Groove pancreatitis. A benign entity simulating pancreatic head tumor

Introduction.Neuroendocrine carcinoma (NEC) of pancreas is a rare tumor with aggressive progression and poor prognosis. Its coexistence with adenocarcinoma poses significant clinical problems and has not been addressed in the literature.Methods.We describe a case of a 51-year-old male who underwent pancreatoduodenectomy due to pancreatic head tumor1.5×1×1.4 cm. Histological examination of the specimen revealed a mixed neoplasm: (1) a well differentiated adenocarcinoma, neoplastic blasts of which are extended focally to the submucosa without invading the muscular layer, and (2) a low differentiated NEC consisting of solid clusters and pagetoid formations. All 18 lymph nodes of the specimen were free of neoplastic disease and the surgical margins of the specimen were tumor-free. No adjuvant treatment was administered and two months after the operation the patient developed liver metastasis. FNA cytology of the hepatic lesions revealed low grade carcinoma with neuroendocrine characteristics. Five lines of chemotherapy were administered: VP + CDDP, paclitaxel + ifosfamide + Mesna + CDDP, Folfox + Avastin, Folfiri + Avastin, and CAV. During his treatment he revealed PD and succumbed to his disease 13 months after the operation.Conclusion.Coexistence of NEC with adenocarcinoma of the pancreas is a very rare entity presenting significant challenges regarding its adjuvant treatment and the treatment of distant relapse.

Download Full-text

A duodenal stromal tumor mimicking a pancreatic head tumor: one case report and literature review

European Surgery ◽

10.1007/s10353-012-0176-6 ◽

2013 ◽

Vol 45 (1) ◽

pp. 40-43

Author(s):

O. Mouaqit ◽

R. Ktaibi ◽

A. Ktaibi ◽

M. Mounim ◽

El H. O. El malki ◽

...

Keyword(s):

Case Report ◽

Literature Review ◽

Pancreatic Head ◽

Stromal Tumor ◽

Pancreatic Head Tumor

Download Full-text

SU-E-J-122: Quantification of Respiratory-Induced Pancreatic Head Tumor Rotation and Deformation Using 4DCT and Fiducial Markers

Medical Physics ◽

10.1118/1.4734958 ◽

2012 ◽

Vol 39 (6Part8) ◽

pp. 3680-3680

Author(s):

S Chen ◽

C Lin ◽

C Enke ◽

S Zhou

Keyword(s):

Pancreatic Head ◽

Fiducial Markers ◽

Pancreatic Head Tumor

Download Full-text

Single-Incision Laparoscopic Gastrojejunal Bypass with Intraoperative Ultrasonography for Obstructive Pancreatic Head Tumor

Videoscopy ◽

10.1089/vor.2014.0205 ◽

2014 ◽

Vol 24 (4) ◽

Author(s):

Giovanni Dapri

Keyword(s):

Single Incision ◽

Pancreatic Head ◽

Intraoperative Ultrasonography ◽

Pancreatic Head Tumor

Download Full-text

Spontaneous Resolution of Hemorrhagic Pseudocyst-Associated Pseudoaneurysm in Groove Pancreatitis

Case Reports in Gastroenterology ◽

10.1159/000502836 ◽

2020 ◽

Vol 14 (1) ◽

pp. 131-136

Author(s):

Gwang Mo Kim ◽

Soon Young Ko ◽

Joon Ho Wang

Keyword(s):

