1/21. 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 = cystadenocarcinoma (Clic here for more details about this article) |
2/21. 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 = 2.5keywords = cystadenocarcinoma (Clic here for more details about this article) |
3/21. 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 = 2.5keywords = cystadenocarcinoma (Clic here for more details about this article) |
4/21. 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 = 2keywords = cystadenocarcinoma (Clic here for more details about this article) |
5/21. Giant biliary cystadenoma: case report and literature review.Biliary cystadenoma is a very rare cystic neoplasm of the liver. This tumor is insidiously progressive and usually presents in white females in their fifth decade. It has a characteristic appearance on ultrasound, computed tomography, and angiography. The exact etiology of these tumors is unknown, but several theories have been proposed. Historically these cystic tumors have been treated by a variety of techniques including aspiration, fenestration, internal drainage, and resection. Previously reported series have confirmed a >90 percent recurrence rate with anything less than complete excision. In addition biliary cystadenoma is a premalignant lesion and only surgical excision can differentiate it from its malignant counterpart, biliary cystadenocarcinoma.- - - - - - - - - - ranking = 0.5keywords = cystadenocarcinoma (Clic here for more details about this article) |
6/21. Mucinous cystadenocarcinoma in the appendix in a patient with nonrotation: report of a case.Mucinous cystadenocarcinoma in the appendix is uncommon. An anomaly in the rotation of the intestine is also uncommon in adults. We herein report a case of mucinous cystadenocarcinoma in the appendix in a patient with nonrotation. To the best of our knowledge, this is the first report of appendiceal carcinoma in a patient with an anomaly of intestinal rotation. A 76-year-old woman was admitted to our hospital with left low abdominal pain. physical examination revealed tenderness with muscle rigidity in the left lower quadrant. The patient was diagnosed to have intussusception by computed tomography and ultrasonography. An emergency operation showed nonrotation and the top of the appendix situated in the left iliac fossa. An appendectomy was performed because of gangrenous acute appendicitis. However, the cut surface of the appendix showed a mucocele measuring 4 x 4 cm in size. It was diagnosed to be mucinous cystadenocarcinoma histopathologically. A right hemicolectomy with lymph node dissection was performed, and no remaining cancer cells or lymph node metastases were found in the resected specimen pathologically. The patient had an uneventful postoperative course. No signs of recurrence have been observed for 23 months since her last operation.- - - - - - - - - - ranking = 3.5keywords = cystadenocarcinoma (Clic here for more details about this article) |
7/21. Mucinous cystadenoma of the pancreas resected 11 years after cystgastrostomy.There have been numerous reports that mucinous cystadenoma of the pancreas can transform to mucinous cystadenocarcinoma after cystenterostomy, but few authors have reported morphological changes long after cystenterostomy for mucinous cystadenoma. A 41-year-old Japanese woman had undergone cystgastrostomy at a nearby hospital 11 years before undergoing the treatment reported here. The preoperative diagnosis at the time of cystgastrostomy was a pancreatic cyst. At laparotomy a cyst, measuring 10cm in diameter, was found in the body and tail of the pancreas. The histopathological diagnosis of the cyst wall was mucinous cystadenoma of mild dysplasia. Computed tomography 10 years after the cystgastrostomy showed that the cyst had decreased in diameter from 10 cm to 5cm. gastroscopy showed a scar at the cystgastrostomy site in the stomach. A complete resection of the mucinous cystadenoma was done, 11 years after the cystgastrostomy, because of the malignant potential. The resected specimen showed mucinous cystadenoma of mild dysplasia with structural and cellular atypia similar to that in the previous specimen. There was no malignant change. The patient was discharged after an uneventful postoperative course and no recurrence has been evident for 6 months to date. This case showed imaging and histopathological evidence of the slow-growing nature of mucinous cystadenoma of the pancreas.- - - - - - - - - - ranking = 0.5keywords = cystadenocarcinoma (Clic here for more details about this article) |
8/21. Appendiceal mucocoele: a case report and review of the literature.Mucocoele of the appendix denotes an obstructive dilatation of the appendiceal lumen due to abnormal accumulation of mucus, which may be related to a variety of pathological conditions. This may be the outcome of various processes. Most important for the surgeon, however, are the mucocoeles that are caused by mucinous cystadenomas and cystadenocarcinomas. In the latter case, a possible rupture of the mucocoele, either spontaneous or accidental, during surgery may result in the clinical condition of pseudomyxoma peritonei, a spread of malignant cells throughout the entire peritoneal cavity in the form of multiple mucinous deposits. It is therefore important both to identify the disease preoperatively and to plan a careful resection to remove the mass. We report one case and present the clinical and diagnostic aspects of this disease.- - - - - - - - - - ranking = 0.5keywords = cystadenocarcinoma (Clic here for more details about this article) |
9/21. Benign inflammatory pancreatic mucinous cystadenomas mimicking locally advanced cystadenocarcinomas. Presentation of 3 cases.We report 3 cases of benign mucinous cystadenoma of the pancreas mimicking, both clinically and on imaging findings, locally advanced cystadenocarcinoma spreading to neighbouring organs (stomach, splenic and mesenteric vessels, and diaphragm). Surgical resection was performed in light of the suspicion of invasive carcinoma in all 3 cases. Histological examination of the resected specimens showed entirely benign mucinous cystadenomas associated with marked peri-tumoural inflammation that accounted for the pre-operative misdiagnoses. All 3 patients are alive 40, 47 and 54 months after surgery without evidence of tumour relapse. These cases indicate that surgery must be considered in patients with cystic tumour of the pancreas suggesting locally advanced cystadenocarcinoma, even when pre-operative imaging findings suggest tumour extension into neighbouring organs.- - - - - - - - - - ranking = 3keywords = cystadenocarcinoma (Clic here for more details about this article) |
10/21. Mucinous cystadenoma of the appendix.Mucinous neoplasms of the appendix are rare conditions, usually diagnosed intraoperatively or postoperatively on the pathology report. They have an association with colonic and ovarian neoplasms, and spillage can result in pseudomyxoma peritonei. While appendicectomy is adequate treatment for cystadenomas, cystadenocarcinomas require a right hemicolectomy. Open approach is recommended for the surgical treatment of these lesions.- - - - - - - - - - ranking = 0.5keywords = cystadenocarcinoma (Clic here for more details about this article) |
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