Pancreatic Cancer With Ovarian Metastasis: Clinical Features, Diagnosis and Management

Abstract Background: To summarize the clinical features, diagnosis and management of pancreatic cancer with ovarian metastasis.Methods: We retrospectively analyzed the clinical data of patients with ovarian metastases of primary pancreatic cancer who were admitted to our hospital from 01/01/1985 to 04/01/2020.Results: In total, there were 3757 female pancreatic-cancer patients. 9 of them were diagnosed with ovarian metastasis at an average age of 51.89 (38-69) years. The reason for the patients’ visit was generally a mass in the lower abdomen and/or abdominal pain. 7 patients had significantly higher serum CA19-9 levels. 8 patients had pancreatic tumors located in the body or tail; 1 patient, in the pancreatic head. All patients underwent excision of ovarian tumors and resection or biopsy of pancreatic tumors. 6 patients had pancreatic ductal adenocarcinoma (PDAC), 2 had pancreatic cystadenocarcinoma (PCC), and 1 had pancreatic neuroendocrine carcinoma (PNEC), all revealed by the pathological results. Ovarian tumors were assessed by pathology and were consistent with pancreatic metastasis. Currently, 2 patients are still alive (followed until 04/2020). The median survival time for all patients was 7 months (2.9-22 months).Conclusions: Pancreatic cancer with ovarian metastases is rare and easily misdiagnosed. When ovarian tumors are suspected to be metastatic, elevated serum CA19-9 may indicate that the primary cancer is pancreatic. Enhanced CT can facilitate diagnostic localization. In addition, if the pancreatic tumor cannot be removed, the ovarian tumor should still be resected to reduce the tumor load and improve quality of life.

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Diffuse Pancreatic Carcinoma with Hepatic Metastases

Case Reports in Oncological Medicine ◽

10.1155/2020/8815745 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Hoang Quan Nguyen ◽

Ngoc Trinh Thi Pham ◽

Van Trung Hoang ◽

Hoang Anh Thi Van ◽

Chinh Huynh ◽

...

Keyword(s):

Pancreatic Cancer ◽

Pancreatic Carcinoma ◽

Hepatic Metastases ◽

Therapeutic Management ◽

Pancreatic Tumors ◽

Cancer Death ◽

Diagnosis And Management ◽

Timely Diagnosis ◽

Made In

Pancreatic cancer is one of the seven leading causes of cancer death worldwide. Diffuse pancreatic carcinoma is very rare and underreported in the literature. Many advances have been made in the diagnosis and management of pancreatic cancer. However, most pancreatic cancer cases are detected at the terminal or metastatic stages. Therefore, timely diagnosis and therapeutic management are desirable goals for this disease. Although the proliferation of pancreatic cancer has been reduced by intervention, more work is needed to treat and prevent the disease. The purpose of this article is to present a case of a 54-year-old male with pancreatic cancer and to review the epidemiology, diagnosis, management, and prevention of pancreatic tumors in general as well as pancreatic carcinoma in particular.

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A multicenter phase II study of istiratumab (MM-141) plus nab-paclitaxel (A) and gemcitabine (G) in metastatic pancreatic cancer (MPC).

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.4_suppl.tps481 ◽

2016 ◽

Vol 34 (4_suppl) ◽

pp. TPS481-TPS481 ◽

Cited By ~ 7

Author(s):

Andrew H. Ko ◽

James Murray ◽

Kerry E Horgan ◽

Julia Dauer ◽

Michael Curley ◽

...

Keyword(s):

