1
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Chang JH, Perlmutter BC, Wehrle C, Naples R, Stackhouse K, McMichael J, Chao T, Naffouje S, Augustin T, Joyce D, Simon R, Walsh RM. Natural history and growth prediction model of pancreatic serous cystic neoplasms. Pancreatology 2024; 24:489-492. [PMID: 38443232 DOI: 10.1016/j.pan.2024.02.016] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/07/2024] [Accepted: 02/26/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Serous cystic neoplasms (SCN) are benign pancreatic cystic neoplasms that may require resection based on local complications and rate of growth. We aimed to develop a predictive model for the growth curve of SCNs to aid in the clinical decision making of determining need for surgical resection. METHODS Utilizing a prospectively maintained pancreatic cyst database from a single institution, patients with SCNs were identified. Diagnosis confirmation included imaging, cyst aspiration, pathology, or expert opinion. Cyst size diameter was measured by radiology or surgery. Patients with interval imaging ≥3 months from diagnosis were included. Flexible restricted cubic splines were utilized for modeling of non-linearities in time and previous measurements. Model fitting and analysis were performed using R (V3.50, Vienna, Austria) with the rms package. RESULTS Among 203 eligible patients from 1998 to 2021, the mean initial cyst size was 31 mm (range 5-160 mm), with a mean follow-up of 72 months (range 3-266 months). The model effectively captured the non-linear relationship between cyst size and time, with both time and previous cyst size (not initial cyst size) significantly predicting current cyst growth (p < 0.01). The root mean square error for overall prediction was 10.74. Validation through bootstrapping demonstrated consistent performance, particularly for shorter follow-up intervals. CONCLUSION SCNs typically have a similar growth rate regardless of initial size. An accurate predictive model can be used to identify rapidly growing outliers that may warrant surgical intervention, and this free model (https://riskcalc.org/SerousCystadenomaSize/) can be incorporated in the electronic medical record.
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Affiliation(s)
- Jenny H Chang
- Cleveland Clinic, Digestive Disease and Surgery Institute, Department of General Surgery, USA.
| | - Breanna C Perlmutter
- Cleveland Clinic, Digestive Disease and Surgery Institute, Department of General Surgery, USA
| | - Chase Wehrle
- Cleveland Clinic, Digestive Disease and Surgery Institute, Department of General Surgery, USA
| | - Robert Naples
- Cleveland Clinic, Digestive Disease and Surgery Institute, Department of General Surgery, USA
| | - Kathryn Stackhouse
- Cleveland Clinic, Digestive Disease and Surgery Institute, Department of General Surgery, USA
| | - John McMichael
- Cleveland Clinic, Digestive Disease and Surgery Institute, Department of General Surgery, USA
| | - Tu Chao
- Cleveland Clinic, Lerner Research Institute, Department of Quantitative Health Sciences, USA
| | - Samer Naffouje
- Cleveland Clinic, Digestive Disease and Surgery Institute, Department of General Surgery, USA
| | - Toms Augustin
- Cleveland Clinic, Digestive Disease and Surgery Institute, Department of General Surgery, USA
| | - Daniel Joyce
- Cleveland Clinic, Digestive Disease and Surgery Institute, Department of General Surgery, USA
| | - Robert Simon
- Cleveland Clinic, Digestive Disease and Surgery Institute, Department of General Surgery, USA
| | - R Matthew Walsh
- Cleveland Clinic, Digestive Disease and Surgery Institute, Department of General Surgery, USA
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Pollini T, Salvia R, Maker AV. Concomitant Serous Cystadenoma and Intraductal Papillary Mucinous Neoplasm in Pancreatic Cysts-a Diagnostic and Surgical Dilemma. J Gastrointest Surg 2023; 27:3105-3107. [PMID: 37783910 DOI: 10.1007/s11605-023-05839-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 10/04/2023]
Affiliation(s)
- T Pollini
- Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - R Salvia
- Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona, Verona, Italy
| | - A V Maker
- Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, San Francisco, CA, USA.
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3
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Gao J, Liu C, Zhou J, Lin X, Zhang Y. Increased Uptake in Microcystic Serous Cystadenoma Mimicking Pancreatic Neuroendocrine Tumor on 68 Ga-DOTATATE PET/MRI. Clin Nucl Med 2023; 48:987-988. [PMID: 37756486 DOI: 10.1097/rlu.0000000000004857] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
ABSTRACT A 2.6-cm solid cystic lesion in the pancreatic head was found in a 51-year-old woman on CT. A pancreatic neuroendocrine tumor was suspected, and a 68 Ga-DOTATATE PET/MRI was performed, which showed increased tracer uptake in the lesion. However, postsurgical pathologic examination indicated a pancreatic serous cystadenoma. Here, we reported a case of microcystic pancreatic serous cystadenoma that could be misdiagnosed as a pancreatic neuroendocrine tumor on a 68 Ga-DOTATATE PET/MRI.
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Affiliation(s)
- Jing Gao
- From the Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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4
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Yang KS, O'Shea A, Zelga P, Liss AS, Del Castillo CF, Weissleder R. Extracellular vesicle analysis of plasma allows differential diagnosis of atypical pancreatic serous cystadenoma. Sci Rep 2023; 13:10969. [PMID: 37414831 PMCID: PMC10325992 DOI: 10.1038/s41598-023-37966-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/30/2023] [Indexed: 07/08/2023] Open
Abstract
Increased use of cross-sectional imaging has resulted in frequent detection of incidental cystic pancreatic lesions. Serous cystadenomas (SCAs) are benign cysts that do not require surgical intervention unless symptomatic. Unfortunately, up to half of SCAs do not have typical imaging findings ("atypical SCAs"), overlap with potentially malignant precursor lesions, and thus pose a diagnostic challenge. We tested whether the analysis of circulating extracellular vesicle (EV) biomarkers using a digital EV screening technology (DEST) could enhance the discrimination of cystic pancreatic lesions and avoid unnecessary surgical intervention in these atypical SCAs. Analysis of 25 different protein biomarkers in plasma EV from 68 patients identified a putative biomarker signature of Das-1, Vimentin, Chromogranin A, and CAIX with high discriminatory power (AUC of 0.99). Analysis of plasma EV for multiplexed markers may thus be helpful in clinical decision-making.
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Affiliation(s)
- Katherine S Yang
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA, 02114, USA
- Department of Radiology, Massachusetts General Hospital, 32 Fruit St, Boston, MA, 02114, USA
| | - Aileen O'Shea
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA, 02114, USA
- Department of Radiology, Massachusetts General Hospital, 32 Fruit St, Boston, MA, 02114, USA
| | - Piotr Zelga
- Department of Surgery, Massachusetts General Hospital, 32 Fruit St, Boston, MA, 02114, USA
| | - Andrew S Liss
- Department of Surgery, Massachusetts General Hospital, 32 Fruit St, Boston, MA, 02114, USA
| | | | - Ralph Weissleder
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA, 02114, USA.
- Department of Radiology, Massachusetts General Hospital, 32 Fruit St, Boston, MA, 02114, USA.
- Department of Systems Biology, Harvard Medical School, 200 Longwood Ave, Boston, MA, 02115, USA.
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Balhara K, Mallya V, Khurana N, Tempe A. Coexisting ovarian serous cystadenoma with fibroma: A very unusual combination. J Cancer Res Ther 2023; 19:1474-1476. [PMID: 37787335 DOI: 10.4103/jcrt.jcrt_2319_21] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Surface epithelial neoplasms are the most common ovarian tumors, constituting around 60% of all ovarian malignancies. They are classified as benign, borderline, and malignant. Ovarian cystadenomas are common benign epithelial neoplasms which carry an excellent prognosis. Ovarian thecoma-fibroma groups are uncommon sex cord-stromal neoplasms, constituting 1.0%-4.0% of all ovarian tumors. Most of them are benign and often found in postmenopausal patients. Combination tumors in the ovary are known. The most common combination is mucinous cystadenoma which occurs in association with Brenner tumor, mature cystic teratoma, Sertoli-Leydig cell tumor, or even a serous cystadenoma. A combination of surface epithelial and thecoma-fibroma group is very rarely encountered. A case of one such combination of serous cystadenoma and fibroma of the ovary is being presented here in a postmenopausal woman.
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Affiliation(s)
- Kirti Balhara
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Varuna Mallya
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Nita Khurana
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Anjali Tempe
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
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Kumarasamy S, Kumar M, Sakaray Y, Savlania A, Tandup C, Kaman L. Serous cystadenoma of head pancreas masquerading as pancreatic neuroendocrine tumor: Treated by Whipple's pancreaticoduodenectomy. J Cancer Res Ther 2023; 19:829-831. [PMID: 37470621 DOI: 10.4103/jcrt.jcrt_1871_20] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Serous cystadenoma (SCA) is the most common cystic neoplasm of the pancreas. Serous cystadenoma is best diagnosed by imaging with computed tomography scan. Fine-needle aspiration cytology is required for definitive preoperative diagnosis. Serous cystadenoma may be sometime difficult to differentiate from pancreatic neuroendocrine tumor (PNET) in the preoperative stage. Differentiating the two entities are important for proper treatment strategy. Serous cystadenoma may be managed in expectant observation. However, all PNETs will need surgical treatment including pancreaticoduodenectomy (PD). Here, we present a rare presentation of serous cystadenoma head of pancreas masquerading as PNET with local compressive symptoms for which Whipple's PD was done successfully.
