Benign and Premalignant Lesions of the Pancreas

2016 ◽  
Author(s):  
Abdurrahman Kadayifci ◽  
William R. Brugge
Keyword(s):  
Malignant Tumors ◽  
Balloon Dilation ◽  
Pancreatic Head ◽  
Premalignant Lesions ◽  
World Health ◽  
Pancreatic Tumors ◽  
Thick Wall ◽  
Cystic Lesions ◽  
Cystic Neoplasms

Pancreatic cancer is among the most aggressive human cancers, with few symptoms and clinical findings until it is detected in an advanced stage. Today, the only favorable treatment is surgical resection before progression to an invasive stage. There are a variety of benign and premalignant conditions of the pancreas that may appear similar to malignant tumors; early detection and management of those premalignant pancreatic lesions may provide a significant improvement in patient outcome. This review covers cystic neoplasms of the pancreas, premalignant solid lesions of the pancreas, and inflammatory lesions of the pancreas. Figures show a 30 mm diameter hypoechoic lesion without septae in the pancreatic head, an oval 20 mm diameter pancreatic mass with mixed solid and cystic components, a 24 mm diameter hypoechoic mass with well-defined borders in the tail of the pancreas, a 22 × 18 mm cystic lesion with a thick wall and internal debris in the head of the pancreas, and an endoscopic cyst gastrostomy after balloon dilation. Tables list World Health Organization (WHO) 2010 classification of pancreatic tumors, classification of pancreatic cystic lesions, main characteristics of common pancreatic cystic lesions, high-risk stigmata and worrisome features of intraductal papillary mucinous neoplasm on cross-sectional imaging, and WHO classification of pancreatic neuroendocrine tumors.   This review contains 5 highly rendered figures, 5 tables and 55 references

scholarly journals Mixed adenoneuroendocrine carcinoma of the hepatic bile duct: a case report and review of the literature

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sulai Liu ◽  
Zhendong Zhong ◽  
Meng Xiao ◽  
Yinghui Song ◽  
Youye Zhu ◽  
...  
Keyword(s):  
Bile Duct ◽  
Neuroendocrine Tumors ◽  
Radical Surgery ◽  
Malignant Tumors ◽  
World Health ◽  
Ki 67 ◽  
Mixed Adenoneuroendocrine Carcinoma ◽  
Hilar Bile Duct ◽  
Hilar Tumor

Abstract Background The World Health Organization's updated classification of digestive system neuroendocrine tumors in 2010 first proposed the classification of mixed adenoneuroendocrine carcinoma (MANEC). The incidence of biliary malignant tumors with neuroendocrine tumors accounts for less than 1% of all neuroendocrine tumors. Moreover, the incidence of hilar bile duct with MANEC is very rare. Case presentation A 65-year-old female patient came to our hospital for repeated abdominal pain for more than 4 months and skin sclera yellow staining for 1 week. Contrast-enhanced computed tomography imaging and magnetic resonance results suggested a hilar tumor for Bismuth-Corlette Type II. The patient underwent radical surgery for hilar cholangiocarcinoma. Finally, the patient was diagnosed with hilar bile duct MANEC, staged 1 (pT1N0M0) based on the eighth edition of the AJCC. Histopathology showed that the tumor was a biliary tumor with both adenocarcinoma and neuroendocrine carcinoma. No evidence of recurrence and metastasis after 20 months of follow-up. Conclusions We first reported a MANEC that originated in the hilar bile duct. As far as we known, there were few reports of biliary MANEC, and the overall prognosis was poor. We also found that the higher the Ki-67 index, the worse the prognosis of this type of patient. Radical surgery is the most effective treatment.

scholarly journals Congenital eruption cyst: a case report

2010 ◽  
Vol 21 (3) ◽  
pp. 259-262 ◽  
Author(s):  
Ramón Manuel Alemán Navas ◽  
María Guadalupe Martínez Mendoza ◽  
Mário Roberto Leonardo ◽  
Raquel Assed Bezerra da Silva ◽  
Henry W. Herrera ◽  
...  
Keyword(s):  
Case Report ◽  
Tooth Extraction ◽  
Who Classification ◽  
World Health ◽  
Close Monitoring ◽  
Cystic Lesions ◽  
Separate Entity ◽  
Epithelial Cysts ◽  
Health Organization

Congenital pathologies are those existing at or dating from birth. Occurrence of congenital cystic lesions in the oral cavity is uncommon in neonates. Eruption cyst (EC) is listed among these unusual lesions. It occurs within the mucosa overlying teeth that are about to erupt and, according to the current World Health Organization (WHO) classification of epithelial cysts of the jaws, EC is a separate entity. This paper presents a case of congenital EC successfully managed by close monitoring of the lesion, without any surgical procedure or tooth extraction. Eruption of the teeth involved, primary central incisors, occurred at the fourth month of age. During this time neither the child nor mother had any complication such as pain on sucking, refusal to feed, airway obstruction, or aspiration of fluids or teeth.

