Comparison of Preoperative Cytopathology, Tumor Markers and Molecular Analysis for the Diagnosis of Mucinous Pancreatic Cysts in Patients Undergoing Surgical Resection: 2010 Presidential Poster

2010 ◽  
Vol 105 ◽  
pp. S63
Author(s):  
Abdul Hamid El Chafic ◽  
Ihab El Hajj ◽  
Max Schmidt ◽  
John DeWitt ◽  
Stuart Sherman ◽  
...  
Keyword(s):  
Tumor Markers ◽  
Surgical Resection ◽  
Molecular Analysis ◽  
Pancreatic Cysts

scholarly journals Pancreatic Cysts after Endoscopic Ultrasonography-Guided Ethanol and/or Paclitaxel Ablation Therapy: Another Mimic of Pancreatic Pseudocysts

Pathobiology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Soyeon An ◽  
You-Na Sung ◽  
Sung Joo Kim ◽  
Dong-Wan Seo ◽  
Sun-Young Jun ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Cystic Tumor ◽  
Pancreatic Pseudocysts ◽  
Pancreatic Cysts ◽  
Clinical Impression ◽  
Female Ratio ◽  
Ablation Therapy ◽  
Cystic Tumors ◽  
Wide Range ◽  
Egg Shell

<b><i>Background:</i></b> Endoscopic ultrasound-guided ablation (EUS-A) therapy is a minimally invasive procedure for pancreatic-cystic tumors in patients with preoperative comorbidities or in patients who are not indicated for surgical resection. However, histopathologic characteristics of pancreatic cysts after ablation have not been well-elucidated. <b><i>Methods:</i></b> Here, we analyzed pathological findings of 12 surgically resected pancreatic cysts after EUS-A with ethanol and/or paclitaxel injection. <b><i>Results:</i></b> Mean patient age was 49.8 ± 13.6 years with a 0.3 male/female ratio. Clinical impression before EUS-A was predominantly mucinous cystic neoplasms. Mean cyst size before and after ablation therapy was similar (3.7 ± 1.0 cm vs. 3.4 ± 1.6 cm; <i>p</i> = 0.139). Median duration from EUS-A to surgical resection was 18 (range, 1–59) months. Mean percentage of the residual neoplastic lining epithelial cells were 23.1 ± 37.0%. Of the resected cysts, 8 cases (67%) showed no/minimal (&#x3c;5%) residual lining epithelia, while the remaining 4 cases (33%) showed a wide range of residual mucinous epithelia (20–90%). Ovarian-type stroma was noted in 5 cases (42%). Other histologic features included histiocytic aggregation (67%), stromal hyalinization (67%), diffuse egg shell-like calcification along the cystic wall (58%), and fat necrosis (8%). <b><i>Conclusion:</i></b> Above all, diffuse egg shell-like calcification along the pancreatic cystic walls with residual lining epithelia and/or ovarian-type stroma were characteristics of pancreatic cysts after EUS-A. Therefore, understanding these histologic features will be helpful for precise pathological diagnosis of pancreatic cystic tumor after EUS-A, even without knowing the patient’s history of EUS-A.

scholarly journals Growing Teratoma Syndrome: Two case reports

2021 ◽  
Author(s):  
anju shrestha ◽  
Hari Dhakal ◽  
Sirish Pandey ◽  
Kapendra Amatya ◽  
Sudip Shrestha ◽  
...  
Keyword(s):  
Tumor Markers ◽  
Surgical Resection ◽  
Case Reports ◽  
Mature Teratoma ◽  
Immature Teratoma ◽  
Surgical Staging ◽  
Growing Teratoma Syndrome ◽  
Complete Surgical Resection

We present two cases of nine and twenty-seven years old girls with recurrence of immature teratoma after an incomplete surgical staging. In both cases, there were huge abdominopelvic masses despite decrease in tumor markers with chemotherapy. Complete surgical resection of these masses was done, and histopathology showed only mature teratoma.

scholarly journals Utility of molecular tests in cytopathology

CytoJournal ◽  
2014 ◽  
Vol 11 ◽  
pp. 5 ◽  
Author(s):  
Arthur David Somoza ◽  
F. Zahra Aly
Keyword(s):  
Molecular Analysis ◽  
Diagnostic Information ◽  
Classification Systems ◽  
Cervical Cytology ◽  
Pancreatic Cysts ◽  
Molecular Testing ◽  
Thyroid Cytology ◽  
Anaplastic Lymphoma ◽  
Molecular Tests ◽  
Test Kit