Pancreatic Cancer ◽

Tumor Regression ◽

Phase 1 ◽

Elevated Serum ◽

Pancreatic Tumors ◽

Fixed Dose ◽

Current Phase ◽

Study Cohort ◽

Entire Study ◽

Free Serum

TPS481 Background: Despite recent advances in the treatment of MPC, overall prognosis for patients remains poor. This may be attributed in part to the ability of pancreatic tumors to co-opt growth factor signaling pathways to counteract the activity of chemotherapy. We previously demonstrated that IGF-1 and heregulin, the ligands for IGF-1R and ErbB3, respectively, can decrease the cytotoxic activity of A/G (JCO 33 2015 s3 a289). Additionally, co-expression of IGF-1R and ErbB3 is known to be associated with poor survival prognosis in MPC patients (JCO 33 2015 s3 a295). Istiratumab, a fully human bispecific antibody directed at IGF-1R and ErbB3, produced significant tumor regression, including durable complete responses, when combined with A/G in preclinical models of pancreatic cancer, and has been shown to be safe and tolerable in a Phase 1 study (JCO 33 2015 s3 a384). On these bases, the current Phase 2 study was developed to evaluate istiratumab plus A/G in pts with MPC. Methods: Eligible patients have biopsy-confirmed MPC, ECOG PS 0-1, no prior therapy for advanced disease, and elevated serum levels of free IGF-1 (estimated to be ~40% of all screened patients). The study design includes two parts: Part 1 (n = 12) is an open-label assessment of the safety, tolerability, and pharmacokinetics (PK) of a fixed dose of istiratumab (2.8 grams IV q 2 weeks) in combination with A/G; in Part 2 (n = 146), pts are randomized 1:1 to receive A/G plus either istiratumab or placebo. The primary objective of Part 2 is to compare progression free survival (PFS) between the two treatment arms in two distinct cohorts: a) patients with high free serum IGF-1 levels (i.e., the entire study cohort), and b) patients with both high free serum IGF-1 levels and positive expression of heregulin in tumor tissue. Additional objectives include safety, overall survival, PK and immunogenicity analyses of istiratumab, and correlative analyses of pre-defined biomarkers and their potential correlation with study outcomes. The study is designed with 80% power to detect a hazard ratio of 0.63 in favor of the experimental arm (8 vs 5 months) at a one-sided significance level of 0.05. The study has been open to enrollment as of September 2015. Clinical trial information: NCT02399137.

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Whole-Exome Sequencing of Tumor-only Samples Reveals the Association between Somatic Alterations and Clinical Features in Pancreatic Cancer

Current Bioinformatics ◽

10.2174/1574893615999200626190346 ◽

2020 ◽

Vol 15 ◽

Author(s):

Wenwen Ran ◽

Xiangbin Chen ◽

Bo Wang ◽

Ping Yang ◽

Yongxing Li ◽

...

Keyword(s):

Pancreatic Cancer ◽

Exome Sequencing ◽

Whole Exome Sequencing ◽

Clinical Features ◽

Somatic Mutations ◽

Pancreatic Head ◽

Pancreatic Tumors ◽

Next Generation Sequencing Technology ◽

Whole Exome ◽

Genomic Markers

Background: Identification of genomic markers using NGS (next generation sequencing) technology would be valuable for guiding precision medicine treatments for pancreatic cancers. Traditional somatic mutation methods require both tumor and matched non-tumor samples. However, only tumor samples are available in most times, especially in retrospective studies. In this study, we tried to analyze the associations between clinical features and oncogenic somatic mutations in genome-wide from tumor-only samples. Method: 54 tumor-only samples derived from pancreatic cancer patients were used for whole-exome sequencing. An approach involving SNP filtering of variants included in Catalogue of Somatic Mutations in Cancer (COSMIC) database was used to identify oncogenic somatic mutations. The relationships between oncogenic mutations and clinical features were analyzed and simultaneously compared with those from the TCGA database. Results: By analyzing the mutations from tumor only samples, divergent mutation profiles were observed in different locations (head vs body/tail) of pancreatic tumors. The divergences between pancreatic head and body/tail cancers were also confirmed by the TCGA data. Furthermore, mutations of several genes were found significantly associated with clinical features, such as pathological stage and the degree of tumor differentiation. Conclusion: The results confirmed the efficiency of our approach for identifying oncogenic somatic mutations from tumor only samples and revealed the associations between somatic mutations and clinical features in pancreatic cancer.

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Metastatic ovarian tumor of a lung cancer at the hospital center of Chauny (France): a case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174464 ◽

2017 ◽

Vol 6 (10) ◽

pp. 4682

Author(s):

Adjoby Cassou Roland ◽

Kouamé Arthur Didier ◽

Koffi Achille ◽

Kakou Charles ◽

Konan Joachim ◽

...