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Affiliation(s)
| | - Manish Kumar
- Department of General Surgery, PGIMER, Chandigarh, India
| | | | - Ajay Savlania
- Department of General Surgery, PGIMER, Chandigarh, India
| | | | - Lileswar Kaman
- Department of General Surgery, PGIMER, Chandigarh, India
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7
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Saragoni L, Pacilio CA, Cavaliere D, Limarzi F, Isopi C, Ercolani G. Solid serous cystadenoma of the pancreas: A rare tumor with challenging differential diagnosis. Hepatobiliary Pancreat Dis Int 2022; 21:303-306. [PMID: 34256995 DOI: 10.1016/j.hbpd.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 06/03/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Luca Saragoni
- Pathology Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, Via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Carlo Alberto Pacilio
- General and Oncologic Surgery Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, Via Carlo Forlanini 34, 47121, Forlì, Italy.
| | - Davide Cavaliere
- General and Oncologic Surgery Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, Via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Francesco Limarzi
- Pathology Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, Via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Claudio Isopi
- General and Oncologic Surgery Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, Via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Giorgio Ercolani
- General and Oncologic Surgery Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, Via Carlo Forlanini 34, 47121, Forlì, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
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8
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Kriger AG, Gorin DS, Akhtanin EA, Glotov AV, Panteleev VI. [A rare variant of pancreatic serous cystadenoma]. Khirurgiia (Mosk) 2022:94-97. [PMID: 35775850 DOI: 10.17116/hirurgia202207194] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The authors present a patient with serous cystadenoma of the pancreatic head. Atypical symptoms and CT data did not allow excluding pancreatic cancer. Thus, pancreaticoduodenectomy was performed.
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Affiliation(s)
- A G Kriger
- Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
| | - D S Gorin
- Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
| | - E A Akhtanin
- Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
| | - A V Glotov
- Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
| | - V I Panteleev
- Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
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9
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Amico EC, Salgado CTS, Alves JR, Liguori ADEAL, Sousa RL. Non-inflammatory pancreatic cysts: from diagnosis to treatment (97 cases series). Rev Col Bras Cir 2021; 48:e20213009. [PMID: 34816881 PMCID: PMC10683443 DOI: 10.1590/0100-6991e-20213009] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/30/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to describe the implications of the diagnosis and treatment of non-inflammatory pancreatic cysts in a series of patients. METHODS we included patients with pancreatic cysts ≥1.0 cm, excluding those with a presumptive diagnosis of a pseudocyst. Imaging tests, echoendoscopy, and histopathology determined the diagnosis of the type of cyst. We applied the guidelines of the International Association of Pancreatology, with some modifications, in patients with mucinous or indeterminate lesions. RESULTS 97 adult patients participated in the study. A cystic neoplasm of the pancreas was diagnosed in 82.5% of cases. Diagnosis was mainly made by magnetic resonance (46% of cases). The two most common diagnoses were intraductal papillary mucinous neoplasm (43.3%) and serous cystadenoma (26%). Twenty-nine patients underwent surgery (33.3%). The most common surgical procedure was distal pancreatectomy associated with splenectomy in 19 cases (65.5%). Among the operated patients, 11 were diagnosed with cancer. None of the followed, non-operated patients had a diagnosis of cancer. CONCLUSIONS magnetic resonance showed good accuracy, particularly in the diagnosis of intraductal papillary mucinous neoplasm. The guidelines of the International Association of Pancreatology, as applied in this study, showed a negative predictive value for cancer of 100%. A development of better diagnostic tests can reduce the number of unnecessary operations.
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Affiliation(s)
- Enio Campos Amico
- - Centro de Gastroenterologia e Endoscopia Digestiva de Natal, GASTROCENTRO - Natal - RN - Brasil
- - Universidade Federal do Rio Grande do Norte (UFRN), Departamento de Medicina Integrada - Natal - RN - Brasil
| | | | - José Roberto Alves
- - Universidade Federal de Santa Catarina, Departamento de Cirurgia - Florianopolis - SC - Brasil
| | - Adriano DE Araújo Lima Liguori
- - Universidade Federal do Rio Grande do Norte (UFRN), Unidade de Diagnóstico por Imagem e Métodos Gráficos do Hospital Universitário Onofre Lopes - Natal - RN - Brasil
| | - Rogério Lacerda Sousa
- - Universidade Federal do Rio Grande do Norte (UFRN), Unidade de Diagnóstico por Imagem e Métodos Gráficos do Hospital Universitário Onofre Lopes - Natal - RN - Brasil
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10
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Huang J, Li L. Young Woman with Periumbilical Abdominal Pain. Ann Emerg Med 2021; 78:e27-e28. [PMID: 34420570 DOI: 10.1016/j.annemergmed.2021.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Jun Huang
- Department of Cardiovascular Ultrasound, the Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, China
| | - Li Li
- Department of Pediatrics, Changzhou Fourth People's Hospital, Changzhou Tumor Hospital Affiliated to Soochow University, Changzhou, China
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11
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Gorris M, Bruno MJ, Cahen DL, Fockens P, van Santvoort HC, van Hooft JE, Besselink MG. [Pancreatic cystic neoplasms: a clinical dilemma]. Ned Tijdschr Geneeskd 2021; 164:D5327. [PMID: 33651501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Pancreatic cystic neoplasms are increasingly detected in the general population. Although most of these lesions are benign, some are (pre)malignant and require follow-up or even surgical intervention. Three cases are presented and used to discuss the clinical implications of the renewed European Guideline on pancreatic cystic neoplasms in which relative and absolute indications for resection are proposed. In the first case, a pancreatic cystic lesion was found on abdominal ultrasound in a 77-year old female patient. After endoscopic ultrasound was performed, a serous cystic neoplasm was diagnosed without need for surveillance. In a 57-year old male, an abdominal MRI was performed to further assess an incidentally found pancreatic cystic lesion. Based on the MRI, a side-branch intraductal papillary mucinous neoplasm (SB-IPMN) was diagnosed and yearly surveillance was initiated. A 61-year old male underwent a laparoscopic distal pancreatectomy because of a mixed-type IPMN (MT-IPMN). The pathological results showed an IPMN with high-grade dysplasia.
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Affiliation(s)
- M Gorris
- Amsterdam UMC, Amsterdam GastroenterologyEndocrinologyMetabolism, afd. Maag-Darm-Leverziekten, Amsterdam(tevens: Cancer Center Amsterdam, afd. Chirurgie)
| | - M J Bruno
- Erasmus MC, afd. Maag-Darm-Leverziekten, Rotterdam
| | - D L Cahen
- Erasmus MC, afd. Maag-Darm-Leverziekten, Rotterdam
| | - P Fockens
- Amsterdam UMC, Amsterdam GastroenterologyEndocrinologyMetabolism, afd. Maag-Darm-Leverziekten, Amsterdam
| | - H C van Santvoort
- St. Antonius Ziekenhuis, afd. Hepato-Pancreato-BiliaireChirurgie, Nieuwegein(tevens: UMC Utrecht, Regionaal Academisch Kankercentrum Utrecht)
| | | | - M G Besselink
- Amsterdam UMC,Cancer Center Amsterdam, afd. Chirurgie, Amsterdam
- Contact: M.G. Besselink
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Cioltean CL, Bartoş A, Raluca S, Iancu I, Breazu C, Iancu C, Bartoş D. Laparoscopic Central Pancreatectomy with Pancreato-Gastric Anastomosis for Pancreatic Cystadenoma. Chirurgia (Bucur) 2020; 115:520-525. [PMID: 32876026 DOI: 10.21614/chirurgia.115.4.520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2020] [Indexed: 11/23/2022]
Abstract
We present the case of a 42-year-old woman diagnosed with a cystic pancreatic lesion, suggestive of a serous cystadenoma of 27/13 mm. The diagnosis was established by the examination of abdominal CT and eco-endoscopy. The patient was referred to the surgery department for treatment. The benign etiology suggested by imaging and the desire to preserve the spleen along with as much of the pancreatic parenchyma, indicated a laparoscopic central pancreatectomy with a anastomosis between the distal pancreatic stump and the stomach. The authors reviewed the national and international publications related to the indications of this minimally invasive surgery.