scholarly journals A Surgically Resected Pancreatic Schwannoma with Obstructive Jaundice with Special Reference to Differential Diagnosis from Other Cystic Lesions in the Pancreas

2018 ◽  
Vol 12 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Takayoshi Watanabe ◽  
Kenichiro Araki ◽  
Norihiro Ishii ◽  
Takamichi Igarashi ◽  
Akira Watanabe ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Obstructive Jaundice ◽  
Protein Expression ◽  
Histopathological Examination ◽  
S100 Protein ◽  
Pancreatic Head ◽  
Pancreatic Tumors ◽  
Cystic Lesions ◽  
Cystic Tumors ◽  
Pancreatic Schwannoma

Pancreatic schwannomas are uncommon. About 60% of pancreatic schwannomas develop cystic lesions, and the differential diagnosis from other cystic pancreatic tumors is difficult. A 43-year-old man presented for evaluation of liver dysfunction detected during a medical checkup. Blood testing detected obstructive jaundice. A computed tomography scan revealed a well-defined polycystic tumor of about 5 cm at the pancreatic head. We performed surgical resection to treat the patient’s symptoms and facilitate long-term management. Histopathological examination revealed spindle-shaped cells. Immunohistochemical studies showed S100 protein expression and the absence of CD34 and c-kit protein expression. Finally, we diagnosed a schwannoma. Pancreatic schwannoma is usually asymptomatic. The present case presented with obstructive jaundice, which is reportedly a rare symptom. Pancreatic schwannomas should be considered as a differential diagnosis of pancreatic cystic tumors. Dilatation of the pancreatic duct and the 18-fluorodeoxyglucose positron emission tomography findings are important for the differential diagnosis.

scholarly journals Clinical classification of cardiovascular tumors and tumor-like lesions, and its incidences

2013 ◽  
Vol 61 (8) ◽  
pp. 435-447 ◽  
Author(s):  
Jun Amano ◽  
Jun Nakayama ◽  
Yasuo Yoshimura ◽  
Uichi Ikeda
Keyword(s):  
Malignant Tumors ◽  
Cardiac Myxoma ◽  
World Health ◽  
Benign Tumors ◽  
Cardiac Tumors ◽  
New Classification ◽  
Metastatic Tumors ◽  
Great Vessels ◽  
Tumor Like Lesions

Abstract Tumors of the heart and the great vessels are very rare disease, and there are many disorders such as tumors originated from the heart and great vessels, metastatic tumors, and tumor-like lesions which do not fit into the usual concept of tumor or neoplasm; thus, it is very difficult to classify these tumors. We proposed a new classification of cardiovascular tumors for clinical use based on the accumulated biological analyses and clinical data of the reported literatures and our own study as benign tumors, malignant tumors, ectopic hyperplasia/ectopic tumors/others, and tumors of great vessels, with reference to the series of Atlas of tumor pathology of the Armed Forces Institute of Pathology and the recent World Health Organization classification of cardiac tumors issued in 2004. More than 50 disorders have been reported as tumors originated from the cardiovascular system, and various metastatic tumors from nearby organs, distant lesions, and intravascular extension tumors to the heart were reported. Based on the new classification, we reviewed epidemiology and incidence of cardiovascular tumors. Metastatic tumors are more frequent than tumors originated from the heart and great vessels, and cardiac myxoma is the most frequent tumors in all cardiac tumors.

scholarly journals Cystic lesions of pancreas: challenges in diagnosis and management

2016 ◽  
Vol 18 (3) ◽  
pp. 53
Author(s):  
S Bohara ◽  
TY Tamang ◽  
DK Maharjan ◽  
SK Shrestha ◽  
PB Thapa
Keyword(s):  
Cystic Lesion ◽  
Mucinous Cystadenoma ◽  
Pancreatic Head ◽  
College Teaching ◽  
Serous Cystadenoma ◽  
Pancreatic Tumors ◽  
Pancreatic Cysts ◽  
Cystic Lesions ◽  
Pancreatic Cystic Lesion ◽  
First Case

Introduction: Pancreatic cysts are common (2.5%). Cystic neoplasms represent 10% of cystic lesions and 1% of pancreatic tumors. However, it is difficult to differentiate benign cyst from malignant cystic lesions preoperatively.Objective: To study the cases of pancreatic cystic lesion who underwent various forms of pancreatic resection.Materials and Methods: Nine cases of pancreatic cystic lesion who presented to Kathmandu Medical College Teaching Hospital, Surgical Unit 3 within December 2014- November 2015 were evaluated. Four pancreatic cysts who underwent resection are discussed whereas not managed with resection are excluded.Results: There were 4 cases of pancreatic cyst who underwent pancreatic resection. First case underwent pancreaticoduodenectomy for pancreatic mucinous cystadenoma. However histopathological examination revealed a serous cystadenoma. In second case, pancreatic neck lesion suspected to be mucinous cystadenoma or pseudocyst in MRCP, with negative malignant cells in EUS guided FNAC underwent Central pancreatectomy and was found to be serous cystadenoma. The third case with suspected pseudocyst underwent Pancreaticoduodenectomy after a 3X2 cm2 cystic mass was felt at the posteroinferior side of pancreatic head and malignancy was suspected intraoperatively . HPE report was mucinous cystadenoma. The fourth case with pancreatic pseudocyst at tail with duct calculi and chronic pancreatitis underwent distal pancreatectomy with splenectomy with Frey’s procedure.Conclusion: Management of pancreatic cystic lesion is challenging. Though radiological imaging has limited role in accurate diagnosis, endoscopic ultrasound may be of some benefit.

