1/228. Biliary cystadenocarcinoma of the liver: the need for complete resection.We report on a patient with biliary cystadenocarcinoma and review 112 previously published cases of this rare cystic hepatic neoplasm. This tumour mainly occurs in women at a ratio of 62% (female) to 38% (male), and at an average age of 56.2 years (range 18-88 years). The origin of these neoplasms is intrahepatic in 97% of cases and extrahepatic in the remaining 3%. The clinical symptoms are nonspecific and are not distinctive from benign cystic liver lesions unless invasive growth of the tumour occurs or distant metastases are present. Sonography and computed tomography (CT), as well as magnetic resonance imaging (MRI) demonstrate the multilocular nature of the tumour with septal or mural nodules. Discrete soft tissue masses, thick and coarse calcifications and varying density on CT or intensity on MRI within the loculi are additional non-specific imaging findings. The best therapeutic result with a 5-year survival rate of 100% and a recurrence rate of only 13% was achieved by complete excision (n = 16). Surgical removal of the tumour by complete excision is, therefore, the treatment of choice for biliary cystadenocarcinomas.- - - - - - - - - - ranking = 1keywords = cystadenocarcinoma (Clic here for more details about this article) |
2/228. Hepatic arterial infusion chemotherapy of cisplatin for biliary cystadenocarcinoma.Biliary cystadenocarcinoma is a rare tumor which has a better prognosis after complete surgical removal. However, since there is no other effective therapeutic option instead of surgery, the prognosis is very poor if surgical resection is impossible. We report the case of a 78 year-old woman who was treated only by hepatic arterial infusion (HAI) chemotherapy of cisplatin (85 mg) because liver functional reserve was too bad to perform a major hepatectomy. Huge biliary cystadenocarcinoma occupying the right lobe of the liver measuring 12 cm in size before chemotherapy was drastically decreased to 2 cm in size 8 months after chemotherapy. Although she had abdominal pain and anorexia before chemotherapy, she is doing well and has no complaints 9 months after chemotherapy. In conclusion, an effective therapy may be possible using hepatic arterial infusion chemotherapy of cisplatin in patients with biliary cystadenocarcinoma for whom surgical treatment is not suitable.- - - - - - - - - - ranking = 1.1666666666667keywords = cystadenocarcinoma (Clic here for more details about this article) |
3/228. Operative indications for cystic lesions of the pancreas with malignant potential--our experience.BACKGROUND/AIMS: There are still many important but unclear points regarding the differential diagnosis and operative indications of cystic lesions of the pancreas with malignant potential. Studies of the clinicopathological and molecular biological characteristics of such diseases are necessary. In this paper, we discuss operative indications for this condition based on a review of the literature and our own experience. METHODOLOGY: Seven cases of serous cystadenoma and 9 cases of mucinous cystadenoma or cystadenocarcinoma of the pancreas that were operated on or autopsied in our department from 1980 to 1996 were analyzed clinicopathologically. Small cystic lesions incidentally found in 300 autopsied cases were also studied. Finally, mucin-producing tumors described in several reports were reviewed, and the branch type of this tumor was especially investigated. RESULTS: A marked disappearance of pancreatic acini in the upstream pancreas was found when serous cystadenoma became large. Papillary projection was histologically found in all of the cases. Tumorous invasion to the interstitium was suspected in tumors more than 5 cm in diameter, and malignancy was reported when tumors were larger than 6 cm. As for mucinous cystadenocarcinoma, the patients had a poor prognosis. In 2 of 42 cases with a pseudocyst, small duct cell carcinoma was incidentally found adjacent to the pseudocyst on the duodenal side. With regard to branch-type intraductal papillary neoplasm, 80% of the tumors larger than 4 cm were malignant. Most of the small cystic lesions found in elderly autopsy cases were accompanied by hyperplastic epithelia without evidence of malignancy. CONCLUSIONS: Based on our experience, an operation should be considered and resection is recommended under the following circumstances: 1) cystic lesions in the body and tail of the pancreas in middle-aged women; 2) typical serous cystadenoma larger than 4 cm; 3) mucinous cystadenoma of any size; 4) branch-type intraductal papillary neoplasm larger than about 3 cm; and, 5) pseudocysts of unknown cause. Small cystic lesions in elderly patients should not necessarily be operated on, but should be followed-up carefully.- - - - - - - - - - ranking = 0.33333333333333keywords = cystadenocarcinoma (Clic here for more details about this article) |
4/228. Biliary cystadenocarcinoma: sonographic and cytologic findings.Biliary cystadenocarcinoma is a rare hepatic cystic tumor. We report sonographic, CT, and MRI findings in an unusual case in an 87-year-old man. The diagnosis was aided by sonographically guided needle aspiration of the lesion, which revealed elevated levels of carcinoembryonic antigen and CA 19-9 in the cystic fluid.- - - - - - - - - - ranking = 0.83333333333333keywords = cystadenocarcinoma (Clic here for more details about this article) |