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13
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Harrell K, Dowden J. Atypical Solid Serous Cystadenoma of the Pancreas. Am Surg 2018; 84:e405-e406. [PMID: 30454515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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14
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Fernández Aceñero MJ, Vázquez M, Esteban JM, García Diego G, Díaz Del Arco C. Influence of the Histopathological Features of the Lesion on the Diagnostic Yield of Fine-Needle Aspiration Cytology of Pancreatic Solid Lesions. Acta Cytol 2018; 62:259-264. [PMID: 29705811 DOI: 10.1159/000488383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/14/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The rate of pancreatic lesions has increased in recent decades due to the widespread use of advanced imaging techniques. Nowadays, a significant proportion of cases are incidentally discovered in asymptomatic patients and cytology is an important tool for the diagnosis and multidisciplinary management of these cases. STUDY DESIGN In this study we retrospectively review the experience with pancreatic fine-needle aspiration cytology in the last 17 years at a single large tertiary hospital in Madrid, Spain. RESULTS Our results indicate that more than 60% of pancreatic malignant lesions are cytologically confirmed before surgery and 30% of the patients are asymptomatic. Despite this, we have noted that the total number of malignant lesions surgically resected in our hospital has basically remained unchanged over the years, because incidental diagnosis is not always synonymous with resectability and a substantial number of patients are already metastatic at the time of diagnosis. Our series also shows an increase in the number of neuroendocrine tumors, which now represent almost 20% of all cytological diagnoses at our hospital. The sensitivity in our series is 70% and the false negative rate remains 30%, despite sample quality control by experienced cytologists and standardized technical conditions. Fibrosis and necrosis are the 2 features of the primary tumor that significantly and negatively influence the accuracy of cytologic diagnosis. CONCLUSION We herein report our experience with cytologic diagnosis of pancreatic lesions in a single tertiary hospital. Our results confirm that cytology is a safe, reliable, and important tool for pancreatic lesion diagnosis and management.
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Affiliation(s)
- M Jesús Fernández Aceñero
- Department of Endoscopy (Endoscopic Ultrasonography Unit), Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - M Vázquez
- Department of Surgical Pathology (Cytology Unit), Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - J M Esteban
- Department of Surgical Pathology (Cytology Unit), Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Guillermo García Diego
- Department of Endoscopy (Endoscopic Ultrasonography Unit), Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Cristina Díaz Del Arco
- Department of Endoscopy (Endoscopic Ultrasonography Unit), Hospital Clínico Universitario San Carlos, Madrid, Spain
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15
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Ogino T, Kim Y, Hata T, Hoshino H, Okano M, Kawada J, Okuyama M, Yamazaki M, Tsujinaka T. [The Surgical Experience for Bulky Serous Cystic Neoplasm of Pancreas]. Gan To Kagaku Ryoho 2018; 45:315-317. [PMID: 29483432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 74-year-old femalewas admitted to our hospital dueto thebulky abdominal tumor pointed out by ultrasonography of medical screening. Abdominal CT revealed the tumor, in a diameter 20 cm, replaced the total pancreas and compressed the surrounding organs and portal vein. We diagnosed as a pancreatic serous cystic neoplasm with a possibility of malignancy. The operative findings showed the tumor tightly adhered to stomach, duodenum, liver, transverse colon mesenterium, retroperitoneum and the surrounding main vessels. Total pancreatectomy, cholecystectomy, splenectomy and distal gastrectomy were performed. As a histopathological finding, thetumor surfacewas smooth and theinsidewas sponge-likeappe arancemixe d with microcystic and solid components. No malignant finding was observed. The patient was discharged without major complications on postoperative day 42, and remains alive with no recurrence for 9 months after surgery.
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16
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Muncie C, Morris M, Blewett C. Cystic Lymphangioma of the Mesenteric Root in an Adolescent, an Operative Challenge. Am Surg 2017; 83:e354-e355. [PMID: 30454349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Colin Muncie
- Division of Pediatric Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA
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Abstract
We notice an increasing frequency in the detection and evaluation of pancreatic cystic lesions (PCLs) over the last three decades. They show awide spectrum of imaging and clinical features. The diagnosis and discrimination of these lesions are very important because of the risk for concurrent or later development of malignancy. The main reason is the increased awareness of these lesions and the extensive use of cross-sectional imaging, an always improving technique (1). Commonly, PCLs are diagnosed incidentally during investigation for often unrelated and nonspecific abdominal complaints using state-of-the art abdominal imaging (CT, MRT). The term PCN denotes a histologically heterogeneous collection of neoplasms showing a wide spectrum of diagnoses, ranging from completely benign to potentially malignant, to carcinoma in situ, to frankly invasive and malignant (2,3). In 1978, Compagno and Oertel were the first to recognize the crucial distinction between the serous and the mucinous cystic neoplasms of the pancreas by explaining the importance of identifying the mucinous neoplasms because of their overt or latent malignant potential (4,5). Since then, the interest in PCLs increased markedly, especially so with the recognition of the importance and prevalence of intraductal papillary mucinous neoplasms (IPMNs). Nowadays, PCLs represent a common and often difficult challenge in clinical practice, because of the increase in their detection in asymptomatic patients and our still immature understanding of some aspects of their biologic behavior. Their important differences regarding their outcome and the fact of being increasingly often identified has put a special focus on these neoplasms by surgeons, pathologists, gastroenterologists, radiologists, and oncologists alike. Management of patients with PCNs can be challenging and varies considerably among the various subtypes of PCNs. Their treatment ranges from resection of malignant lesions, to resection and/or surveillance in the case of premalignant lesions, to simple observation in the case of benign or indolent lesions. Under these circumstances, the accurate classification of PCNs becomes crucial. Therapeutic decision making and classification rely mainly on the presenting symptoms and radiologic findings, often without actual histologic tissue. It is of extreme importance to identify suspicious features indicating potential or certain malignancy in order to select the appropriate treatment. The risk of overtreatment (unnecessary pancreatectomy) should he balanced carefully with the risk of under treatment (missing the opportunity to cure a potentially curable malignant or premalignant disease).
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Sabarwal VK, Chandrasekar A, Engel J, Toubaji A, Engel JD. A Retroperitoneal Serous Cystadenoma of Müllerian Origin Masquerading as a Massive Renal Cyst. Urology 2017; 105:e9-e10. [PMID: 28408339 DOI: 10.1016/j.urology.2017.03.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 02/10/2017] [Revised: 03/23/2017] [Accepted: 03/31/2017] [Indexed: 11/17/2022]
Abstract
A 78-year-old woman presented to the urology clinic with a large, symptomatic left-sided abdominal cyst that was believed to be renal in etiology for many years and that had been percutaneously drained 3 times previously with persistent regrowth. The patient underwent laparoscopic resection of this mass, which proved to be a completely distinct retroperitoneal cystic structure and was not renal in nature. Pathologic analysis ultimately revealed a rare occurrence: a benign retroperitoneal Müllerian serous cystadenoma. To our knowledge, this is the first report of such an entity "disguised" as a renal cyst.
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Affiliation(s)
- Vikram K Sabarwal
- Department of Urology, George Washington University, Washington, DC.
| | | | - Joshua Engel
- Department of Biology, Duke University, Washington, DC
| | - Antoun Toubaji
- Department of Pathology, George Washington University, Washington, DC
| | - Jason D Engel
- Department of Urology, George Washington University, Washington, DC; Urologic Surgeons of Washington, Washington, DC
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Souto Nacif L, Ferrer Fábrega J, García Pérez R, García-Valdecasas JC. Giant symptomatic pancreatic cyst mimicking a malignant tumor. Rev Esp Enferm Dig 2016; 108:813-815. [PMID: 27931109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Pancreatic cystic lesions found in the literature are estimated between 2.6-19.6%. These neoplasms are almost exclusively benign tumors, and rarely become malignant. The aim of this paper was to report a feasible total pancreatectomy with portal resection in a giant pancreatic serous cystadenoma mimicking a malignant tumor. CASE PRESENTATION A healthy 52-year-old female patient presented to us with a giant pancreatic cyst with unknown preoperative diagnosis and a secondary dilatation of the Wirsung duct, and unclear vascular invasion. The imaging assessment was not conclusive for malignancy. Furthermore, it was decided to perform a total pancreatectomy with portal vein resection and splenectomy. The pathological findings revealed a microcystic serous cystadenoma of 10 cm with abundant myxoid stromal degeneration and focal papillary proliferation without atypia. CONCLUSION Unless the diagnosis of serous cystadenoma is certain, cystic tumors with inconclusive clinical and imaging features should be radically treated.
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Affiliation(s)
- Lucas Souto Nacif
- Liver and Gastrointestinal Transplant Division. , University of São Paulo School of Medicine, Brazil, Brasil
| | - Joana Ferrer Fábrega
- Cirugia Hepato-Bilio-Pancreática y Trasplante., Hospital Clinic Barcelona, España
| | - Rocío García Pérez
- Hepato-Bilio-Pancreatic Surgery and Transplant., Hospital Clínic Barcelona, España
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Lilo MT, VandenBussche CJ, Allison DB, Lennon AM, Younes BK, Hruban RH, Wolfgang CL, Ali SZ. Serous Cystadenoma of the Pancreas: Potentials and Pitfalls of a Preoperative Cytopathologic Diagnosis. Acta Cytol 2016; 61:27-33. [PMID: 27889754 DOI: 10.1159/000452471] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 09/21/2016] [Accepted: 10/12/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Pancreatic serous cystadenomas (SCAs) are benign tumors. Technological advances in imaging have led to increased recognition of asymptomatic pancreatic cysts, consequently increasing the demand for cytomorphologic evaluations of cyst fluid. STUDY DESIGN A retrospective search through the pathology archives over an 11-year period was performed to identify SCAs from pancreatectomy specimens with a presurgical pancreatic EUS-guided fine-needle aspiration (FNA). RESULTS Fifty-one FNAs were identified. The average patient age was 59.9 years and 34 (67%) were female. Thirty-five (69%) of the SCAs were located in the body or tail of the pancreas. SCAs ranged in size from 1.3 to 8.0 cm (mean 4.9). On imaging, features suggestive of SCA were seen in 7 (14%) cases. The cytologic diagnoses were as follows: SCA in 5 (10%) cases, suspicious for mucin-producing neoplastic cyst in 4 (8%), pseudocyst in 4 (8%), and benign ductal and/or acinar epithelium, not otherwise specified in 24 (47%). Additionally, 14 (27%) cases were deemed nondiagnostic. CONCLUSIONS A cytopathologic diagnosis of SCA on FNA is extremely difficult. The salient cytomorphologic features for identifying SCAs included scant cellularity, a mostly clear background, absence of extracellular mucin, hemosiderin-laden macrophages, and loose fragments of cuboidal cells with a notable absence of necrosis, atypia, and mitoses.
