Invasive Carcinoma Derived from Intraductal Papillary Carcinoma of the Pancreas Manifested in the Follow-up of Branch-type Mucin Producing Pancreatic Tumor

Background: Thyroid carcinoma is rare in childhood and adolescence. The presentation is more advanced in case of children as compared to adults. However, the prognosis for survival in children is reportedly excellent. The aim of the study was to see the outcome of patients with well differentiated thyroid carcinoma during childhood and adolescence treated at a single institute.Patients and methods: A retrospective study of 61 children and adolescent patients (age ≤18years) with well differentiated thyroid carcinoma (DTC) enrolled in the National Institute of Nuclear Medicine and Allied Sciences, Dhaka during the period of January1986 up to December 2007 was carried out. To allow for a theoretical follow up of at least 5 years the last inclusion year was 2007 and follow up was carried on up to June 2013. All patients were treated by thyroidectomy followed by radioiodine ablation therapy. Whole body scans, Tg, anti Tg Ab and neck ultrasound findings were recorded six months to one year after initial therapy to classify patients into remission, persistent or recurrent disease. Status on last follow up was noted to estimate the survival rate.Results: A total of 40 patients had papillary carcinoma, 18 had follicular variant of papillary carcinoma (FVPCT) and three had follicular carcinoma. Age range at diagnosis was nine to 18 years with a mean of 15± 2 years. The number of patients ≤10 years were five and > 10 years were 56. There were 12 males and 49 females giving a M: F ratio of about 1:4. Among the 61 patients 30 patients had lymph node metastases and two had both nodal and lung metastases at initial presentation. After one year follow up from the initial radioiodine therapy, 30 patients were in remission and 31 patients had persistent disease. Eventually recurrence occurred in five patients. Three patients died during the whole observation period and all of them were cancer related giving a cancer specific mortality ratio of 0.049%, 95% CI 0 to 0.105%. Cancer specific survival by Kaplan-Meier curve was 98.2%, 98.2% and 66% at 5, 10 and 15 years respectively.Conclusion: DTC in children and adolescent has a good prognosis in the presence of neck and distant metastases. Awareness of the patient and regular follow up with life long surveillance is essential to obtain a favorable outcome.Bangladesh J. Nuclear Med. 20(2): 99-104, July 2017

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Malignant progression in intraductal papillary mucinous neoplasms of the pancreas: Results of 157 patients selected for radiographic surveillance.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.4_suppl.152 ◽

2012 ◽

Vol 30 (4_suppl) ◽

pp. 152-152 ◽

Cited By ~ 1

Author(s):

Jennifer LaFemina ◽

Sebastien Gaujoux ◽

Michael Ian D'Angelica ◽

William R. Jarnagin ◽

Nora Katabi ◽

...

Keyword(s):

Invasive Carcinoma ◽

Invasive Disease ◽

Ductal Adenocarcinoma ◽

Branch Duct ◽

Mucinous Neoplasms ◽

Natural History Studies ◽

Operative Strategies ◽

Risk Of Malignancy

152 Background: Natural history studies suggest that intraductal papillary mucinous neoplasm (IPMN) is a field defect of pancreatic ductal instability. The risk of malignancy is well known, but it is unclear if the radiographic abnormality is the predominant site at which this progression occurs. This study analyzes the prevalence and site of pancreatic ductal adenocarcinoma (PDAC) progression in patients initially selected for radiographic surveillance. Methods: Patients evaluated for pancreatic cystic lesions between 1995-2010 were reviewed. Patients were included if they were followed for > 6 months for a cystic lesion with either a documented cyst fluid CEA >/= 200 ng/mL or pathologic confirmation of an IPMN. Results: Of the 157 patients initially selected for surveillance, 97 (62%) eventually underwent resection. The median length of surveillance prior to operation was 15 mo (range: 6-193 mo). Pathologically confirmed carcinoma in situ (high grade dysplasia, n=22) or invasive carcinoma (n=18) was identified in 40 patients. Of the 18 patients who were found to have invasive carcinoma, 10 had main duct IPMN (56%), 5 had branch duct (28%), and 3 had combined (17%). Four of the 18 patients who developed invasive cancer during surveillance (22% of those resected for carcinoma and 3% of those followed) developed PDAC in a region of the gland distinct from the radiographically identified lesion for which surveillance was recommended. Invasive carcinoma was diagnosed a median of 24 mo after the original IPMN diagnosis. During follow-up (median = 8 months from the cancer diagnosis), 1 patient died of disease, 2 are cancer-free, and 1 patient is alive with recurrence. Conclusions: In this study, 11% of patients with IPMN initially selected for surveillance developed invasive disease; 22% of those tumors arose in an area of the gland distinct from the initially identified lesion. Diagnostic and operative strategies for IPMN should consider the cancer risk in the entire gland. [Table: see text]

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Incidence, significance, and follow-up of para-aortic lymph node metastases in late invasive carcinoma of the cervix

American Journal of Obstetrics and Gynecology ◽

10.1016/0002-9378(77)90633-0 ◽

1977 ◽

Vol 128 (3) ◽

pp. 336-340 ◽

Cited By ~ 80

Author(s):

James H. Nelson ◽

John Boyce ◽

Milagros Macasaet ◽

Therese Lu ◽

Joseph F. Bohorquez ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastases ◽

Invasive Carcinoma ◽

Aortic Lymph Node ◽

Node Metastases

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Laryngeal Dysplasia: Epidemiology and Treatment Outcome

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949510400802 ◽

1995 ◽

Vol 104 (8) ◽

pp. 596-602 ◽

Cited By ~ 46

Author(s):

Keith E. Blackwell ◽

Thomas C. Calcaterra ◽

Yao-Shi Fu

Keyword(s):

Treatment Group ◽

Carcinoma In Situ ◽

Invasive Carcinoma ◽

Endoscopic Therapy ◽

Partial Laryngectomy ◽

Severe Dysplasia ◽

Long Term Follow Up

A retrospective analysis was undertaken of 65 patients with long-term follow-up for laryngeal squamous dysplasia. Based on the degree of dysplasia demonstrated on initial biopsy, 0 of 6 patients showing hyperkeratosis without dysplasia, 3 of 26 patients (12%) showing mild dysplasia, 5 of 15 patients (33%) showing moderate dysplasia, 4 of 9 patients (44%) showing severe dysplasia, and 1 of 9 patients (11%) showing carcinoma in situ eventually progressed to invasive carcinoma. An analysis was made of the impact of various treatment modalities in 33 patients demonstrating moderate dysplasia, severe dysplasia, or carcinoma in situ. Invasive carcinoma developed in 10 of 21 patients (48%) treated endoscopically and 0 of 12 patients treated by more aggressive therapy, including external beam radiotherapy, partial laryngectomy, or total laryngectomy. Of the patients in the endoscopic therapy group who developed invasive carcinoma, all were salvaged successfully. The overall rate of laryngeal preservation was 15 of 21 patients (71%) in the endoscopic treatment group and 11 of 12 patients (92%) in the aggressive treatment group. This difference is not statistically significant. We conclude that there is a moderately high rate of progression to invasive carcinoma in patients undergoing repeated endoscopic therapy for intraepithelial neoplasms of the larynx. However, with close, long-term follow-up, patients undergoing endoscopic therapy have an overall outcome similar to that in patients treated with partial laryngectomy or radiotherapy prior to developing invasive disease.

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