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Aaquist T, Dembic M, Thomassen M, de Stricker K, Bertelsen M, Christensen LG, Mortensen MB, Detlefsen S. Synchronous detection of pancreatic adenocarcinoma and paraganglioma in a Whipple resection specimen. Pathol Res Pract 2021; 226:153590. [PMID: 34454393 DOI: 10.1016/j.prp.2021.153590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 08/14/2021] [Indexed: 01/17/2023]
Abstract
We report a case of a pancreatic ductal adenocarcinoma (PDAC) presenting synchronously with a paraganglioma (PGL) in a Whipple reaction specimen. The patient was a 72-year-old female with a history of breast and vulvar cancer. The simultaneous occurrence of two synchronous tumours in the pancreas was striking. Due to the presence of PGL and multiple meta- and synchronous tumours, the patient was referred to genetic counselling. Tumour tissue from the vulvar carcinoma, the PDAC and the PGL was analysed by targeted next-generation sequencing (NGS) of 161 cancer-related genes and by whole exome sequencing (WES). Peripheral blood was also examined by NGS and WES. These genetic analyses revealed germline polymorphisms in AXIN2 (NM_004655.4:c 0.2272 G>A; p.Ala758Thr), BRCA2 (NM_000059.3:c.9976 A>T; p.Lys3326Ter), NCOR1 (NM_006311.4:c 0.6544 G>A; p.Ala2182Thr) and SPTA1 (NM_003126.3:c 0.373 G>A; p.Ala125Thr) and somatic mutations of KRAS (NM_033360.3;c 0.35 G>A; p.Gly12Asp) and TP53 (NM_000546.5; c.602delT; p.Leu201CysfsTer46) in the PDAC and of TP53 (NM_000546.5; c 0.733 G>A; p.Gly245Ser) and TERT (NM_198253.2; c.-124 C>T; promotor region) in the vulvar carcinoma. Breast carcinoma tissue was not available for genetic analysis. The results of the genetic analyses did not explain the presence of multiple tumours in this patient, despite a slightly increased risk of breast cancer associated with the identified BRCA2 polymorphism. To our knowledge, this is the first report of the synchronous occurrence of PDAC and PGL. This case emphasizes the importance of thorough macroscopic examination of pancreatic resection specimens, as coexisting neoplasms may otherwise be missed.
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Affiliation(s)
- Trine Aaquist
- Department of Pathology, Odense University Hospital, Odense, Denmark; Odense Pancreas Center (OPAC), Odense University Hospital, Odense, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Maja Dembic
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark; Department of Mathematics and Computer Science (IMADA), University of Southern Denmark, Odense, Denmark
| | - Mads Thomassen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Karin de Stricker
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Mette Bertelsen
- Department of Clinical Genetics, Rigshospitalet, Copenhagen, Denmark
| | | | - Michael Bau Mortensen
- Odense Pancreas Center (OPAC), Odense University Hospital, Odense, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Surgery, Odense University Hospital, Odense, Denmark
| | - Sönke Detlefsen
- Department of Pathology, Odense University Hospital, Odense, Denmark; Odense Pancreas Center (OPAC), Odense University Hospital, Odense, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
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Kriger AG, Gorin DS, Berelavichus SV, Panteleev VI, Kaldarov AR. Successful Surgical Treatment of a Patient with Synchronic Intraductal Papillary Mucinous Carcinoma and Solid Pseudopapillary Neoplasm of the Pancreas. Gastrointest Tumors 2020; 7:151-155. [PMID: 33173779 DOI: 10.1159/000509185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/05/2020] [Indexed: 11/19/2022] Open
Abstract
Intraductal papillary mucinous neoplasm (IPMN) and solid pseudopapillary neoplasm (SPN) are uncommon cystic tumors of the pancreas. The simultaneous occurrence of these 2 pancreatic neoplasms is extremely rare. We present a case of synchronous solid SPN and IPMN - carcinoma in a 44-year-old female patient. An uncommon surgical treatment was performed - pancreatoduodenectomy with the resection of the pancreas body, resection of the mesentericoportal trunk + distal pancreatectomy, and splenectomy. Part of the pancreatic tissue was preserved.