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Affiliation(s)
- Mohammed T Lilo
- Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, Baltimore, MD, USA
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21
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Bicer M, Gol M, Karas C, Guner Z, Akarsu S. Laparoscopic Restaging Surgery for Ovarian or Fallopian Tube Cancer. J Coll Physicians Surg Pak 2016; 26:944-945. [PMID: 27981938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 07/23/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Merve Bicer
- Department of Gynecology and Obstetrics, Izmir University Hospital, Izmir, Turkey
| | - Mert Gol
- Near East University, Faculty of Medicine, Obstetrics and Gynecology Department, Lefkosa, TRNC, Mersin, 10, Turkey
| | - Cigdem Karas
- Department of Gynecology and Obstetrics, Izmir University Hospital, Izmir, Turkey
| | - Zekeriya Guner
- Department of Gynecology and Obstetrics, Izmir University Hospital, Izmir, Turkey
| | - Suleyman Akarsu
- Department of Gynecology and Obstetrics, Izmir University Hospital, Izmir, Turkey
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Koncoro H, Putra IKWD, Wibawa IDN. Obstructive Jaundice as a Complication of Macrocystic Serous Cystadenoma of the Pancreas. Acta Med Indones 2016; 48:129-133. [PMID: 27550882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Macrocystic serous cystadenoma is an unusual and essentially benign pancreatic tumor. Herein, we report on a 40-year-old woman diagnosed with macrocystic serous cystadenoma who presented with obstructive jaundice. A cystic lesion in the head and body of the pancreas was revealed by abdominal computed tomography. Intraoperative pancreatic cyst aspiration ruled out mucinous cystic neoplasm which has a malignant potential. The pancreatic cyst fluid cytology was basophilic amorph materials concluded as benign cystic lesion. Internal drainage was performed instead of pancreatic resection which showed good outcome. Biliary obstruction is a rare complication of serous cystadenoma. This case describes an unusual clinical presentation of macrocystic serous cystadenoma.
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Affiliation(s)
- Hendra Koncoro
- Department of Internal Medicine, Faculty of Medicine, University of Udayana - Sanglah Hospital, Denpasar, Bali, Indonesia
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Mikhin IV, Panchishkin AS. [Long-term results of surgical treatment of giant serous cystadenoma of left ovary]. Khirurgiia (Mosk) 2016:64-66. [PMID: 27239918 DOI: 10.17116/hirurgia2016464-66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- I V Mikhin
- Chair of Surgical Diseases, Pediatric and Dental Faculties of Volgograd State Medical University
| | - A S Panchishkin
- Chair of Surgical Diseases, Pediatric and Dental Faculties of Volgograd State Medical University
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Fregoso-García MDC, Campomanes-Azamar RD, Rodríguez-Chávez JL, Madrigal-Rodríguez VM, Bañuelos-Franco A. [Serous cystadenoma in supernumerary ovary. Case report and literature review]. Ginecol Obstet Mex 2015; 83:722-727. [PMID: 27311170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The ovaries accessories, ectopic and supernumerary represent a rare gynecological disorder; incidence ranges from 129,000 to 1:700,000 cases. CLINIC CASE Patient 55 years of age who arrived at by diffuse abdominal pain 2 weeks of evolution, nausea and vomiting, with no history of chronic degenerative diseases or surgical. Palpation abdomen soft depressible globoso palpable mass at the expense of 30x20 cm, painless to superficial and deep pressure. Bimanual: anteversoflexion uterus 9 cm, 20 cm tumor, soft, fixed, mild pain in the cervical mobilization funds free bag. Laboratory tests and tumor markers for ovarian unchanged. The abdominopelvic ultrasound ecomixta reported prodomain cystic mass of 28x13x26 cm, volume 5,470 mL, with papillary projections, septa and caps 6 mm thick. Contrasted abdominal tomography: nodular image of 20 cm, heterogeneous, predominantly cystic, with septa, uptake of contrast medium in the pelvic cavity of probable ovarian origin. laparotomy was performed and found: 8 cm uterus, normal, both atrophic ovaries; 30x20 cm tumor, smooth edges, with neovascularization and areas of calcification with serous content of 5,000 cc, attached to the handles of the jejunum and ileum; transverse colon, back and tail of the pancreas; It was dissected into the retroperitoneum and great vessels, apparent root of the prevertebral fascia. CONCLUSION The supernumerary ovary is an extremely rare disorder, but should be considered in patients with abdominal tumors.
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Pravisani R, Intini SG, Girometti R, Avellini C, Leo CA, Bugiantella W, Risaliti A. Macrocystic serous cystadenoma of the pancreas: Report of 4 cases. Int J Surg 2015; 21 Suppl 1:S98-S101. [PMID: 26118606 DOI: 10.1016/j.ijsu.2015.04.097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 03/27/2015] [Accepted: 04/10/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Macrocystic serous cystadenomas (MaSCA) are rare benign tumor of the pancreas which represent an atypical macroscopic morphologic variant of serous cystadenomas (SCA). They are characterized by a limited number of cysts with a diameter of >2 cm and share imaging features overlapping those of mucinous cystic neoplasm (MCN) and branch-duct intraductal papillary mucinous neoplasm (BD-IPMN), thus frequently making the pre-operative radiologic diagnosis difficult. MATERIALS AND METHODS Four cases of MaSCA, which were surgically treated in our structure, are reported. RESULTS Two women (62 and 39 year-old) presented with upper abdominal pain and palpable mass underwent CT with evidence of a lobulated cystic neoformation (98 × 70 and 94 × 75 mm respectively) originating from the body and the tail of the pancreas respectively. They underwent distal pancreatectomy for suspected MCN. A 38 year-old woman underwent laparoscopic distal pancreatectomy because of the incidental finding of an unilocular cystic lesion in the pancreatic tail (23 mm) of indeterminate origin (MCN, SCA or metastasis). In a 40 year-old woman, admitted for acalculous acute pancreatitis, an unilocular cystic lesion in the body of the pancreas (62 mm) was detected and confirmed after 2 months at CT, therefore she underwent distal pancreatectomy for suspected pseudocyst or SCA. In all of the 4 patients the histological examination of the specimens revealed a MaSCA. CONCLUSION Imaging techniques have a low diagnostic power in terms of differentiation of MaSCA from malignant lesions (as MCNs and BD-IPMN). In the clinical practise of MaSCA, surgery appears to gain indications that are wider than those correlated to the pathologic outcome, because of the necessity of a correct differential diagnosis from potentially malignant cystic tumors and the frequent symptoms requiring treatment.
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Affiliation(s)
- Riccardo Pravisani
- Dipartimento di Scienze Mediche e Biologiche, Universitá degli Studi di Udine, Piazzale Kolbe, 4, 33100 Udine, Italy.
| | - Sergio Giuseppe Intini
- Dipartimento di Scienze Mediche e Biologiche, Universitá degli Studi di Udine, Piazzale Kolbe, 4, 33100 Udine, Italy.
| | - Rossano Girometti
- Institute of Radiology, University Hospital "S. Maria della Misericordia", Udine, Italy.
| | - Claudio Avellini
- Institute of Pathology, University Hospital "S. Maria della Misericordia", Udine, Italy.
| | - Cosimo Alex Leo
- Dipartimento di Scienze Mediche e Biologiche, Universitá degli Studi di Udine, Piazzale Kolbe, 4, 33100 Udine, Italy.
| | - Walter Bugiantella
- General Surgery, AUSL Umbria 2, Italy, PhD School of Biotechnologies, University of Perugia, Italy.
| | - Andrea Risaliti
- Dipartimento di Scienze Mediche e Biologiche, Universitá degli Studi di Udine, Piazzale Kolbe, 4, 33100 Udine, Italy.
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Dokmak S, Aussilhou B, Rasoaherinomenjanahary F, Sauvanet A, Vullierme MP, Rebours V, Lévy P. Laparoscopic fenestration of pancreatic serous cystadenoma: Minimally invasive approach for symptomatic benign disease. World J Gastroenterol 2015; 21:7047-7051. [PMID: 26078583 PMCID: PMC4462747 DOI: 10.3748/wjg.v21.i22.7047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 11/23/2014] [Accepted: 02/05/2015] [Indexed: 02/06/2023] Open
Abstract
Serous cystadenoma (SC) is a benign pancreatic cystic tumor. Surgical resection is recommended for symptomatic forms, but laparoscopic fenestration of large symptomatic macrocystic SC was not yet described in the literature. In this study, 3 female patients underwent laparoscopic fenestration for macrocystic SC (12-14 cm). Diagnosis was established via magnetic resonance imaging and endoscopic ultrasound, with intra-cystic dosage of tumors markers (ACE and CA19-9) in 2 patients. All patients were symptomatic and operated on 15-60 mo after diagnosis. Radiological evaluation showed constant cyst growth. Patients were informed about this new surgical modality that can avoid pancreatic resection. The mean operative time was 103 min (70-150 min) with one conversion. The post-operative course was marked by a grade A pancreatic fistula in one patient and was uneventful in the other two. The hospital stay was 3, 10, and 18 d, respectively. The diagnosis of macrocystic SC was histologically-confirmed in all cases. At the last follow-up (13-26 mo), all patients were symptom-free, and radiological evaluation showed complete disappearance of the cyst. Laparoscopic fenestration, as opposed to resection, should be considered for large symptomatic macrocystic SC, thereby avoiding pancreatic resection morbidity and mortality.
