1/70. 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 = 1keywords = carcinoma, ductal (Clic here for more details about this article) |
2/70. Endocrine cell micronests in an ovarian mucinous cystadenofibroma: a mimic of microinvasion.An ovarian mucinous cystadenofibroma with peculiar neuroendocrine cell micronests is described in a 59-year-old Japanese woman. Aggregates of epithelial cells resembling microinvasive carcinoma cells were scattered throughout the adenofibromatous area. These micronests were composed of small uniform cells with argentaffin and argyrophil granules. Numerous small cells with neuroendocrine granules were also seen within mucinous glands. This is the first report of neuroendocrine micronests in an ovarian neoplasm, a finding that should be distinguished from microinvasion.- - - - - - - - - - ranking = 0.2616709134904keywords = carcinoma (Clic here for more details about this article) |
3/70. Mucinous cystadenocarcinoma in combination with hemangiosarcoma in the ovary.The ovary is the sixth most frequent site of cancer in women in denmark with an incidence of approximately 600 cases per year. Carcinomas predominate whereas sarcomas are rare. We describe a case of the combination mucinous cystadenocarcinoma and hemangiosarcoma in a 37-year old woman, who had a right-sited oophorectomy because of a cyst. Clinically there was no suspicion of malignancy. The macro- and microscopic findings are described as well as the immunohistochemical stainings performed to confirm the diagnosis. The case shows the importance of careful sampling at the macroscopic examination, especially from areas with a striking appearance.- - - - - - - - - - ranking = 1.308354567452keywords = carcinoma (Clic here for more details about this article) |
4/70. A pancreatic intraductal papillary mucinous tumor causing recurrent acute pancreatitis at the onset of menstrual periods.The unusual case of a young woman with pancreatitis recurring at onset of her menstrual periods is reported. The patient was diagnosed with pancreatic intraductal papillary mucinous tumor (IPMT). The temporal relation of clinical exacerbation of pancreatitis to the menstrual cycle is suggestive of a hormonal-mediated mechanism. The hypothesis of a possible role of progesterone receptors was dismissed with verification of the absence of progesterone and estrogen receptors in the neoplastic tissue. The possible role of activin A or inhibin A in our patient's clinical picture is theorized.- - - - - - - - - - ranking = 0.53746814882199keywords = ductal (Clic here for more details about this article) |
5/70. Micropapillary carcinoma of the parotid gland arising in mucinous cystadenoma.We describe a 45-year-old man who had a 2-year history of a slowly enlarging tumor in the left parotid gland. Histologically, the tumor was a mucinous cystadenoma with focal apocrine differentiation, which revealed a widespread invasive micropapillary adenocarcinoma component. A rim of lymphoid tissue surrounded the margins of the micropapillary carcinoma. The invasive micropapillary adenocarcinoma component was morphologically identical with the invasive micropapillary carcinoma of the mammary gland. The tumor is different from so-far recognized salivary gland tumor entities.- - - - - - - - - - ranking = 2.0933673079232keywords = carcinoma (Clic here for more details about this article) |
6/70. Mucinous ductal ectasia of the biliary tree secondary to mucous metaplasia. A case report.Mucinous ductal ectasia is an uncommon disorder, characterized by ductal dilatation and filling with thick, viscid mucus, described in the pancreas. We report a case of mucinous ductal ectasia of the biliary tree. The cause of the mucus production was mucous metaplasia in the biliary epithelium. The patient was followed for 16 years, treated with serial saline flushings of the biliary tree whenever he became symptomatic.- - - - - - - - - - ranking = 0.75245540835078keywords = ductal (Clic here for more details about this article) |
7/70. Simultaneous mucinous cystadenoma of ovary and mucinous cystadenocarcinoma of pancreas.Mucinous cystic tumors were discovered synchronously in the tail of the pancreas and in the right ovary of an adult female. Both tumors were amenable to surgical resection. The pancreatic tumor was a noninvasive mucinous cystadenocarcinoma and the ovarian tumor was a mucinous cystadenoma. We feel these tumors represent two primaries, an uncommon occurrence, and not a single primary tumor with metastasis.- - - - - - - - - - ranking = 1.308354567452keywords = carcinoma (Clic here for more details about this article) |
8/70. Clear cell carcinoma of the ovary arising in a mucinous cystadenoma.A 57 year old woman presented complaining of increasing abdominal swelling of six months duration. A mixed solid cystic left ovarian tumour measuring 24 cm in diameter was excised. histology showed numerous cysts lined by benign mucinous epithelium blending imperceptibly into borderline clear cell and mucinous areas that in turn merged with an invasive clear cell carcinoma. To the best of our knowledge, this is the first reported case of clear cell carcinoma arising in a mucinous cystadenoma. The implications for the previously postulated pathogenesis of these tumours are discussed.- - - - - - - - - - ranking = 1.5700254809424keywords = carcinoma (Clic here for more details about this article) |
9/70. liver cystadenocarcinoma originating in cystadenoma without mesenchymal stroma. Therapeutic strategy in case of atypical radiological criteria. A case report.Optimal treatment of cystadenoma if diagnosed consists of complete resection of the tumor. In case of atypical radiological criteria, therapeutic strategy is not well defined. The attitude we adopt is to regularly monitor the lesion. Surgical removal of the tumor is of course indicated facing any significant change on sonography or tomodensiometry.- - - - - - - - - - ranking = 1.0466836539616keywords = carcinoma (Clic here for more details about this article) |
10/70. choriocarcinoma of the ovary associated with mucinous cystadenoma.We report choriocarcinoma of the ovary associated with mucinous cystadenoma in a 54-year-old postmenopausal woman, the first reported case of this condition. Doppler ultrasonography, computed tomography, and magnetic resonance imaging showed hypervascularity of the tumor that corresponded to the area of choriocarcinoma within the multilocular cyst. The patient exhibited multiple pulmonary metastases and died of intracerebral hemorrhage.- - - - - - - - - - ranking = 1.5700254809424keywords = carcinoma (Clic here for more details about this article) |
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