1/8. Coexistence of an endocrine tumour in a serous cystadenoma (microcystic adenoma) of the pancreas, an unusual association.A pancreatic endocrine tumour arising within a serous cystadenoma is reported. A 49 year old woman was admitted with a history of epigastric pain, nausea, vomiting, and weight loss of two months duration. She had been diabetic for 12 years. An epigastric mass was palpated in the physical examination, and computed tomography revealed a multiloculated cystic lesion in the pancreas. Pathological examination of the pancreatic tumour revealed the coexistence of a serous cystadenoma and an endocrine tumour. The endocrine tumour, which was located inside the serous cystadenoma, was 1 cm in diameter. The first case of a serous cystadenoma of the pancreas containing a pancreatic endocrine tumour was reported in the literature recently. This paper reports another incidentally found pancreatic endocrine tumour arising within a serous cystadenoma.- - - - - - - - - - ranking = 1keywords = endocrine (Clic here for more details about this article) |
2/8. Pancreatic head resection for noninflammatory benign lesions of the head of the pancreas.INTRODUCTION: duodenum-preserving pancreatic head resection (DPPHR) has been safely performed in patients with chronic pancreatitis. The procedure has rarely been used to remove benign or borderline lesions of the head of the pancreas. AIMS: To review our experience with 13 patients who underwent DPPHR and to review reports in the literature on the same subject. METHODOLOGY: From October 1991 to September 2000, 13 patients underwent DPPHR to resect endocrine pancreatic tumors (n = 4), beta cell hyperplasia (n = 1), pancreatic pseudocysts (n = 2), serous cystadenomas (n = 3), congenital (n = 1) and choledochal (n = 1) cysts, and intraductal papillary mucinous tumor (n = 1). The Kocher maneuver was performed in seven patients (group 1) and avoided in six (group 2). Type 1, 2, and 3 DPPHR were defined depending on the amount of pancreatic tissue left at the inner surface of the duodenum. Ten patients underwent evaluation that included an oral glucose tolerance test and exocrine pancreatic function test. RESULTS: The mortality rate was zero; the complication rate was 69%. patients in whom the Kocher maneuver was not performed (group 2) experienced fewer complications, shorter stay on nasogastric tube and abdominal drain(s), and earlier water intake and discharge. Type of DPPHR did not influence the postoperative course. One patient died 3 months after surgery of unrelated disease. Twelve patients were alive and well 2 months to 8 years after surgery. CONCLUSION: DPPHR is a low-risk procedure in patients with benign or borderline noninflammatory lesions of the head of the pancreas in whom pylorus-preserving pancreaticoduodenectomy is otherwise indicated. Whenever possible, the Kocher maneuver should be avoided.- - - - - - - - - - ranking = 0.11111111111111keywords = endocrine (Clic here for more details about this article) |
3/8. Central (middle segment) pancreatectomy: a suitable operation for small lesions of the neck of the pancreas.A 73-year-old male was worked up for persistent abdominal pain and found to have a 2.5 cm cystic lesion of the neck of the pancreas. At celiotomy the lesion was felt to be a benign cystic lesion and a central pancreatectomy consisting of removal of the lesion with one centimeter of pancreas on either side was performed. The proximal pancreatic duct was oversewn and the distal body and tail of the pancreas was drained into a Roux-en-Y limb of the jejunum. At present, there are 70 cases of central pancreatectomy published in the literature. mortality of the operation is zero and the major complications of pancreatic fistula, delayed gastric emptying, pancreatitis and abscess, are all temporary and self limiting. Central pancreatectomy affords the opportunity to save normal pancreatic tissue thus avoiding the complications of exocrine pancreatic insufficiency, namely steatorrhea and endocrine pancreatic insufficiency namely diabetes.- - - - - - - - - - ranking = 0.11111111111111keywords = endocrine (Clic here for more details about this article) |
