Pediatric Pseudo papillary Pancreatic Tumor: A Case Based Review

2021 ◽  
pp. 1-7
Author(s):  
Mir Ibrahim Sajid ◽  
Ayesha Saleem ◽  
Muhammad Arshad
Keyword(s):  
African American Women ◽  
Pancreatic Tumor ◽  
Adult Population ◽  
Pancreatic Tumors ◽  
Cystic Tumor ◽  
Low Grade ◽  
Female Predominance ◽  
Risk Of Malignancy ◽  
Papillary Neoplasm ◽  
Specific Line

Introduction The solid pseudo papillary neoplasm (SPN) of the pancreas also known as a papillary-cystic tumor or Frantz tumor, is a distinct epithelial neoplasm of unfamiliar origin. Solid pseudo papillary neoplasm of the pancreas is a low-grade malignant tumor derived from exocrine cells and composed of poorly cohesive epithelial cells, forming solid and pseudo papillary arrangement and lacking a specific line of pancreatic epithelial differentiation [1]. In adult population it accounts for approximately 2% to 3% of pancreatic neoplasms but differs from other pancreatic tumors by a female predominance and a low risk of malignancy. SPN for the most part occurs in the younger population and occasionally in children, contrary to other pancreatic carcinomas. It also seems to have a predilection for Asian and African American women [2]. Continuous...

scholarly journals Solid-pseudopapillary neoplasm of the pancreas in a patient with familial adenomatous polyposis: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Daishi Naoi ◽  
Koji Koinuma ◽  
Hideki Sasanuma ◽  
Yasunaru Sakuma ◽  
Hisanaga Horie ◽  
...  
Keyword(s):  
Familial Adenomatous Polyposis ◽  
Pancreatic Tumor ◽  
Laparoscopic Resection ◽  
Tumor Development ◽  
Colonic Polyps ◽  
Pancreatic Tumors ◽  
Beta Catenin ◽  
Adenomatous Polyposis ◽  
Solid Pseudopapillary Neoplasm ◽  
Extracolonic Manifestations

Abstract Background Familial adenomatous polyposis (FAP) is characterized by the presence of hundreds to thousands of colonic polyps, and extracolonic manifestations are likely to occur. Pancreatic tumors are rare extracolonic manifestations in patients with FAP, among which solid-pseudopapillary neoplasm (SPN) are extremely rare. We report here a patient with an SPN of the pancreas found during the follow-up of FAP. Case presentation A 20-year-old woman was diagnosed with FAP 3 years previously by colonoscopy which revealed less than 100 colonic polyps within the entire colon. She complained of left upper abdominal pain and a 10-cm solid and cystic pancreatic tumor was found by computed tomography scan. Solid and cystic components within the tumor were seen on abdominal magnetic resonance imaging. Simultaneous laparoscopic resection of the distal pancreas and subtotal colectomy was performed. Histopathological findings confirmed the pancreatic tumor as an SPN without malignancy. Abnormal staining of beta-catenin was observed by immunohistochemical study. Multiple polyps in the colorectum were not malignant. Molecular biological analysis from peripheral blood samples revealed a decrease in the copy number of the promoter 1A and 1B region of the APC gene, which resulted in decreased expression of the APC gene. Conclusions A rare association of SPN with FAP is reported. The genetic background with relation to beta-catenin abnormalities is interesting to consider tumor development. So far, there are few reports of SPN in a patient with FAP. Both lesions were treated simultaneously by laparoscopic resection.

scholarly journals Pancreatic tumor cell metastasis is restricted by MT1-MMP binding protein MTCBP-1

2018 ◽  
Vol 218 (1) ◽  
pp. 317-332 ◽  
Author(s):  
Li Qiang ◽  
Hong Cao ◽  
Jing Chen ◽  
Shaun G. Weller ◽  
Eugene W. Krueger ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Pancreatic Tumor ◽  
Binding Protein ◽  
Critical Role ◽  
Inverse Correlation ◽  
Pancreatic Tumors ◽  
Matrix Remodeling ◽  
Peripheral Tissues