Keyword(s):

Ovarian Tumor ◽

Small Cell Lung Carcinoma ◽

Ovarian Metastasis ◽

Small Cell ◽

Ovarian Tumors ◽

Small Cell Lung ◽

Bronchial Cancer ◽

Cell Lung Carcinoma ◽

Ovarian Metastases ◽

Hospital Center

The ovary is an organ that can be the site of metastases for many cancers. In general, malignant ovarian tumors are primary; however, cases of extra gynecological metastatic tumors (breast, colon, stomach, and pancreas) have been reported. In most cases, the primary cancers of these ovarian tumors are gastrointestinal or gynecological, the lung being very rarely involved. We report a rare case of ovarian metastases of bronchial cancer discovered during an extensional assessment. The histological examination coupled with immunohistochemistry concludes that ovarian metastasis of small cell lung carcinoma. In addition to chemotherapy such as Taxol-Hycamtin, the management required cerebral radiotherapy for a cerebral metastasis detected.

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Role of Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Pancreatic Cancer

Diagnostics ◽

10.3390/diagnostics11020238 ◽

2021 ◽

Vol 11 (2) ◽

pp. 238

Author(s):

Yasutaka Ishii ◽

Masahiro Serikawa ◽

Tomofumi Tsuboi ◽

Ryota Kawamura ◽

Ken Tsushima ◽

...

Keyword(s):

Pancreatic Cancer ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Endoscopic Ultrasonography ◽

Treatment Decision ◽

Needle Aspiration ◽

Pancreatic Tumors ◽

Decision Strategy ◽

Endoscopic Retrograde ◽

Small Pancreatic Cancer ◽

Eus Elastography

Pancreatic cancer has the poorest prognosis among all cancers, and early diagnosis is essential for improving the prognosis. Along with radiologic modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), endoscopic modalities play an important role in the diagnosis of pancreatic cancer. This review evaluates the roles of two of those modalities, endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiopancreatography (ERCP), in the diagnosis of pancreatic cancer. EUS can detect pancreatic cancer with higher sensitivity and has excellent sensitivity for the diagnosis of small pancreatic cancer that cannot be detected by other imaging modalities. EUS may be useful for the surveillance of pancreatic cancer in high-risk individuals. Contrast-enhanced EUS and EUS elastography are also useful for differentiating solid pancreatic tumors. In addition, EUS-guided fine needle aspiration shows excellent sensitivity and specificity, even for small pancreatic cancer, and is an essential examination method for the definitive pathological diagnosis and treatment decision strategy. On the other hand, ERCP is invasive and performed less frequently for the purpose of diagnosing pancreatic cancer. However, ERCP is essential in cases that require evaluation of pancreatic duct stricture that may be early pancreatic cancer or those that require differentiation from focal autoimmune pancreatitis.

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The Cellular and Biological Impact of Extracellular Vesicles in Pancreatic Cancer

Cancers ◽

10.3390/cancers13123040 ◽

2021 ◽

Vol 13 (12) ◽

pp. 3040

Author(s):

Zainab Hussain ◽

Jeremy Nigri ◽

Richard Tomasini

Keyword(s):

Pancreatic Cancer ◽

Tumor Cells ◽

Extracellular Vesicles ◽

Cell Communication ◽

Pancreatic Tumors ◽

Mediated Communication ◽

Biological Impact ◽

Physiological Relevance ◽

Cellular Components ◽

Tumoral Cells

Deciphering the interactions between tumor and stromal cells is a growing field of research to improve pancreatic cancer-associated therapies and patients’ care. Indeed, while accounting for 50 to 90% of the tumor mass, many pieces of evidence reported that beyond their structural role, the non-tumoral cells composing the intra-tumoral microenvironment influence tumor cells’ proliferation, metabolism, cell death and resistance to therapies, among others. Simultaneously, tumor cells can influence non-tumoral neighboring or distant cells in order to shape a tumor-supportive and immunosuppressive environment as well as influencing the formation of metastatic niches. Among intercellular modes of communication, extracellular vesicles can simultaneously transfer the largest variety of signals and were recently reported as key effectors of cell–cell communication in pancreatic cancer, from its development to its evolution as well as its ability to resist available treatments. This review focuses on extracellular vesicles-mediated communication between different cellular components of pancreatic tumors, from the modulation of cellular activities and abilities to their biological and physiological relevance. Taking into consideration the intra-tumoral microenvironment and its extracellular-mediated crosstalk as main drivers of pancreatic cancer development should open up new therapeutic windows.

