pathology than expected. A new case of pancreatic PEComa is reported and a systematic review of the literature is carried out according to the PRISMA guidelines with the aim of divulge this pathology, deepening its knowledge and updating its management.
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Affiliation(s)
- Manuel Nogueira Sixto
- Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de Vigo, Vigo, Galicia, España.
| | - Roberto Carracedo Iglesias
- Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de Vigo, Vigo, Galicia, España
| | - Sergio Estévez Fernández
- Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de Vigo, Vigo, Galicia, España
| | - Carlos Rodríguez Pereira
- Servicio de Anatomía Patológica, Complejo Hospitalario Universitario de Vigo, Vigo, Galicia, España
| | - Raquel Sánchez Santos
- Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario de Vigo, Vigo, Galicia, España
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Almousa MA, Alnashwan YA, Amr SS. Perivascular Epithelioid Cell Tumor (PEComa) of the Pancreas in a Patient with Ulcerative Colitis: A Case Report and Review of the Literature. Healthcare (Basel) 2023; 11:healthcare11040547. [PMID: 36833081 PMCID: PMC9956215 DOI: 10.3390/healthcare11040547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Perivascular epithelioid cell tumors (PEComas) are mesenchymal tumors of peculiar cells that are focally associated with blood vessels, and generally have a distinctive bi-phenotypic expression of both smooth muscle and melanocytic markers. There are several entities in the PEComa family, including tumors that arise in the soft tissues and viscera. Frequently affected organs include the lungs (sugar tumors), uterus, broad ligament, colon, small bowel, liver, and pancreas. Ulcerative colitis (UC) has been associated with the development of tumors, especially colorectal and hepatobiliary carcinomas. Rare cases of UC have been reported in the PEComa family of tumors, but none in the pancreas. Here, we present a case study of a 27-year-old female patient with a history of UC who developed PEComa of the pancreas, a unique association that has not been previously reported. We also review reported cases of PEComas in the pancreas, as well as PEComas at all anatomic sites associated with UC.
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Affiliation(s)
- Maryam A. Almousa
- Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital, Dammam 34258, Saudi Arabia
| | - Yara A. Alnashwan
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 1982, Saudi Arabia
- Correspondence:
| | - Samir S. Amr
- Department of Pathology and Laboratory Medicine, Istishari Hospital, Amman 840431, Jordan
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