scholarly journals Morbidity and mortality of pancreatic tumors undergoing surgical treatment

2014 ◽  
Vol 27 (4) ◽  
pp. 275-279 ◽  
Author(s):  
Luiza Bueno ZENI ◽  
Ricardo Fantazzini RUSSI ◽  
Alexandre Faleiro FIALHO ◽  
Ana Luiza Pagani FONSECA ◽  
Lyara Schaefer SOMBRIO ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Medical Records ◽  
Malignant Tumors ◽  
Surgical Techniques ◽  
Pancreatic Head ◽  
Ductal Adenocarcinoma ◽  
Pancreatic Tumors ◽  
Early Postoperative Complications

BACKGROUND: Pancreatic cancer has a high mortality rate due to late diagnosis and aggressive behavior. The prognosis is poor, with 5-year survival occurring in less than 5% of cases. AIM: To analyze demographic characteristics, comorbidities, type of procedure and early postoperative complications of patients with pancreatic cancer submitted to surgical treatment. METHODS: Cross-sectional study with analysis of 28 medical records of patients with malignant tumors of the pancreas in a 62 month. Data collection was performed from the medical records of the hospital. RESULTS: Of the total, 53,6% were male and the mean age was 60.25 years. According to the procedure, 53,6% was submitted to duodenopancreactectomy the remainder to biliodigestive derivation or distal pancreatectomy. The ductal adenocarcinoma occurred in 82,1% and 92,9% of tumors were located in the pancreatic head. Early postoperative complications occurred in 64,3% of cases and the most prevalent was intra-abdominal abscess (32,1%). Among duodenopancreactectomies 77,8% had early postoperative complications. CONCLUSION: Its necessary to encourage early detection of tumors of the pancreas to raise the number operations with curative intent. Refinements in surgical techniques and surgical teams can diminish postoperative complications and, so, operative morbimortality can also decrease over time.

scholarly journals Diagnosis and management of pancreatic cystic neoplasms

2019 ◽  
Vol 10 (3) ◽  
pp. 300-308 ◽  
Author(s):  
Mathew James Keegan ◽  
Bharat Paranandi
Keyword(s):  
Endoscopic Ultrasound ◽  
Clinical Guidelines ◽  
Clinicopathological Features ◽  
Evidence Based ◽  
Cystic Lesions ◽  
Cystic Neoplasms ◽  
Cross Sectional ◽  
Current Classification ◽  
Pancreatic Cystic Neoplasms

This review outlines the current classification of pancreatic cystic lesions, with a particular emphasis on pancreatic cystic neoplasms (PCNs). It will describe the diagnostic approach to PCNs, with reference to clinicopathological features, cross-sectional radiology and endoscopic ultrasound. This review will conclude with an evidence-based discussion of the management of PCNs focused on recent clinical guidelines.

Sixth Edition: the New Standard

2008 ◽  
Vol 13 (1) ◽  
pp. 1-12
Author(s):  
Christopher R. Brigham ◽  
Robert D. Rondinelli ◽  
Elizabeth Genovese ◽  
Craig Uejo ◽  
Marjorie Eskay-Auerbach
Keyword(s):  
Review Process ◽  
Peer Review Process ◽  
World Health ◽  
International Classification Of Functioning ◽  
Revision Process ◽  
Sixth Edition ◽  
Impairment Ratings ◽  
Health Organization ◽  
Impairment Severity

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, was published in December 2007 and is the result of efforts to enhance the relevance of impairment ratings, improve internal consistency, promote precision, and simplify the rating process. The revision process was designed to address shortcomings and issues in previous editions and featured an open, well-defined, and tiered peer review process. The principles underlying the AMA Guides have not changed, but the sixth edition uses a modified conceptual framework based on the International Classification of Functioning, Disability, and Health (ICF), a comprehensive model of disablement developed by the World Health Organization. The ICF classifies domains that describe body functions and structures, activities, and participation; because an individual's functioning and disability occur in a context, the ICF includes a list of environmental factors to consider. The ICF classification uses five impairment classes that, in the sixth edition, were developed into diagnosis-based grids for each organ system. The grids use commonly accepted consensus-based criteria to classify most diagnoses into five classes of impairment severity (normal to very severe). A figure presents the structure of a typical diagnosis-based grid, which includes ranges of impairment ratings and greater clarity about choosing a discreet numerical value that reflects the impairment.

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