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Metodiev D, Ivanova V, Omainikova B, Boshnakova T. [OVARIAN ANASTOMOSING HEMANGIOMA WITH STROMAL LUTEINIZATION: A CASE REPORT]. Akush Ginekol (Sofiia) 2015; 54:58-61. [PMID: 26863799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In 2009, Montgomery and Epstein coined the term "anastomosing hemangioma" for a newly described variant of capillary hemangioma with an unusual sinusoidal pattern, histologically mimicking angiosarcoma. The lesion was considered unique for genitourinary system with predilection to kidney but we found in the literature only 4 cases of this entity in ovaries. A 70-year-old woman presented with ultrasound visualized myometrial nodules and cystic formation of the right ovary, intraoperatively diagnosed as serous cystadenoma. Hysterectomy with bilateral adnexectomy was performed. The section of the ovary revealed a fortuitous finding in the cortex: circumscribed lesion, 7 mm in diameter, with mahogany brown, spongy appearance. Microscopic examination of H&E-stained slides manifested well-demarcated but un-encapsulated vascular proliferation, composed of tightly packed capillary-sized blood vessels with an anastomosing sinusoidal-like architecture and tortuous "feeding" and "draining" vessels of medium caliber. Endothelial lining featured only mild cytologic atypia and lack of mitotic figures. The lesion was surrounded by luteinized ovarian stroma. Immunohistochemical examination with CD34 highlighted endothelial cells; SMA--supporting stromal cells. The anastomosing hemangioma of the ovary with stromal luteinisation was diagnosed as accidental finding. The authors discuss morphological characteristics of anastomosing hemangioma and the unusual for menopausal women but quite often combination between this lesion in the ovary and stromal luteinisation.
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Abstract
Epithelial ovarian cancer is one of the most lethal gynecological malignant tumors despite improvement of the treatment. Recent molecular studies show that ovarian cancer is a heterogeneous disease which is reflected by different histologic types. These subtypes differ from their origin, pathogenesis and molecular alterations and can be divided in two major groups. The type I cancer (low grade) evolves from precursor lesions in a step-wise process. In contrast, the type II cancer (high grade) grows rapidly without any identifiable precursors. Among all subtypes is heterogeneity in the biological behavior which has implications in patient prognosis and treatment especially for individualized therapies in the future.
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MESH Headings
- Adenocarcinoma, Clear Cell/genetics
- Adenocarcinoma, Clear Cell/mortality
- Adenocarcinoma, Clear Cell/pathology
- Adenocarcinoma, Clear Cell/surgery
- Biomarkers, Tumor/genetics
- Carcinoma/genetics
- Carcinoma/mortality
- Carcinoma/pathology
- Carcinoma/surgery
- Carcinoma in Situ/pathology
- Carcinoma, Endometrioid/genetics
- Carcinoma, Endometrioid/mortality
- Carcinoma, Endometrioid/pathology
- Carcinoma, Endometrioid/surgery
- Cystadenoma, Mucinous/mortality
- Cystadenoma, Mucinous/pathology
- Cystadenoma, Mucinous/surgery
- Cystadenoma, Serous/genetics
- Cystadenoma, Serous/mortality
- Cystadenoma, Serous/pathology
- Cystadenoma, Serous/surgery
- Female
- Gene Expression Regulation, Neoplastic/genetics
- Humans
- Neoplasm Staging
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/mortality
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/surgery
- Ovary/pathology
- Prognosis
- Survival Rate
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Affiliation(s)
- Aurelia Noske
- Institut für Klinische Pathologie, Universitätsspital Zürich
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Oh NJ, Kim WY. Laparoendoscopic single-site surgery (LESS) for large benign adnexal tumors: one surgeon's experience over one-year period. CLIN EXP OBSTET GYN 2014; 41:319-322. [PMID: 24992785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To present the authors' experience with laparoendoscopic single-site surgery (LESS) surgery for large benign adnexal tumors and to compare the removal time of resected specimen with that of conventional laparoscopy. STUDY DESIGN Ten consecutive patients underwent LESS for huge adnexal tumors at Myongjil Hospital, Korea between March 2011 and July 2012. A modified open Hasson technique was used to gain access to the abdominal cavity. The single-port device was inserted trans-umbilically into the wound opening. After suction of large amount of fluid content, LESS salpingo-oophorectomy was performed. The resected adnexal specimen was placed into a LapBag for removal out of the abdominal cavity. The authors compared the removal time of resected specimen between LESS and previously performed conventional laparoscopy for large benign adnexal tumors. RESULTS The adnexal tumors in this study were all very large cystic tumors reaching near or over the umbilicus. It took less than ten minutes for the removal of the resected adnexal tumors in all LESS cases (three to ten minutes), much less time than that of the conventional laparoscopy (usually ten to 17 minutes). CONCLUSION LESS for large benign adnexal tumors is feasible and removal of resected adnexal tumor is easier than conventional laparoscopic surgery.
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Cruz-Galarza D, Pérez-Rodríguez O, Laboy-Torres J, Gutiérrez-Rivera S. An unusual case of a borderline Brenner tumor associated with bilateral serous cystadenoma and endometrial carcinoma. Bol Asoc Med P R 2014; 106:54-56. [PMID: 24791367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Brenner tumor accounts for 1.5 to 2.5% of ovarian tumors. Nearly all are benign and 1% malignant. Less than twenty-five cases of borderline Brenner tumor have been reported worldwide. Our case is the first one related to a bilateral ovarian serous cystadenofibroma and endometrioid adenocarcinoma. This unusual case increases the limited data for borderline Brenner tumors.
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MESH Headings
- Antineoplastic Agents, Hormonal/adverse effects
- Antineoplastic Agents, Hormonal/therapeutic use
- Biomarkers, Tumor/analysis
- Breast Neoplasms/drug therapy
- Breast Neoplasms/surgery
- Brenner Tumor/metabolism
- Brenner Tumor/pathology
- Brenner Tumor/surgery
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/surgery
- Combined Modality Therapy
- Cystadenoma, Serous/pathology
- Cystadenoma, Serous/surgery
- Endometrial Neoplasms/chemically induced
- Endometrial Neoplasms/etiology
- Endometrial Neoplasms/pathology
- Endometrial Neoplasms/surgery
- Estrogens/metabolism
- Female
- Humans
- Hysterectomy
- Middle Aged
- Neoplasms, Hormone-Dependent/chemically induced
- Neoplasms, Hormone-Dependent/etiology
- Neoplasms, Hormone-Dependent/pathology
- Neoplasms, Hormone-Dependent/surgery
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/surgery
- Neoplasms, Second Primary/chemically induced
- Neoplasms, Second Primary/pathology
- Neoplasms, Second Primary/surgery
- Ovarian Cysts/complications
- Ovarian Neoplasms/metabolism
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/surgery
- Ovariectomy
- Salpingectomy
- Tamoxifen/adverse effects
- Tamoxifen/therapeutic use
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Djukic M, Stankovic Z, Vasiljevic M, Savic D, Lukac B, Djuricic S. Laparoscopic management of ovarian benign masses. CLIN EXP OBSTET GYN 2014; 41:296-299. [PMID: 24992780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To determine whether the presence of normal ovarian tissue could assist in the diagnosis of large benign ovarian neoplasms in young females and in choosing the laparoscopic treatment. MATERIALS AND METHODS A prospective study of 25 patients treated surgically for a cystic ovarian neoplasm measuring diameter more than ten cm or volume more than 500 ml and having normal ovarian tissue or ovarian crescent sign (OCS). Ultrasonography was performed at six weeks, then at three, six, nine, and 12 months postoperatively. RESULTS The mean age of patients was 15.3 +/- 3.6 years, ranging between 6.5 and 19 years. The mean preoperative volume of the ovarian neoplasm was 1,686 +/- 1,380 cm3, ranging between 550 and 6,000 cm3. The presence of OCS was visualized by ultrasonography in all 25 patients and serum tumor markers were negative in 22. No borderline tumors or malignancies were identified. There was a statistically significant difference between the volume of the affected ovary and the contralateral ovary during the first six weeks follow-up, but without significant difference after three months. CONCLUSIONS Postoperative ultrasound revealed that the affected ovary resumed its normal volume within three months after surgery, despite the thinned appearance of the ovarian cortex present on ultrasound as the OCS. Laparoscopic ovarian preservation should be the preferred surgical approach for adolescents to ensure the conservation of the entire ovarian tissue.