The process by which tumor cells mechanically invade through surrounding stroma into peripheral tissues is an essential component of metastatic dissemination. The directed recruitment of the metalloproteinase MT1-MMP to invadopodia plays a critical role in this invasive process. Here, we provide mechanistic insight into MT1-MMP cytoplasmic tail binding protein 1 (MTCBP-1) with respect to invadopodia formation, matrix remodeling, and invasion by pancreatic tumor cells. MTCBP-1 localizes to invadopodia and interacts with MT1-MMP. We find that this interaction displaces MT1-MMP from invadopodia, thereby attenuating their number and function and reducing the capacity of tumor cells to degrade matrix. Further, we observe an inverse correlation between MTCBP-1 and MT1-MMP expression both in cultured cell lines and human pancreatic tumors. Consistently, MTCBP-1–expressing cells show decreased ability to invade in vitro and metastasize in vivo. These findings implicate MTCBP-1 as an inhibitor of the metastatic process.

scholarly journals Surgery for Cystic Pancreatic Lesions in the Post-Sendai Era: A Single Institution Experience

HPB Surgery ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Jörg Kleeff ◽  
Christoph Michalski ◽  
Bo Kong ◽  
Mert Erkan ◽  
Susanne Roth ◽  
...  
Keyword(s):  
Preoperative Diagnosis ◽  
Postoperative Morbidity ◽  
Intraepithelial Neoplasia ◽  
Cystic Tumor ◽  
Diagnostic Challenge ◽  
Branch Duct ◽  
Cystic Neoplasms ◽  
Biological Behaviour ◽  
Risk Of Malignancy ◽  
Cystic Pancreatic Lesions

Introduction. The management of cystic pancreatic lesions has changed in recent years as a result of increasing knowledge of their biological behaviour, better diagnostic options, and international guidelines. Methods. Retrospective analysis of a cohort of 86 patients operated for cystic pancreatic lesions during a seven-year period (2007–2014). Results. Final histopathology revealed 53 intraductal papillary mucinous neoplasms (19 branch duct IPMNs, 15 mixed type IPMNs, and 19 main duct IPMNs), 14 serous and 13 mucinous cystic neoplasms, 3 solid pseudopapillary neoplasms, and 3 other lesions. 4 cases displayed high grade intraepithelial neoplasia and 2 cases displayed invasive cancer. A pylorus-preserving partial duodenopancreatectomy was carried out in 27 patients, a total pancreatectomy was carried out in 9 patients, a left resection was carried out in 42 patients, and segmental resections and enucleations were carried out in 4 patients each. Overall postoperative morbidity and mortality were 40% and 2.3%, respectively. The preoperative diagnosis of a specific cystic tumor was accurate in 79% of patients and 9 patients (10%) could have avoided surgery with the correct preoperative diagnosis. Conclusion. Cystic pancreatic lesions are still a diagnostic challenge, requiring a dedicated multidisciplinary approach. The rate of malignancy is relatively small, whereas postoperative morbidity is substantial, underscoring the importance of adequate patient selection considering both the risk of surgery and the long term risk of malignancy.

Challenges in the Management of COVID-19 Patients with Metabolic Syndrome with Special Emphasis on Gender and Age - A Review

2021 ◽  
Vol 8 (38) ◽  
pp. 3401-3405
Author(s):  
Arunima Chaudhuri ◽  
Suhrita Paul ◽  
Tapas Ghosh
Keyword(s):  
Metabolic Syndrome ◽  
Virus Disease ◽  
Adult Population ◽  
Density Lipoprotein ◽  
Blood Stream ◽  
Low Grade ◽  
Corona Virus ◽  
Gender And Age ◽  
The World ◽  
Low Grade Inflammation