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Affiliation(s)
- Andrey G Kriger
- A.V. Vishnevsky Centre of Surgery, Moscow, Russian Federation
| | - David S Gorin
- A.V. Vishnevsky Centre of Surgery, Moscow, Russian Federation
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Chen M, Zhang H, Hu Y, Liu K, Deng Y, Yu Y, Wu Y, Qi A, Li Y, Wen G. Adult pancreatoblastoma: A case report and clinicopathological review of the literature. Clin Imaging 2018; 50:324-329. [PMID: 29753278 DOI: 10.1016/j.clinimag.2018.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/27/2018] [Accepted: 05/01/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE Our purpose was to report a case of adult pancreatoblastoma, and review the literature in order to assist clinicians in the management of the disease. MATERIALS AND METHODS The demographic, clinical, and imaging findings of 41 patients with pathologically proven pancreatoblastoma from 1986 to 2017 identified in PubMed were reviewed. The key words used for searching PubMed were: "pancreatoblastoma", "pancreatic tumor", and "adult pancreatoblastoma." We also reported the details of a case of adult pancreatoblastoma treated at our institution. RESULTS We identified 41 cases of adult pancreatoblastomas, and the mean age at diagnosis was 41.4 ± 17.4 years. Pancreatoblastomas occurred in the pancreatic head in 48.4% of patients, and in 39.0% of cases the tumor was >8 cm in diameter at diagnosis. Patient age and tumor size were similar between males and females (P = 0.59; P = 0.32, respectively). Metastases was present in 17 of the 41 adult patients (41.5%). No significant difference in age, sex, tumor size, and tumor location was found between patients with and without metastases (P = 0.57, 0.58, 0.64, 0.39, respectively). CONCLUSION Preoperative diagnosis of adult pancreatoblastoma is difficult because of the heterogeneous, variable cellular differentiation and atypical clinical and imaging features. A pancreatoblastoma should be considered when tumors in the pancreas are solid and cystic.
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Affiliation(s)
- Menglin Chen
- Medical Imaging Teaching and Research Office, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Haijie Zhang
- Medical Imaging Teaching and Research Office, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Yixin Hu
- Medical Imaging Teaching and Research Office, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Kai Liu
- Medical Imaging Teaching and Research Office, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Yanjia Deng
- Medical Imaging Teaching and Research Office, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Yuanmeng Yu
- Department of Medical Imaging, Jinling Hospital, Nanjing University Medical School, Nanjing 210002, Jiangsu, China
| | - Yulan Wu
- Medical Imaging Teaching and Research Office, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Anqi Qi
- Medical Imaging Teaching and Research Office, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Yingjia Li
- Department of Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China.
| | - Ge Wen
- Medical Imaging Teaching and Research Office, Southern Medical University, Guangzhou 510515, Guangdong, China.
