Metastatic pancreatic ductal adenocarcinoma in a teenage girl: A rare disease

Pancreatic ductal adenocarcinoma (PDAC) is highly uncommon in patients < 20 years of age, at less than 0.1% of population.1 Pancreatic tumors in children and adolescents can develop from endocrine or exocrine cells. The tumor types include solid pseudopapillary tumor, ductal adenocarcinoma, pancreatoblastoma, acinar cell carcinoma, and pancreatic endocrine neoplasm (malignant and benign).2 Other types of tumors may be attached to it or secondarily engage the gland or emerge from other kinds of non-pancreatic cells inside the pancreas. The prevalent type of classic PDAC in adults is highly uncommon in children. We report here on a fifteen-year old girl with metastatic pancreatic ductal adenocarcinoma (mPDAC), who presented with abdominal discomfort and jaundice.

Treatment of insulinomas by laparoscopic radiofrequency ablation: case reports and literature review

Despite its rarity, insulinoma is the most common type of pancreatic endocrine neoplasm, with an occurrence of 1 to 5 per million per year in the population. Surgical resection or enucleation is the first line of curative treatment choice for insulinoma. Eight patients with symptomatic insulinomas treated by radiofrequency ablation have been described since 2009. In the past two years, we treated two patients with symptomatic insulinomas (one in the pancreatic tail and the other in the pancreatic neck) successfully using laparoscopic radiofrequency ablation. Both patients achieved complete elimination without any significant complications. Our study suggests laparoscopic radiofrequency ablation could be developed as a safe and effective alternative treatment to surgery for the patients with insulinomas who refuse or are not eligible for surgery.

Intestinal Heterotopic Pancreas Involved by Simultaneous PanIN-2 Lesion and Endocrine Microadenoma: a Unique Case

We hereby present the case of a 58-year-old male who underwent a total gastrectomy for gastric neoplasm. During the surgery, a tumor mass in the jejunum was identified, considered as metastasis, and resected. The histopathological examination of the jejunal lesion showed ectopic pancreas. In this area, two pathological distinct lesions were identified, one histologically compatible with pancreatic intraepithelial neoplasia (PanIN) type 2 lesion and the other with morphologic criteria for endocrine microadenoma. To our knowledge, this is the first case that evidences the presence of a concomitant premalignant exocrine lesion and benign endocrine lesion in a heterotopic pancreas (HP).Abbreviations: HP: heterotopic pancreas; IPMN: Intraductal Papillary Mucinous Neoplasms; PanIN: Pancreatic Intraepithelial Neoplasia; PEN: pancreatic endocrine neoplasm.