BACKGROUND The corona virus disease-19 (Covid-19) pandemic has put human civilization into a huge challenge, especially in the field of medicine in the management of patients with co-morbidities. Health authorities across the world depend greatly on reliable data to make major decisions and this is especially true during this global pandemic. The present review was conducted to estimate the challenges in the management of Covid-19 patients with metabolic syndrome with special emphasis on gender and age. Patients having pre-existing health conditions e.g., heart disease, diabetes are at higher risk of morbidity and mortality due to COVID-19. According to the WHO newsletter, COVID-19 has tragically claimed more than 1.5 million lives. The burden of obesity across the world has nearly tripled since 1975. In 2016, 1.9 billion adults, were overweight; 650 million were obese; 13 % of the world's adult population (11 % of males and 15 % of females) were obese in 2016. Obesity has been observed to be a high-risk factor for COVID-19 severity. Severe acute respiratory syndrome-corona virus-2 (SARS-CoV-2) targets the angiotensinconverting enzyme 2 (ACE2) for cell entry and ACE2 is highly expressed in adipose tissue. This suggests an important role for the tissue in determining COVID-19 disease severity in obese individuals.1-2 There has been an increase in death from diabetes by 70 % globally between 2000 and 2019, and an 80 % rise in deaths among males has been observed. Metabolic syndrome comprises three or more of the following factors: increased waist circumference; hypertriglyceridemia; elevated blood pressure; reduced high-density lipoprotein cholesterol; hyperglycemia.1-2 Visceral fat is known to produce higher concentrations of proinflammatory cytokines. These are then released in the bloodstream. Release of proinflammatory markers in blood stream may cause auto-amplifying cytokine production (“cytokine storms”) and low-grade inflammation. Cytokine storm and low-grade inflammation can contribute to worsening of COVID-19 patients with obesity. Components of metabolic syndrome such as hypertension, type 2 diabetes mellitus (T2DM), and obesity are highly prevalent among the general population and have been observed to significantly increase the risk of hospitalization and mortality in COVID-19 patients.1-2 KEYWORDS Covid-19 Pandemic, Metabolic syndrome, Aging, Gender

scholarly journals Intraductal papillary mucinous neoplasm of the pancreas. Personal series and synthetic review

2012 ◽  
Author(s):  
F. Gallucci ◽  
D. Avolio ◽  
R. De Ritis ◽  
L. Ferrara ◽  
U. Valentino ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Mixed Type ◽  
Pancreatic Tumors ◽  
Malignant Degeneration ◽  
Main Duct ◽  
Branch Duct ◽  
Asymptomatic Patients ◽  
Risk Of Malignancy ◽  
Tumor Types

Intraductal papillary mucinous neoplasms (IPMNs) are rare pancreatic tumors, accounting for less than 1-2% of all neoplasms of the pancreas. The main characteristic of IPMNs is their favorable prognosis, as these pre-malignant or malignant lesions are usually slow-growing tumors and radical surgery is frequently possible. According to the localization of the lesions, three different tumor types have been identified: the main-duct IPMN, the branch-duct IPMN and the mixed-type IPMN (involving both the main pancreatic duct and the side branches). IMPNs do not present pathognomonic signs or symptoms. The obstruction of the main pancreatic duct system may cause abdominal pain and acute pancreatitis (single or recurrent episodes). The tumor may be incidentally discovered in asymptomatic patients, particularly in those with branch-duct IPMNs. In clinical practice, any non-inflammatory cystic lesion of the pancreas should be considered as possible IPMN. Computed tomography, magnetic resonance imaging with cholangiopancreatography and endoscopic ultrasonography can localize an IPMN and assess its morphology and size. The choice between non-operative and surgical management depends on the risk of malignancy and on the definitive distinction between benign and malignant IPMNs. Main-duct IPMNs have a high risk of malignant degeneration, especially in older patients. The clinical and radiological features, as well as treatment and outcome, of eight patients with IPMN (five with main-duct, two with branch-duct and one with mixed-type) observed by the authors over the last ten years are presented.