Pancreatic Duct ◽

Clinical Presentation ◽

Healing Process ◽

Stable Condition ◽

Pancreatic Head ◽

Stent Insertion ◽

First Line ◽

Groove Pancreatitis ◽

Pancreatic Sphincterotomy

Hemorrhagic pseudocyst (HP) and pseudocyst-associated pseudoaneurysms (PPs) are complications of pseudocyst. Angiography with embolization has been advocated as the first-line intervention for HP. A 47-year-old man with groove pancreatitis combined with HP near the pancreatic head was treated conservatively. He had relapsed pancreatitis with a newly identified pseudoaneurysm; however, the pseudocyst size was reduced. Although pseudoaneurysm was identified, angiography was not performed because there was no evidence of ongoing bleeding, and he was in a stable condition. Sphincterotomy and stent insertion in the pancreatic duct was applied to prevent relapsed pancreatitis with facilitation of the flow of pancreatic juice. He has done well during the 10-month follow-up, without recurrent pancreatitis. Angiography as an initial approach in HP and PPs may need to be more selective depending on the clinical presentation of the patient. A lysed clot within the strictured pancreatic duct during the healing process has been thought to be the cause of relapsed pancreatitis, and pancreatic sphincterotomy and stent insertion should be the preferred treatment methods.

Download Full-text

A Case of Solid Pseudopapillary Neoplasm Spontaneously Ruptured Into the Duodenum: Case Report

International Surgery ◽

10.9738/intsurg-d-15-00271.1 ◽

2019 ◽

Vol 103 (9-10) ◽

pp. 461-467

Author(s):

Seiji Natsume ◽

Yoshiki Senda ◽

Tsuyoshi Sano ◽

Seiji Ito ◽

Koji Komori ◽

...

Keyword(s):

Computed Tomography ◽

Case Report ◽

Portal Vein ◽

Rare Case ◽

Pancreatic Head ◽

Resected Specimen ◽

Solid Pseudopapillary Neoplasm ◽

Contrast Radiography ◽

Pancreatic Head Tumor

There have been no reports of ruptured solid pseudopapillary neoplasm (SPN) into adjacent organs. A 22-year-old female was referred to our hospital for treatment of a pancreatic head tumor. Computed tomography (CT) examination at our hospital showed a 5-cm tumor containing air, although CT at a previous hospital revealed an 8-cm tumor without air. Thus, a spontaneous rupture of the tumor into the duodenum was suspected. Subtotal stomach preserving pancreaticoduodenectomy with combined resection of the portal vein was performed. Contrast radiography of resected specimen showed the medium injected into the tumor leaking out from the 2nd portion of the duodenum. Histologically, the patient was diagnosed as SPN. Microscopic invasion to the portal vein and duodenum were also confirmed. She did not experience any postoperative complications and has remained well without any signs of recurrence during 2 years of follow-up. Although there have been 14 studies reporting ruptured SPN, this is the first report of SPN that spontaneously ruptured into the duodenum. An extremely rare case of SPN of the pancreatic head that spontaneously ruptured into the duodenum was reported.

Download Full-text

Simultaneous transoral parathyroidectomy and laparoscopic pancreatic resection in type 1 Multiple Endocrine Neoplasia syndrome

Annaly khirurgicheskoy gepatologii = Annals of HPB surgery ◽

10.16931/1995-5464.2021-4-126-132 ◽

2021 ◽

Vol 26 (4) ◽

pp. 126-132

Author(s):

S. E. Gryaznov ◽

I. M. Buriev ◽

G. G. Melkonyan ◽

N. S. Malyuga ◽

B. K. Laypanov

Keyword(s):

Multiple Endocrine Neoplasia ◽

Pancreatic Head ◽

Original Solution ◽

Men 1 ◽

Endocrine Neoplasia ◽

Multiple Endocrine Neoplasia Syndrome ◽

Laparoscopic Pancreatic Resection ◽

Pancreatic Head Tumor

The article presents a clinical observation of a patient with type 1 Multiple Endocrine Neoplasia syndrome (MEN 1). During the diagnostic search, a combination of primary hyperparathyroidism, parathyroid adenoma and hormonally inactive pancreatic head tumor was found. Simultaneous transoral parathyroidectomy and laparoscopic resection of the pancreatic head was performed. We haven`t found the literature data describing such kind of operations for MEN 1 syndrome. An original solution was applied to perform intraoperative ultrasonography monitoring. The results of 1-year postoperative follow-up are presented. This observation demonstrates the possibilities of endoscopic technologies in the treatment of MEN 1 syndrome.

Download Full-text