5/228. Mucin Hypersecreting Intraductal Papillary Neoplasm of the pancreas.Mucin Hypersecreting Intraductal Papillary Neoplasm is a rare neoplasm that arises from ductal epithelial cells. This entity is distinct from the more commonly known Mucinous cystadenoma or Mucinous cystadenocarcinoma. Despite this distinction, it has been erroneously categorized with these more common cystic neoplasms. Characteristic clinical presentation, radiographic, and endoscopic findings help distinguish this neoplasm from the cystadenomas and cystadenocarcinomas. Histopathologic identification is not crucial to the preoperative diagnosis. This neoplasm is considered to represent a premalignant condition and, therefore, surgical resection is warranted. prognosis, following resection, is felt to be curative for the majority of patients. We present two cases of Mucin Hypersecreting Intraductal Papillary Neoplasm and discuss their diagnosis and surgical therapy.- - - - - - - - - - ranking = 0.16666666666667keywords = cystadenocarcinoma (Clic here for more details about this article) |
6/228. pancreatitis associated with Crohn's disease: a premalignant state for cystadenocarcinoma of pancreas?We report a 74-yr-old woman with Crohn's disease and acute pancreatitis who, 3 yr after resolution of the latter, developed cystadenocarcinoma of the pancreas. No drug, toxin, or other etiologies including contiguous duodenal involvement were identified as responsible for the pancreatitis, suggesting that pancreatitis was an extraintestinal manifestation of her Crohn's disease. Could Crohn's-associated pancreatitis be a premalignant state for cystadenocarcinoma of the pancreas?- - - - - - - - - - ranking = 1keywords = cystadenocarcinoma (Clic here for more details about this article) |
7/228. Combined hepatocellular and cystadenocarcinoma presenting as a giant cyst of the liver--a case report.Primary cystic lesions of the liver are very rare. Most of the solid tumours are hepatocellular carcinomas (HCC) with a smaller number being cholangiocarcinomas. The association of HCC with other primary liver malignancies is also extremely rare. This case report is about a 27 year old male patient who presented with a giant cystic lesion of the left liver. A CT scan showed a cystic lesion with internal septations and a thrombus in the main portal vein. The patient underwent an extended left hepatectomy and a portal venotomy with removal of the thrombus. Coexistent hepatocellular and cystadenocarcinoma were reported on histopathological examination. The patient was put on 5-FU postoperatively. He is doing well 11 months after surgery.- - - - - - - - - - ranking = 0.83333333333333keywords = cystadenocarcinoma (Clic here for more details about this article) |
8/228. Spontaneous rupture of a nonparasitic liver cyst complicated by intracystic hemorrhage.a case of spontaneous rupture of simple liver cyst complicated by intracystic hemorrhage is described. This rare condition was detected in a 61-year-old man who underwent left trisegmentectomy of liver under a suspected diagnosis of cystadenocarcinoma because of elevated serum levels of carbohydrate antigen (CA) 19-9 and DUPAN 2, and the presence of an intracystic structure. The resected specimen showed a benign liver cyst with intracystic hematoma and high levels of CA19-9 and DUPAN 2 in the cystic fluid. It is suggested that cyst rupture may increase serum levels of tumor markers whose levels are high in the cystic fluid, and that repeated observations of an intracystic structure may be the most reliable method to distinguish intracystic hemorrhage from cystic neoplasm.- - - - - - - - - - ranking = 0.16666666666667keywords = cystadenocarcinoma (Clic here for more details about this article) |
9/228. Mucobilia in association with a biliary cystadenocarcinoma of the caudate duct: a rare cause of malignant biliary obstruction.Mucobilia is a rare condition characterized by the accumulation of abundant mucus within the intra- or extrahepatic biliary tree. A variety of hepatobiliary and pancreatic neoplasms are mucin producing and have been associated with the development of mucobilia including biliary mucinosis, biliary papillomatosis, mucin-producing cholangiocarcinoma (MPCC), or cystic neoplasms of the pancreas or biliary tree (cystadenoma or cystadenocarcinoma). We report the case of 46 year-old male with a biliary cystadenocarcinoma of the caudate lobe which resulted in chronic biliary obstruction and relapsing cholangitis. A review of the literature for both mucobilia and biliary cystadenocarcinoma is provided along with a discussion addressing the clinical presentation, diagnosis, treatment, and prognosis for this rare entity.- - - - - - - - - - ranking = 1.1666666666667keywords = cystadenocarcinoma (Clic here for more details about this article) |
10/228. Bilateral metastatic carcinoma of the breast from primary ovarian cancer.We report a case of ovarian cancer with metastasis to both breasts and axillary lymph nodes and the vaginal cuff. A 41-year-old previously hysterectomized women presented with pelvic mass and malignant pleural effusion. During the courses of chemotherapy; bilateral breast nodules, and bilateral axillary lymphadenopathies and a nodule in the vaginal cuff were identified. The biopsy of both breasts, axillary lymph nodes and the nodule in the vaginal cuff revealed papillary serous cystadenocarcinoma. Immunohistochemical staining of breast specimens were positive for ovarian tumor marker CA-125.- - - - - - - - - - ranking = 0.16666666666667keywords = cystadenocarcinoma (Clic here for more details about this article) |
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