Intraductal papillary neoplasm of bile duct: all rare in one

2020 ◽  
Vol 13 (11) ◽  
pp. e237001
Author(s):  
Aprajita Chaturvedi ◽  
Manjunath Maruti Pol ◽  
Kirti Jangra ◽  
Priyanka Singh
Keyword(s):  
Bile Duct ◽  
Histopathological Examination ◽  
Anatomical Variations ◽  
Small Lesion ◽  
Low Grade ◽  
Pathological Findings ◽  
Intraductal Papillary Neoplasm ◽  
Contrast Enhanced ◽  
Low Grade Dysplasia ◽  
Papillary Neoplasm

A 45-year-old woman was referred from Department of Dermatology to Surgery outpatient department with pruritus since 6 months and an episode of jaundice that lasted for 15 days about 6 months ago. She was referred with a contrast-enhanced MRI finding that showed a small lesion in the lower end of common bile duct. Endoscopy-guided biopsy was performed twice at our hospital, the second revealed low grade dysplasia. Consequently, she underwent pancreaticoduodenectomy. Intraoperatively, there were both vascular and biliary anatomical variations that were missed on preoperative images. On histopathological examination, it turned out to be a mixed variety of intraductal papillary neoplasm of bile duct (IPNB). As all findings were rare in one, hence, we present this case of IPNB that presented to us with variable clinical, radiological, surgical and pathological findings.

scholarly journals Pulmonary function changes in older adults with and without metabolic syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maysa Alves Rodrigues Brandao-Rangel ◽  
Renilson Moraes-Ferreira ◽  
Manoel Carneiro Oliveira-Junior ◽  
Alana Santos-Dias ◽  
André Luis Lacerda Bachi ◽  
...  
Keyword(s):  
Older Adults ◽  
Metabolic Syndrome ◽  
Lung Function ◽  
Pulmonary Function ◽  
Adult Population ◽  
Lung Mechanics ◽  
Low Grade ◽  
Cross Sectional ◽  
Immunological Responses ◽  
Breath Condensate

AbstractThe low-grade inflammation associated with metabolic syndrome (MS) triggers functional and structural alterations in several organs. Whereas lung function impairment is well reported for older adult population, the effect of MS on functional and immunological responses in the lungs remains unclear. In this cross-sectional study we determined whether MS alters pulmonary function, and immunological responses in older adults with MS. The study sample consisted of older adults with MS (68 ± 3 years old; n = 77) and without MS (67 ± 3 years old; n = 77). Impulse oscillometry was used to evaluate airway and tissue resistance, and reactance. Biomarkers of inflammation and fibrosis were assessed in the blood and in breath condensate. The total resistance of the respiratory system (R5Hz; p < 0.009), and the resistance of the proximal (R20Hz; p < 0.001) and distal (R5Hz–R20Hz; p < 0.004) airways were higher in MS individuals compared to those without MS. Pro-inflammatory (leptin, IL-1beta, IL-8, p < 0.001; TNF-alpha, p < 0.04) and anti-inflammatory cytokines (adiponectin, IL-1ra, IL-10, p < 0.001), anti-fibrotic (relaxin 1, relaxin 3, Klotho, p < 0.001) and pro-fibrotic (VEGF, p < 0.001) factors were increased in sera and in breath condensate individuals with MS. The results show that MS adversely affect lung mechanics, function, and immunological response in older adults. The data offer a metabolic basis for the inflammaging of the lungs and suggest the lungs as a potential therapeutic target for controlling the immune response and delaying the onset of impaired lung function in older adults with MS.

scholarly journals Reference values for handgrip strength: data from the TCLSIH cohort study

2019 ◽  
Author(s):  
Hongmei Wu ◽  
Mingyue Liu ◽  
Qing Zhang ◽  
Li Liu ◽  
Ge Meng ◽  
...  
Keyword(s):  
Cohort Study ◽  
Reference Values ◽  
Handgrip Strength ◽  
Adult Population ◽  
Cross Sectional Study ◽  
Mean Value ◽  
Low Grade ◽  
Cross Sectional ◽  
Chinese Adult ◽  
Health Cohort Study