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Hou B, Cui P, Jian Z, Li S, Chen W, Ou Y, Ou J. [Application of three-dimensional visualization technology for laparoscopic resection of cystic carcinoma in the pancreatic body and tail]. Nan Fang Yi Ke Da Xue Xue Bao 2013; 33:1648-1651. [PMID: 24273270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To study the application of three-dimensional visualization technology for laparoscopic resection of cystic carcinoma in the pancreatic body and tail. METHODS Six cases of cystic carcinoma in the pancreatic body and tail treated between Nov, 2009 and Mar, 2011 were retrospectively analyzed. The original image data of 64-slice spiral CT were collected and using adaptive region growing algorithm, the serial CT images were segmented and automatically extracted to obtain the 3-dimensional reconstruction images with customized image manipulation software. The specific surgical approach (the trocar position) and surgical procedure were planned based on the reconstructed mode. RESULTS The reconstructed 3-dimensional model clearly displayed cystic carcinoma in the pancreatic body and tail and the adjacent organs, showing distinct relationship between the cystoma and the splenic artery and vein. All the patients successfully underwent laparoscopic resection of the pancreatic body and tail without perioperative death. The spleen was preserved in 5 cases and removed in 1 case due to mucinous cystadenocarcinoma. The overall rate of pancreatic fistulae was 33.3% without incidences of postoperative hemorrhage. The average hospital stay of the patients was 12 days. CONCLUSION Three-dimensional reconstruction based on pancreatic CT data provides valuable assistance for laparoscopic resection of cystic carcinoma in the pancreatic body and tail.
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Affiliation(s)
- Baohua Hou
- Department of General Surgery, Guangdong General Hospital//Guangdong Academy of Medical Sciences, Guangzhou 510080, China.E-mail:
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Saha R, Karki C. Laparoscopic management of benign ovarian masses. JNMA J Nepal Med Assoc 2013; 52:608-611. [PMID: 25327236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION Laparoscopic surgery is one of the most common procedures performed for benign ovarian masses. The aim of the study was to analyze all benign ovarian masses treated laparoscopically to assess safety, feasibility and outcome. METHODS A prospective study was carried out at Kathmandu Medical College Teaching Hospital, Sinamangal, Nepal. All the patients undergoing laparoscopic surgery for benign ovarian masses from 1st January 2012 to 31st December 2012 were included in the study. The pre-operative findings, intra-operative findings, operative techniques and post-operative complications were analyzed. RESULTS Thirty-six patients were taken for the study. Two cases were excluded since intra-operatively they were tubo-ovarian masses. The most common tumor was dermoid cyst (n=13; 38.23%) and endometriotic cyst (n=14; 41.17%). Out of 34 cases, five cases of endometriotic cyst (14.70%) were converted to laparotomy due to severe adhesions and four cases of endometriotic cyst underwent deroofing surgery. Two cases underwent laparoscopic assisted vaginal hysterectomy with bilateral salphingo-oopherectomy. Successful cystectomies were carried out in 22 cases. None were malignant. Major complications were not noted while minor complications like port-site infection (n=3; 8.82%) and subcutaneous emphysema (n=1; 2.9%) were present. CONCLUSIONS Laproscopic management of benign ovarian masses is safe and feasible.
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Affiliation(s)
- Rachana Saha
- Department of Obstetrics and Gynecology, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal
| | - Chanda Karki
- Department of Obstetrics and Gynecology, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal
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Collins BT. Serous cystadenoma of the pancreas with endoscopic ultrasound fine needle aspiration biopsy and surgical correlation. Acta Cytol 2013; 57:241-51. [PMID: 23635954 DOI: 10.1159/000346911] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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: 11/12/2012] [Accepted: 01/03/2013] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Endoscopic ultrasound (EUS) fine needle aspiration (FNA) biopsies are commonly used to diagnose tumors of the pancreas. Serous cystadenoma (SCA) is a benign neoplasm that is uncommon and accounts for 1-2% of all pancreatic neoplasms. STUDY DESIGN Surgically excised SCAs with preoperative EUS FNA biopsy over a 10-year span were identified. Clinical data were collected, and cytomorphologic features reviewed retrospectively and correlated with surgical excision data. Original cytopathologic diagnoses and retrospectively reviewed cytomorphology features were recorded. RESULTS Seventeen patients were identified. Original EUS FNA interpretation included 1 'unsatisfactory', 9 'negative for malignancy' and 7 'atypical' or greater; however, all cases were categorized as benign/negative or nondiagnostic on retrospective review. The cases were hypocellular and possessed variable (rare to few-moderate) groups of bland cuboidal epithelial cells embedded in granular debris. Mucosal sampling was present (7/17) and cell blocks were acellular (5/17). CONCLUSION This is a large series of pancreas SCAs subjected exclusively to EUS FNA biopsy where all cases had surgical excision confirmation. The 17 cases had hypocellular aspirate smears with the majority showing few bland epithelial cells; however, this can limit definitive diagnosis based on the cytomorphologic evaluation alone. The aspirate smear pattern of EUS FNA of SCAs of the pancreas supports a benign/negative or nondiagnostic categorization.
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Affiliation(s)
- Brian T Collins
- Department of Pathology and Immunology, School of Medicine, Washington University in St. Louis, St. Louis, Mo. 63110-1093, USA.
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Malek-Mellouli M, Ben Amara F, Ferjaoui Mohamed A, Taamallah N, Youssef A, Mbarki M, Reziga H. [Laparoscopic management of borderline malignancy ovarian tumors discovered during pregnancy]. Tunis Med 2013; 91:282-283. [PMID: 23673712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Malleo G, Bassi C, Salvia R. Appraisal of the surgical management for pancreatic serous cystic neoplasms. Surg Endosc 2013; 27:2646-7. [PMID: 23355171 DOI: 10.1007/s00464-012-2783-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 12/21/2012] [Indexed: 01/13/2023]
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Affiliation(s)
- Yi-Ni Yu
- Department of Emergency Medicine, Buddhist Tzu Chi General Hospital, Taiwan
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Tîrnovanu MC, Amancei S, Dumitrescu A, Onofriescu M, Dumitraşcu I. Management of borderline ovarian tumors. Rev Med Chir Soc Med Nat Iasi 2012; 116:1069-1075. [PMID: 23700890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
UNLABELLED Borderline ovarian tumors are an intermediate stage between benign cystadenomas and adenocarcinomas. AIM The paper evaluates the management of borderline ovarian tumors (BOTs) in the patients admitted and treated in our clinic in the interval January 2003 - June 2011. MATERIAL AND METHODS The observation sheets and pathology results of 264 patients with malignant ovarian tumors were analyzed. RESULTS Of the 264 malignant ovarian tumors 74 (28.03%) were low malignant potential. Patients with BOT were aged 18-72 years (mean 46 +/- 6.2 years) and those with invasive tumors 14-83 years (mean 53 +/- 9.8 years). 92.18% were in stage 1. Sixty tumors were graded G1. 53.52 % of the tumors were over 10 cm (maximum 30 cm) in size. The histological types were: serous - 35 cases, mucinous - 19 cases, mixed (serous and mucinous) - 8 cases, and endometrioid - 2 cases. Fifteen patients presented intraepithelial carcinoma and 11 noninvasive implants into the peritoneal cavity. Five women had recurrences. CONCLUSIONS Ovarian borderline tumors with histological characteristics of carcinoma, but with good behavior are now with better defined histological features. The biggest challenge in the management of women with these tumors is to identify the subset that will behave in a malignant fashion and to develop effective treatment for them.
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Mori E, Yuen K, Medrano H, Torres J, García C, Montes J. [Management of pancreatic cystic tumors in the Alberto Sabogal Sologuren hospital]. Rev Gastroenterol Peru 2012; 32:169-177. [PMID: 23023180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Cystic tumors of the pancreas comprise 1% of all neoplasms of the pancreas and 10 to 15% of pancreatic cysts. There are a variety of cystic lesions, of which 90% is made up of serous cystadenomas, mucinous cystic neoplasms, intraductal mucinous neoplasms and solid pseudopapillary neoplasms. MATERIALS AND METHODS This study describes and analyzes retrospectively the clinical, radiological, surgical, pathological and follow up of 12 patients operated on for cystic tumors of the pancreas in the hospital IV Alberto Sabogal Sologuren, in the period 2005 to 2010. RESULTS we found 5 (41%) serous cystadenomas with a mean age of 66 years, localized 80% in the head and 20% body; 2 (17%) mucinous cystic neoplasms with a mean age of 54, all located in body, 2 (17%) intraductal mucinous neoplasms with a mean age of 63, all located in the head, and 3 (25%) solid pseudopapillary neoplasms with a mean age of 33 years, located in body 33% and 66% in tail with a predominance of females in a ratio of 3:1. Had abdominal pain (75%), weight loss (17%) and palpable mass (17%). Of the 2 cystic mucinous neoplasms, only one have a low-grade dysplasia, of the two mucinous intraductal neoplasms, one have grade moderate dysplasia and the other with a high degree, the rest of cystic neoplasms were benign. We realize 6 Pancreaticoduodenectomy, 4 corporocaudales pancreatectomies, 2 distal pancreatectomies; of them splenectomy realize in 4 patients (2 in corporocaudal pancreatectomies and 2 distal pancreatectomies). In all cases the preoperative diagnosis was based on abdominal TEM. in 4 patients was expanded with RMN for suspicion of mucinous tumor and in 2 patients was performed CPRE for suspected intraductal tumors. Two patients coursed with atelectasis, and one patient had pancreatic fistula grade A and other mild pancreatitis post-operative. No patient was reoperated. There was no mortality post operative. Postoperative was more for the pancreaticoduodenectomy group. In a 2 year follow up, no observed recurrence and all patients are alive. CONCLUSION Preoperative diagnosis is crucial given the differences in natural history of the spectrum of lesions. Despite improved radiographic imaging, techniques, definitive diagnosis is only made after studying the resection sample.