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The management of pancreatic metastasis from synovial sarcoma of the soft tissue: A case report

Rare Tumors ◽

10.1177/2036361320983691 ◽

2020 ◽

Vol 12 ◽

pp. 203636132098369

Author(s):

Bouhani Malek ◽

Sakhri Saida ◽

Jaidane Olfa ◽

Kammoun Salma ◽

Slimene Maher ◽

...

Keyword(s):

Synovial Sarcoma ◽

English Literature ◽

Surgical Excision ◽

Left Thigh ◽

Pancreatic Tumors ◽

Pancreatic Metastasis ◽

Pancreatic Metastases ◽

Pancreatic Biopsy ◽

Diagnostic Difficulties ◽

History Of

Pancreatic metastases are rare, accounting for 2%–3% of pancreatic tumors. The pancreas represents an unusual metastatic site of synovial sarcoma (SS) outside the usual localizations (regional nodes, lung, bone, and liver). The diagnosis is evoked by the personnel medical history of SS and imaging then confirmed by histological examination of the guided pancreatic biopsy. Its therapeutic management is mainly surgical with extensive removal of the lesion. So far only four cases have been reported in the English literature. We reported the case of a male aged 30-year-old who was admitted to our Institute for a local recurrence of SS of the left thigh which was initially treated by surgical excision. The patient underwent a wide surgical excision followed by chemotherapy and radiotherapy. About 15 months later, he experienced a pancreatic metastasis of his SS. He had a caudal splenopancreatectomy with partial resection of the transverse colon followed by chemotherapy. This report highlights the diagnostic difficulties of this rare localization and therapeutic challenge.

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Clinical features and therapeutic response in adult and pediatric patients with American tegumentary leishmaniasis in Rio de Janeiro

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/trz095 ◽

2019 ◽

Author(s):

Tatiana C R Senna ◽

Maria Inês F Pimentel ◽

Liliane F A Oliveira ◽

Marcelo R Lyra ◽

Mauricio N Saheki ◽

...

Keyword(s):

Clinical Features ◽

Rio De Janeiro ◽

Pediatric Patients ◽

Therapeutic Response ◽

Age Groups ◽

Healing Time ◽

The Body ◽

Reference Centre ◽

Tegumentary Leishmaniasis ◽

American Tegumentary Leishmaniasis

Abstract Background American tegumentary leishmaniasis (ATL) is a neglected disease with wide territorial distribution. Knowledge is scarce in children and adolescents. This study aims to compare the clinical features and response to antimony treatment in pediatric and adult patients with cutaneous leishmaniasis. Methods A retrospective cohort study was performed with 659 patients who attended a reference centre in Rio de Janeiro, Brazil, from 2000 to 2015. The pediatric cohort consisted of 131 (20%) patients and the adult cohort consisted of 528 (80%) patients. Results The epidemiological profile, antimony therapeutic response and incidence of adverse events (AE) were different in the pediatric cohort compared with the adult cohort. Mucosal form was less frequent in the pediatric cohort (RR:0.49, p=0.011). Lesions in the head, neck and trunk were more frequent in the pediatric cohort (RR:1.49, p=0.043). The effectiveness of antimony treatment was superior in the pediatric cohort (88.3% vs 76.6%) with a shorter healing time (RR:0.49, p=0.009). Pediatric patients had lower proportions of moderate to severe AE compared with adults (RR:0.45, p=0.027). Clinical AE predominated in the adult cohort (RR:0.40, p=0.000) and laboratory AE in the pediatric cohort (RR:1.50, p=0.023). Conclusions This study adds to the body of knowledge on differences that exist between different age groups in ATL.

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