Abstract Background although handgrip strength (HGS) is considered an excellent predictor of morbidity and mortality, there are few reference data available, especially across life from young to old populations. Objective to investigate the reference values and determinants for HGS in a large Chinese adult population. Design this cross-sectional study used data from the Tianjin Chronic Low-Grade Systemic Inflammation and Health Cohort Study ranging from 2013 to 2017. Setting and subjects in total, 37,707 Chinese adults aged 18–93 years with measures of HGS were included. Methods HGS was measured using a handheld digital dynamometer. The percentile distribution of HGS, as well as mean (standard deviation) values of HGS, was calculated according to sex and age categories. The Pearson’s or Spearman’s correlation coefficient and multiple linear regression were also used. Results the peak mean value of HGS was 45.2 ± 6.88 kg in men and 26.8 ± 4.65 kg in women. Different reference values for each sex and age category are present. The prevalence of low HGS was 7.69% in men and 6.46% in women. Multiple regression analysis showed that almost 72.5% of HGS variability can be explained by sex, age, height and weight. Conclusions the HGS reached peak at 40 years old, maintained or slightly lowered between ages 40 and50 and then start an accelerated decline after 50 years old. Reference values of HGS should be stratified by sex and age group. HGS variability can be largely explained by sex, age, height and weight.

scholarly journals The Synergistic Effect of an ATP-Competitive Inhibitor of mTOR and Metformin on Pancreatic Tumor Growth

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Ghada A Soliman ◽  
Surendra K Shukla ◽  
Asserewou Etekpo ◽  
Venugopal Gunda ◽  
Sharalyn M Steenson ◽  
...  
Keyword(s):  
Tumor Growth ◽  
Pancreatic Tumor ◽  
Single Agent ◽  
Nutrient Sensing ◽  
Pancreatic Tumors ◽  
Mice Model ◽  
High Concentration ◽  
Orthotopic Mouse Model ◽  
Low Concentration ◽  
The Impact

ABSTRACT Background The mechanistic target of rapamycin complex 1 (mTORC1) is a nutrient-sensing pathway and a key regulator of amino acid and glucose metabolism. Dysregulation of the mTOR pathways is implicated in the pathogenesis of metabolic syndrome, obesity, type 2 diabetes, and pancreatic cancer. Objectives We investigated the impact of inhibition of mTORC1/mTORC2 and synergism with metformin on pancreatic tumor growth and metabolomics. Methods Cell lines derived from pancreatic tumors of the KPC (KrasG12D/+; p53R172H/+; Pdx1-Cre) transgenic mice model were implanted into the pancreas of C57BL/6 albino mice (n = 10/group). Two weeks later, the mice were injected intraperitoneally with daily doses of 1) Torin 2 (mTORC1/mTORC2 inhibitor) at a high concentration (TH), 2) Torin 2 at a low concentration (TL), 3) metformin at a low concentration (ML), 4) a combination of Torin 2 and metformin at low concentrations (TLML), or 5) DMSO vehicle (control) for 12 d. Tissues and blood samples were collected for targeted xenometabolomics analysis, drug concentration, and cell signaling. Results Metabolomic analysis of the control and treated plasma samples showed differential metabolite profiles. Phenylalanine was significantly elevated in the TLML group compared with the control (+426%, P = 0.0004), whereas uracil was significantly lower (–38%, P = 0.009). The combination treatment reduced tumor growth in the orthotopic mouse model. TLML significantly decreased pancreatic tumor volume (498 ± 104 mm3; 37%; P &lt; 0.0004) compared with control (1326 ± 134 mm3; 100%), ML (853 ± 67 mm3; 64%), TL (745 ± 167 mm3; 54%), and TH (665 ± 182 mm3; 50%) (ANOVA and post hoc tests). TLML significantly decreased tumor weights (0.66 ± 0.08 g; 52%) compared with the control (1.28 ± 0.19 g; 100%) (P &lt; 0.002). Conclusions The combination of mTOR dual inhibition by Torin 2 and metformin is associated with an altered metabolomic profile and a significant reduction in pancreatic tumor burden compared with single-agent therapy, and it is better tolerated.

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