With the popularity of interventional radiology, diagnostic material obtained can be limited requiring critical decisions on making the best use of it. Molecular testing using nanogram amounts of tissue can add useful diagnostic information by improving sensitivity and/or specificity of the diagnosis. This review examines the use of molecular tests in cervical cytology, “indeterminate” thyroid cytology specimens, pancreatic cyst fluid, urinary tract and pulmonary adenocarcinoma cytologic material. Molecular human papillomavirus (HPV) testing combined with cervical cytology increases sensitivity of detection of high grade lesions. In cytologically negative cases, the HPV negative predictive value endorses longer screening intervals. With the high prevalence of benign thyroid nodules, cytology plays a vital role in screening. However, 10-40% of the specimens obtained are cytologically indeterminate. Molecular analysis of these specimens can predict the malignant risk in these cases. Increased detection of pancreatic cysts has necessitated accurate pre-operative diagnosis delineating non-mucinous from mucinous cysts, which have a potential for progression to adenocarcinoma. Multimodal diagnosis of pancreatic cysts and molecular analysis help to clarify neoplastic risk; and in cases of limited fluid, may be the only available diagnostic information. Urothelial carcinoma (UC) of the bladder, a common cancer with frequent recurrences, requires lifelong surveillance. The UroVysion ™ test kit can increase the sensitivity of detection of UC especially in cases of residual/recurrent carcinoma after therapy. Subsets of lung adenocarcinomas are now commonly targeted by therapies based on molecular mutation results of epidermal growth factor receptor, KRAS or echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase re-arrangements. The move toward standardization of reporting of cytology specimens commencing with cervical smears and more recently, thyroid cytology specimens is also changing the practice of cytopathology. Combining the stringent cytology criteria with ancillary molecular testing is expected to yield more discrete and diagnostic categories for research and reporting. The profession is at an exciting point of implementing novel molecular markers to refine diagnostic criteria and create clinically relevant classification systems.

Analysis of Cyst Size and Tumor Markers in the Management of Pancreatic Cysts: Support for the Original Sendai Criteria

2015 ◽  
Vol 220 (6) ◽  
pp. 1087-1095 ◽  
Author(s):  
Rebecca L. Hoffman ◽  
Jenna L. Gates ◽  
Michael L. Kochman ◽  
Gregory G. Ginsberg ◽  
Nuzhat A. Ahmad ◽  
...  
Keyword(s):  
Tumor Markers ◽  
Pancreatic Cysts ◽  
Cyst Size ◽  
Sendai Criteria

Surgical resection in patients withnonseminomatous germ cell tumor who fail to normalize serum tumor markers after chemotherapy

Urology ◽  
1994 ◽  
Vol 43 (1) ◽  
pp. 74-80 ◽  
Author(s):  
James A. Eastham ◽  
Timothy G. Wilson ◽  
Christy Russell ◽  
Thomas E. Ahlering ◽  
Donald G. Skinner
Keyword(s):  
Germ Cell ◽  
Tumor Markers ◽  
Surgical Resection ◽  
Germ Cell Tumor ◽  
Cell Tumor ◽  
Serum Tumor Markers

Novel solution-phase immunoassays for molecular analysis of tumor markers

The Analyst ◽  
2001 ◽  
Vol 126 (8) ◽  
pp. 1285-1292 ◽  
Author(s):  
Xiao-Hong Nancy Xu ◽  
Robert B. Jeffers ◽  
Jinsong Gao ◽  
Brad Logan
Keyword(s):  
Tumor Markers ◽  
Molecular Analysis ◽  
Solution Phase

scholarly journals Late relapsing germ cell tumors with elevated tumor markers

2021 ◽  
Author(s):  
Yue Che ◽  
Achim Lusch ◽  
Christian Winter ◽  
Robert Große Siemer ◽  
Carolin Buddensieck ◽  
...  
Keyword(s):  
Germ Cell ◽  
Tumor Markers ◽  
Surgical Resection ◽  
Elevated Serum ◽  
Germ Cell Tumors ◽  
Salvage Chemotherapy ◽  
Histological Type ◽  
Late Relapse ◽  
Serum Tumor Markers