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Sahora K, Crippa S, Zamboni G, Ferrone C, Warshaw A, Lillemoe K, Mino-kenudson M, Falconi M, Fernandez-del Castillo C. Intraductal papillary mucinous neoplasms of the pancreas with concurrent pancreatic and periampullary neoplasms. Eur J Surg Oncol 2016; 42:197-204. [DOI: 10.1016/j.ejso.2015.10.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 10/14/2015] [Accepted: 10/23/2015] [Indexed: 01/12/2023] Open
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Yang F, Yu X, Bao Y, Du Z, Jin C, Fu D. Prognostic value of Ki-67 in solid pseudopapillary tumor of the pancreas: Huashan experience and systematic review of the literature. Surgery 2015; 159:1023-31. [PMID: 26619927 DOI: 10.1016/j.surg.2015.10.018] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 10/13/2015] [Accepted: 10/13/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Solid pseudopapillary tumor of the pancreas (SPTP) is considered to have a low Ki-67 proliferation index, which may explain the generally good clinical outcome. The aim of our study was to evaluate whether Ki-67 has prognostic value in SPTP. METHODS A case series study of patients with SPTP treated in our institution from June 2002 to April 2014 was conducted. Prognostic factors for clinical outcomes were analyzed by the use of clinical decision and survival analysis. In addition, we performed a systematic review and pooled analysis to evaluate our results. RESULTS The institutional data included 71 patients (13 male and 58 female) ranging in age from 12 to 64 years (median, 31 years). Three patients developed local recurrence and/or liver metastasis after initial surgery. The 5-year recurrence-free survival rate was 93.6%. One patient died of disease, with the 5-year disease-specific survival rate of 98.5%. Ki-67 index ≥ 4% was found significantly associated with the survival of SPTP. Twenty-six studies comprising 163 patients were included in the pooled analysis based on our inclusion criteria. A total of 15 cases showed a Ki-67 index ≥ 4%. Kaplan-Meier survival analysis confirmed that Ki-67 index ≥ 4% was significantly associated with poorer recurrence-free survival and disease-specific survival (both P < .001). CONCLUSION This study highlighted a potential role of Ki-67 in predicting adverse outcome of patients with SPTP and should be considered as part of routine histological reporting of SPTP.
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Affiliation(s)
- Feng Yang
- Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital affiliated to Fudan University, Shanghai, China
| | - Xinzhe Yu
- Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital affiliated to Fudan University, Shanghai, China
| | - Yun Bao
- Department of Pathology, Huashan Hospital affiliated to Fudan University, Shanghai, China
| | - Zunguo Du
- Department of Pathology, Huashan Hospital affiliated to Fudan University, Shanghai, China
| | - Chen Jin
- Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital affiliated to Fudan University, Shanghai, China
| | - Deliang Fu
- Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital affiliated to Fudan University, Shanghai, China.
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Hirabayashi K, Kurokawa S, Maruno A, Yamada M, Kawaguchi Y, Nakagohri T, Mine T, Sugiyama T, Tajiri T, Nakamura N. Sex differences in immunohistochemical expression and capillary density in pancreatic solid pseudopapillary neoplasm. Ann Diagn Pathol 2015; 19:45-9. [DOI: 10.1016/j.anndiagpath.2015.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 02/15/2015] [Indexed: 02/07/2023]
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Jurić I, Pogorelić Z, Stepan JG, Kuzmić IP. Extremely rare presentation of Frantz's tumour: synchronous localisation in the pancreatic head and tail. Scott Med J 2014; 59:e8-e12. [PMID: 25035290 DOI: 10.1177/0036933014543222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Solid pseudopapillary tumour of the pancreas is a rare lesion with low malignant potential occurring predominantly in young women. This is a report of an extremely rare occurrence of synchronous presentation of pseudopapillary tumour in the pancreatic head and tail of a 16-year-old female patient. CASE PRESENTATION The patient presented with a three-month intermittent upper abdominal pain and swelling. Computed tomography scan showed two separate masses, involving the pancreatic head and tail. The patient underwent surgery, where successful tumour enucleation of both tumours was performed. Histological report confirmed solid pseudopapillary tumour of the pancreas with the low malignant potential. CONCLUSION To the best of our knowledge, this is the first report of synchronous presentation of pseudopapillary tumour of the pancreas.
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Affiliation(s)
- Ivo Jurić
- Pediatric Surgeon (Attending Physician), Department of Pediatric Surgery, Split University Hospital Centre and Split University School of Medicine, Croatia
| | - Zenon Pogorelić
- Pediatric Surgeon (Attending Physician), Department of Pediatric Surgery, Split University Hospital Centre and Split University School of Medicine, Croatia
| | | | - Ivana Prusac Kuzmić
- Pathologist (Attending Physician), Department of Pathology, Split University Hospital Centre and Split University School of Medicine, Croatia
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