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Affiliation(s)
- Edmundo Mori
- Servicio de Cirugía General Especializada y Oncológica, Hospital IV Alberto Sabogal Sologuren, Lima, Perú.
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Abstract
Cystic tumors of the pancreas are a subset of rare pancreatic tumors that vary from benign to malignant. Many have specific imaging findings that allow them to be differentiated from each other. This article (1) reviews the imaging features of the common cystic pancreatic lesions, including serous microcystic adenoma, mucinous cystic tumor, intraductal papillary mucinous tumor, and solid pseudopapillary tumor, and including the less common lesions such as cystic endocrine tumors, cystic metastases, cystic teratomas, and lymphangiomas; and (2) provides comprehensive algorithms on how to manage the individual lesions, with recommendations on when to reimage patients.
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MESH Headings
- Adenocarcinoma, Mucinous/diagnosis
- Adenocarcinoma, Mucinous/pathology
- Adenocarcinoma, Mucinous/surgery
- Biopsy, Fine-Needle
- Cystadenocarcinoma/diagnosis
- Cystadenocarcinoma/pathology
- Cystadenocarcinoma/surgery
- Cystadenoma/diagnosis
- Cystadenoma/pathology
- Cystadenoma/surgery
- Cystadenoma, Serous/diagnosis
- Cystadenoma, Serous/pathology
- Cystadenoma, Serous/surgery
- Diagnosis, Differential
- Female
- Humans
- Magnetic Resonance Imaging/methods
- Middle Aged
- Neoplasms, Cystic, Mucinous, and Serous/diagnosis
- Neoplasms, Cystic, Mucinous, and Serous/pathology
- Neoplasms, Cystic, Mucinous, and Serous/surgery
- Pancreas/diagnostic imaging
- Pancreas/pathology
- Pancreatic Neoplasms/diagnosis
- Pancreatic Neoplasms/pathology
- Pancreatic Neoplasms/surgery
- Tomography, X-Ray Computed/methods
- Ultrasonography
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Affiliation(s)
- Catherine E Dewhurst
- Division of Abdominal Imaging and MRI, Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02115, USA
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Erra S, Costamagna D. Serous cystadenofibroma of the fallopian tube: case report and literature review. G Chir 2012; 33:31-33. [PMID: 22357436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Cystadenofibromas of the Fallopian tube are very rare benign tumors of the female genital tract. These tumours are usually asymptomatic and are found incidentally. CASE REPORT We describe a Fallopian serous cystadenofibroma in a 50 year-old woman operated for uterine leiomyoma. The histopathologic finding revealed a cystic lesion connected to the salpinx. The cyst was composed of connective stroma lined by epithelial cuboidal cells, without pleomorfism or detectable mitoses. Pseudopapillary structures were observed in the lumen of the cyst. The patient is well on follow-up. CONCLUSION The origin of serous cystadenofibroma of the Fallopian tube is not clear. The tumor is considered an embryologic remnant rather than a proliferating neoplastic process. These tumours seem to have a benign course and a malignant potential has not been described.
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Hirose A, Tajima H, Okamoto K, Makino I, Kinoshita J, Hayashi H, Nakamura K, Oyama K, Nakagawara H, Inokuchi M, Fujita H, Takamura H, Ninomiya I, Kitagawa H, Fushida S, Tani T, Fujimura T, Ohta T, Koda W, Matsui O. [A safely resected case of hypervascular pancreatic giant tumor after preoperative arterial embolization]. Gan To Kagaku Ryoho 2011; 38:2451-2453. [PMID: 22202410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 73-year-old woman visited our hospital for a treatment of pancreatic tumor that increased steadily in size of 6 cm in diameter in 1999 to 13 cm in 2008, while remaining in asymptomatic condition throughout this follow-up time. The tumor was big and flowed from many vessels such as portal and superior mesenteric veins and the celiac and superior mesenteric arteries. These were critical for determining tumor respectability and the risk of massive intra-operative hemorrhage was felt to be considerable. Therefore, preoperative embolization of the tumor-feeding arteries arising from the celiac axis (gastroduodenal, splenic and dorsal pancreatic arteries) was performed on the previous day of operation. Tumor resection with pancreaticoduodenectomy and partial resection of portal vein and reconstruction were performed. We got to SMA with the use of "paraduodenal mesenteric approach", we called, and we finished the operation without a blood transfusion. The final pathology confirmed the diagnosis of serous microcystic adenoma.
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Affiliation(s)
- Atsushi Hirose
- Dept. of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medicine Science, Kanazawa University
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Feng QL, Shi HR, Qiao LJ, Zhao J. [Expression of hSef and FGF-2 in epithelial ovarian tumor]. Zhonghua Zhong Liu Za Zhi 2011; 33:770-774. [PMID: 22335910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To detect the expression of human similar expression to FGF gene(hSef) and fibroblast growth factor-2(FGF-2) and their correlation with epithelial ovarian tumor. METHODS Immunohistochemical SP staining was used to detect the expression of hSef and FGF-2 proteins in 31 cases of epithelial ovarian carcinoma (EOC), 18 cases of benign epithelial tumor (BET), 10 cases of normal ovarian (NO) tissues collected from July 2007 to May 2008. The expression of hSef mRNA in 24 cases of EOC, BET and NO collected from July 2008 to May 2009 were analyzed by RT-PCR. RESULTS The results of immunohistochemical study showed that the expression of hSef in the EOC tissues were significantly lower than that in the NO and BET (P < 0.001). However, the expression of FGF-2 was higher (P = 0.002). The expression of hSef had a negative correlation with FGF-2 (r(s) = -0.324, P = 0.012). The RT-PCR results showed that there was a gradually declined trend of expression of hSef in NO, BET to EOC (P < 0.001), but the expression of FGF-2 in NO, BET to EOC was gradually increased (P < 0.001), with a significant negative correlation (NO: r(s) = -0.910, P < 0.001; BET: r(s) = -0.859, P < 0.001; EOC: r(s) = -0.888, P < 0.001). CONCLUSIONS The expression of hSef is decreased in epithelial ovarian carcinoma tissue, but the expression of FGF-2 is increased. It is likely that low hSef expression is related to the the carcinogenesis and development of epithelial ovarian carcinoma by suppressing the promoting effects of FGF-2 to cell proliferation.
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MESH Headings
- Adult
- Aged
- Cystadenocarcinoma, Mucinous/genetics
- Cystadenocarcinoma, Mucinous/metabolism
- Cystadenocarcinoma, Mucinous/pathology
- Cystadenocarcinoma, Mucinous/surgery
- Cystadenocarcinoma, Serous/genetics
- Cystadenocarcinoma, Serous/metabolism
- Cystadenocarcinoma, Serous/pathology
- Cystadenocarcinoma, Serous/surgery
- Cystadenoma, Mucinous/genetics
- Cystadenoma, Mucinous/metabolism
- Cystadenoma, Mucinous/pathology
- Cystadenoma, Mucinous/surgery
- Cystadenoma, Serous/genetics
- Cystadenoma, Serous/metabolism
- Cystadenoma, Serous/pathology
- Cystadenoma, Serous/surgery
- Female
- Fibroblast Growth Factor 2/genetics
- Fibroblast Growth Factor 2/metabolism
- Gene Expression Regulation, Neoplastic
- Humans
- Immunohistochemistry
- Middle Aged
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/metabolism
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/surgery
- Ovary/metabolism
- RNA, Messenger/metabolism
- Real-Time Polymerase Chain Reaction
- Receptors, Interleukin/genetics
- Receptors, Interleukin/metabolism
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Affiliation(s)
- Quan-ling Feng
- Department of Gynecology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
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Wang MJ, Qi J, Wang H, Li XX, Wei BJ, Fu C, Gao J, Han BB. [Diagnostic value of combining detection of human epididymis protein 4 and CA125 in patients with malignant ovarian carcinoma]. Zhonghua Zhong Liu Za Zhi 2011; 33:540-543. [PMID: 22093635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To investigate the clinical value of combination of human epididymis protein 4 (HE4), CA125 and the Risk of Ovarian Malignancy Algorithm (ROMA) in diagnosis of ovarian carcinoma. METHODS To detect the serum concentration of HE4 using ELISA and CA125 using ECL in patients of ovarian carcinoma group (n = 119), borderline ovarian tumor group (n = 36), benign ovarian neoplasm group (n = 96) and female healthy control group (n = 53). The ROMA based on the serum level of CA125, HE4 and a woman's menopausal status was used to calculate the predicted probability (PP) and diagnostic results of ovarian cancers. RESULTS The receiver operating characteristic (ROC) analysis showed the cut-off value was 67.3 pmol/L (the AUC was 0.906, the sensitivity was 80.7% and specificity was 94.6%). The serum levels of HE4 and CA125 in the ovarian carcinoma group were significantly higher than that in the borderline ovarian tumor group, benign ovarian neoplasm group and female healthy control group (P < 0.01). The serum levels of CA125 and HE4 showed statistically no significant difference between the borderline ovarian tumor group and benign ovarian neoplasm group (P > 0.05). The levels of HE4 and CA125 were reduced significantly in ovarian patients after surgery therapy (P < 0.01). The sensitivity and specificity of HE4 + CA125 combination was 92.7% and 72.5%. The ROMA that can classify patients into high and low risk groups was established as 9.3% in premenopausal and 27.3% in postmenopausal women. CONCLUSIONS HE4 is a helpful biomarker for ovarian carcinoma diagnosis. Biomarker combination of HE4 and CA125, and applying of the ROMA are helpful to improve the accuracy in diagnosis of ovarian cancers.