Abstract Purpose Late relapsing germ cell tumors (LR-GCT) are considered a rare distinct biologic entity as their clinical presentation and response to treatment is different to early recurrences. While serum tumor markers (AFP and ß-HCG) play an important role at the time of first diagnosis to correctly classify prognosis and treatment of germ cell tumors, they may not have the same significance in a late relapse situation. Patients and methods Thirty-seven patients with LR-GCT with elevated serum tumor markers were identified in our database. Twenty-six patients underwent primary surgical resection of the late relapsing tumor. Eleven patients received salvage chemotherapy and a post-chemotherapy residual tumor resection. Serum tumor markers, histological findings and oncological outcome were analyzed. Results In the histopathological specimen, viable cancer was found in 20 cases (54%) and teratoma was found in 16 cases (43%). In nine cases (24%), a somatic-type malignant transformation was present. In 19 of 37 patients (51.4%), the late relapse specimen presented a histological type of GCT, which was not present in the primary histology. Twenty-two patients (59.5%) were included in follow-up analysis. Mean and median follow-up time was 62.2 and 53 months, respectively. Seventeen patients (77.3%) suffered a relapse or had progressive disease after LR therapy. Five patients (22.7%) have been relapse-free after LR therapy (mean FU 61.6 months). Ten patients died of disease during follow-up (45.5%) and had a mean time from LR to death of 66.4 months. Eleven patients were alive at last follow-up (mean FU 62.2 months). Relapse and survival rate were similar between patients who received primary resection of LR tumor and patients who received salvage chemotherapy followed by surgery. Conclusion Patients with a late relapsing germ cell tumor and elevated markers have a poor prognosis and a high risk for another relapse independent on primary treatment. The histological type and aggressiveness of a late relapsing tumor cannot be predicted with serum tumor marker levels at the time of diagnosis of LR. In up to 54% of cases, primary histology did not coincide with LR histology. Therefore, we propose primary surgical resection of a late relapsing tumor if a complete resection is feasible in order to gain exact histology and tailor further treatment.

Management of growing teratoma syndrome: Aachen University experience.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 385-385
Author(s):  
David J. K. P. Pfister ◽  
Daniel Porres ◽  
Andrea K. Thissen ◽  
Charlotte Piper ◽  
Axel Heidenreich
Keyword(s):  
Tumor Markers ◽  
Surgical Resection ◽  
Systemic Chemotherapy ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Vena Cava ◽  
Retroperitoneal Lymph Node Dissection ◽  
Tumor Diameter ◽  
Growing Teratoma Syndrome ◽  
Complete Surgical Resection

385 Background: Growing teratoma syndrome (GTS) is an infrequent clinical phenomenon. GTS is defined as an enlarging metastatic mass during systemic chemotherapy for advanced nonseminomatous germ cell tumors (NSGCT) despite decreasing serum tumor markers. Complete surgical resection of the mass is mandatory to achieve a favourable outcome. We report on our single center experience in the management of GTS. Methods: Between January 2000 and August 2009 postchemotherapeutic retroperitoneal lymph node dissection (PCRPLND) was performed in 162 patients (pts) with advanced NSGCT. Fourteen pts (4.9%) fulfilled the criteria of a GTS: enlarging metastatic mass in the retroperitoneum or visceral organs during systemic chemotherapy with normalized or regredient tumor markers. In all cases of GTS a complete radical bilateral PCRPLND including the resection of adjacent visceral and vascular structures was performed. Results: Median patient age was 24.5 (18 to 52) years. All patients exhibited NSGCT with a good or intermediate prognosis according to IGCCCG; in all cases the primary tumor contained predominantly (greater than 50%) mature teratoma; 10 and 4 patients presented with clinical stage IIC and III, resp. Median tumor diameter at time of surgery was 6,5 (3,0-35)cm. Tumor markers were normalized in 12 out of 14 patients and markers plateauted in 2 out of 14 patients. Tumor masses were localized in the retroperitoneum in 12 pts.; two patients had additional pulmonary metastases which were resected in a second approach. Median time from start of chemotherapy to surgery was 4.8 (1.5 to 26.5) months Median surgical time was 265 (165 to 585) minutes, and median blood loss 650 (450 to 2,000) ml. Four pts required resection of the inferior vena cava or abdominal aorta with implantation of a prosthetic graft; adjunctive nephrectomy was performed in three pts. After a median follow-up of 4.2 years two pts developed recurrent disease; the remainder are alive without evidence of disease. Conclusions: GTS is a rare phenomenom among pts with advanced NSGCT and necessitates complete surgical resection of all masses with curative intention. Surgery should be considered at time of progression to facilitate complete removal of the mass. Due to the complex surgery, treatment should be performed at specialized centers.

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