4/8. Combined serous microcystic adenoma and well-differentiated endocrine pancreatic neoplasm: a case report and review of the literature.We report a case of combined microcystic adenoma and pancreatic endocrine neoplasm of the pancreas in a 53-year-old male patient. The pancreatic tumor was an incidental computed tomography scan finding and was not accompanied by gastrointestinal symptoms. The tumor was located in the head of the pancreas and was composed of numerous small cysts lined by uniform clear cells with a centrally located solid endocrine component. Four cases of similar neoplasm have recently been reported, exclusively in women. literature review and case analysis indicate that combined microcystic adenoma and pancreatic endocrine neoplasm is characterized by the presence of pancreatic endocrine neoplasm within microcystic adenoma in the head of the pancreas, affects women more often than men, and presents at a younger age when compared to microcystic adenoma.- - - - - - - - - - ranking = 0.88888888888889keywords = endocrine (Clic here for more details about this article) |
5/8. Solid serous cystadenoma of the pancreas: MR imaging with pathologic correlation.We report a case of solid type serous cystadenoma of the pancreas. Computed tomographic and magnetic resonance (MR) images showed a hypervascular solid tumor that was difficult to differentiate from endocrine tumor of the pancreas. However, the tumor showed marked hyperintensity similar to that of hepatic cyst on MR cholangiopancreatography, indicating not a solid but rather a cystic nature. MR cholangiopancreatography (heavily T2-weighted image) is quite useful for clearly differentiating solid from cystic tumors.- - - - - - - - - - ranking = 0.11111111111111keywords = endocrine (Clic here for more details about this article) |
6/8. Pancreatic endocrine tumor coexistent with serous microcystic adenoma: report of a case and review of the literature.Serous cystadenomas of the pancreas have been classified as benign exocrine tumors. There have been rare cases of malignant behavior, and in exceptional cases, coexisting neoplasms have been reported. We report a case of a coexistent neuroendocrine tumor identified within a serous cystadenoma in a 78-year-old woman, which was discovered incidentally after complete resection of the tumor. Given the unpredictable metastatic potential of neuroendocrine tumors of the pancreas, we advocate complete resection of all pancreatic cystic tumors, combined with careful sampling of the pathological specimen to rule out a coexistent potentially malignant neoplasm.- - - - - - - - - - ranking = 0.66666666666667keywords = endocrine (Clic here for more details about this article) |
7/8. Pancreatic endocrine neoplasm can mimic serous cystadenoma.A 57-yr-old female patient was referred to our hospital with a cystic lesion of the head of the pancreas that had been noted on abdominal computed tomography (CT). Endoscopic ultrasonography (EUS) showed a 3.0 cm rounded mass in the head of the pancreas. EUS images showed that the tumor had a solid component consisting of multiple microcysts separated by septae and a cystic component consisting of a macrocystic lesion. Thus, the tumor was suspected of being a serous cystadenoma (SCA). However, the histopathological diagnosis based on endoscopic ultrasound- guided fine-needle-aspiration biopsy (EUS-FNAB) was that of a pancreatic endocrine neoplasm (PEN). Surgical resection was performed. Despite having very similar macroscopic findings to SCA, microscopic examination revealed that the patient's tumor was definitely a PEN. This case suggests that it is very difficult to distinguish PENs from SCAs based solely on imaging methods. EUS-FNAB is essential for determining the appropriate therapeutic strategy, as it provides the histopathological diagnosis.- - - - - - - - - - ranking = 0.55555555555556keywords = endocrine (Clic here for more details about this article) |
8/8. A pancreatic endocrine tumor arising within a serous cystadenoma of the pancreas.We report a pancreatic endocrine tumor arising within an otherwise benign pancreatic serous cystadenoma in a 47-year-old woman with a history of lupus treated by steroids. She presented 10 years before resection with epigastric pain and intermittent jaundice. Histologic and immunohistochemical studies showed that the solid endocrine component was composed of small, uniform cells with stippled nuclei, which were chromogranin a positive. The surrounding cystic component was lined by periodic acid Schiff's-positive, diastase-digestible cells containing glycogen. To the best of our knowledge, this is the first case of a serous cystadenoma of the pancreas that contains a well defined pancreatic endocrine tumor reported in the English literature.- - - - - - - - - - ranking = 0.77777777777778keywords = endocrine (Clic here for more details about this article) |