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MESH Headings
- Adenocarcinoma, Mucinous/blood
- Adenocarcinoma, Mucinous/diagnosis
- Adenocarcinoma, Mucinous/surgery
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/blood
- CA-125 Antigen/blood
- Cystadenocarcinoma, Serous/blood
- Cystadenocarcinoma, Serous/diagnosis
- Cystadenocarcinoma, Serous/surgery
- Cystadenoma, Serous/blood
- Cystadenoma, Serous/diagnosis
- Cystadenoma, Serous/surgery
- Endometriosis/blood
- Endometriosis/diagnosis
- Female
- Humans
- Menopause
- Middle Aged
- Ovarian Neoplasms/blood
- Ovarian Neoplasms/diagnosis
- Ovarian Neoplasms/surgery
- Proteins/metabolism
- ROC Curve
- Sensitivity and Specificity
- Teratoma/blood
- Teratoma/diagnosis
- Teratoma/surgery
- WAP Four-Disulfide Core Domain Protein 2
- Young Adult
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Affiliation(s)
- Min-jie Wang
- Clinical Laboratory, Chinese Academy of Medical Sciences, Beijing, China
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Luchian AM, Pricop M. [Borderline ovarian tumors and global radiation in relation with climate change impact]. Rev Med Chir Soc Med Nat Iasi 2011; 115:813-819. [PMID: 22046792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED There is limited information on borderline ovarian tumor detected intra-surgically and its most favorable treatment in relation with global radiation and climate changes. AIM To study the pre-surgery and intra-surgery differentiation criteria of borderline ovarian tumors from invasive carcinoma, and to make a very complex analysis of the frequency, distribution, and variation in time of global radiation, temperature, and precipitation in North-East Romania. MATERIAL AND METHOD The 54 patients (age range 20-78 years, mean age 46 years) included in this study had borderline ovarian tumors surgically treated during the last 22 years (January 1988 - December 2009) at the 4th Gynecological Clinic at Iaşi, and representing 4.87% of the total 1107 ovarian tumors detected and treated during this interval. The histological types were: serous (18 cases), mucinous (27 cases), mixed (8 cases), and Brenner tumor (1 case). In order to analyze the impact of climate changes on borderline ovarian tumors a thorough study on the frequency of global radiation in relation with climate changes based on data recorded in the last 55 years was also carried out. RESULTS The distribution of these cases depending on when surgery was performed was analyzed. In our study the frequency of ovarian borderline tumors (4.87%) is lower than in similar reports in the literature being due, in our opinion, to the influence of global radiation in relation with climate changes. CONCLUSIONS In our study global radiation is probably responsible for a progression to invasive carcinoma in 0.7% of the borderline ovarian tumors.
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MESH Headings
- Adult
- Aged
- Brenner Tumor/epidemiology
- Brenner Tumor/etiology
- Brenner Tumor/pathology
- Brenner Tumor/surgery
- Cell Transformation, Neoplastic
- Climate Change
- Cosmic Radiation/adverse effects
- Cystadenoma, Mucinous/epidemiology
- Cystadenoma, Mucinous/etiology
- Cystadenoma, Mucinous/pathology
- Cystadenoma, Mucinous/surgery
- Cystadenoma, Serous/epidemiology
- Cystadenoma, Serous/etiology
- Cystadenoma, Serous/pathology
- Cystadenoma, Serous/surgery
- Diagnosis, Differential
- Disease Progression
- Female
- Global Warming
- Humans
- Middle Aged
- Neoplasm Invasiveness
- Ovarian Neoplasms/epidemiology
- Ovarian Neoplasms/etiology
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/surgery
- Prognosis
- Retrospective Studies
- Romania/epidemiology
- Treatment Outcome
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Vilcea ID, Vasile I, Mirea C, Mesină C, Calota F, Pasalega M, Cheie M, Dumitrescu T, Mogoanta S, Vilcea AM. Pancreatic true cysts--diagnosis and treatment difficulties. Chirurgia (Bucur) 2011; 106:389-394. [PMID: 21853751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Pancreatic true cysts represent a rare, heterogeneous group of pancreatic tumors; therapeutic strategy is based on patient's general status, cyst topography, and especially the estimated risk of malignancy. This paper aim is to present 7 cases of pancreatic true cysts, operated on a six years period (January 2004-January 2010) in our surgical clinic: 2 men and 5 women, aged between 24-61 years old; cyst diameter varies between 3.5-15 cm, tumor location being pancreatic head in two cases and the distal pancreas in 5 cases. Surgical treatment consisted in cyst enucleation (two cases), splenopancreatectomy (three cases), duodenopancreatectomy (one case), and subtotal splenopancreatectomy (one case). Histology was represented by serous cystadenoma (one case), mucinous cystadenoma (2 cases), intraductal papillary mucinous cystadenoma (one case), and papillary cystadenocarcinoma (3 cases).Postoperative results were good in all cases, with 3 postoperative pancreatic external fistulas, resolved conservatory; no case of post-pancreatectomy diabetes mellitus was registered. In conclusion, surgical removal of the pancreatic cystic tumors is necessary, especially due to the risk of malignancy, at least in the absence of rigorous histological proofs of benignancy. Postoperative results are favorable in terms of postoperative morbidity and mortality.
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Affiliation(s)
- I D Vilcea
- Second Surgical Clinic, University of Medicine and Pharmacy of Craiova, Romania.
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Song MJ, Lee CW, Park EK, Lee AW, Park JS, Hur SY. Parovarian tumors of borderline malignancy. EUR J GYNAECOL ONCOL 2011; 32:445-447. [PMID: 21941975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The incidence of a parovarian tumor is 10-20% of all uterine adnexal masses, however, it is benign in most cases, and a borderline or malignant tumor is extremely rare. The classification of disease stage and treatment is still controversial owing to its scarcity. We have managed one mucinous and two serous cystadenomas of borderline malignancy originating from paraovarian cysts in our institute over ten year. We report and discuss the cases herein.
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Affiliation(s)
- M J Song
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul
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Nagendran S, Johal N, Samuel M. Benign fimbrial serous cystadenoma: an unusual cause of right iliac fossa pain in a young girl. Br J Hosp Med (Lond) 2010; 71:708-9. [PMID: 21135770 DOI: 10.12968/hmed.2010.71.12.708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hou BH, Ou JR. [The diagnosis and therapy of pancreatic cystic tumors]. Zhonghua Wai Ke Za Zhi 2010; 48:1409-1411. [PMID: 21092578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To discuss the surgical option and the treatment of complications of pancreatic cystic tumors. METHODS From January 1997 to December 2009, 32 patients with pancreatic cystic tumors in our center were reviewed retrospectively. There were 6 male and 26 female, aging from 24 to 76 years. Of the 32 patients, 16 patients had serous cystadenoma, 9 patients had mucinous cystadenoma; 1 patients had mucinous cystadenocarcinoma; 4 patients had intraductal papillary mucinous neoplasms and 3 patients had pancreatic solid pseudopapillary neoplasms. Tumor located in pancreatic head in 12 patients and in pancreatic body and tail in 20 patients. RESULTS All patients received surgical treatment and there was no perioperative death. Pancreato-duodenectomy was performed in 10 patients, duodenum-preserving pancreatic head resection in 1 patient, distal pancreactomy in 13 patients, including laparoscopic distal pancreactomy in 2 patients, pancreatic tumor resection in 3 patients, middle segmental resection in 4 patients; 1 patients with mucinous cystadenocarcinoma received palliative surgery. Complication included gastroparesis in 3 patients and pancreatic fistula in 5 patients, and all recovered by conservative treatment. These 29 patients were followed up 4 - 120 months, 3 patients died from tumor metastasis or other disease within 4 to 34 months after surgery. Others were alive and there was no tumor recurrence or metastasis. CONCLUSIONS CT scan should be the first choice of non-invasive examination for cystic pancreatic diagnosis. Positive and timely operation should be performed in the patient with cystic pancreatic tumor, and it acts as a cancer preventive treatment. The selection of surgical approach should be individualized, the principal of damage control surgery should be followed. Complications such as gastroparesis and pancreatic fistula should be paid more attention.
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Affiliation(s)
- Bao-hua Hou
- Department of Hepto-bila-pancreas, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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