1/333. Benign pancreatic tumor treated with duodenum-preserving resection of the head of the pancreas. Case report.Cystic neoplasms of the pancreas constitute about 9% of all cystic lesions of the pancreas and less than 1% of all pancreatic neoplasms. Authors report the case of a 70 year-old woman with microcystic cystadenoma. Computed tomography (CT) scan of the abdomen diagnosed a 5 cm multilocular septated cyst, with calcifications in the context, localized in the head-uncinate process of the pancreas. The mass was well separated by a sharp cleavage plane with portal vein and superior mesenteric vessels. An endoscopic retrograde cholangiopancreatography (ERCP) showed cephalic symmetrical stenosis (diameter: 3 mm) of the main pancreatic duct (MPD), mildly dilated in the remaining tract (diameter: 6 mm). An intra-operative biopsy of the cystic wall had been performed. Therefore, it was decided to proceed with a duodenum-preserving resection of the head of the pancreas (DPPHR), including stenosis tract of the MPD in the surgical specimen. The reconstructive procedure consisted, by i.v. jejunal loop transposition, of a side-to-side pancreatico-jejunostomy, including in the anastomosis both corpocaudal stump and the resection cavity of the pancreatic head, and an end-to-side Roux-en-Y jejuno-jejunostomy. With respect to long-lasting pain relief and preservation of the endocrine and exocrine functions of the pancreas, duodenum-preserving resection of the head of the pancreas is a highly effective surgical procedure with low early and late morbidity and mortality due to limited surgical resections. This technique, introduced into surgical practice in 1972 by Beger, is indicated in patients with chronic pancreatitis with an inflammatory mass in the head of the pancreas. The authors conclude that this procedure can also be performed in cases of pancreatic benign tumors, such as microcystic cystadenoma. Advantages of this technique make DPPHR an attractive alternative to pylorus-preserving pancreatico-duodenectomy (PPPD).- - - - - - - - - - ranking = 1keywords = adenoma (Clic here for more details about this article) |
2/333. Pancreatic head cystadenoma: a case report.An 18 year-old resident of Zagreb was admitted to our hospital with intermittent pain in the right subcostal region. On examination, a palpable resistance was found in the upper abdomen. After extensive clinical and laboratory tests, a tumor of the pancreatic head, 80-85 mm in diameter, was verified. Cytologically, a diagnosis of microcystic adenoma of the pancreas was established. The patient underwent a cephalic pancreatoduodenectomy with preservation of the pylorus. Six months later the patient was no longer on a diet and, at follow-up, 3 years after surgery, she is symptom-free and feeling well.- - - - - - - - - - ranking = 2.5keywords = adenoma (Clic here for more details about this article) |
3/333. 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 = 1keywords = adenoma (Clic here for more details about this article) |
4/333. Biliary cystadenoma and cystadenocarcinoma: gray scale ultrasound appearance.The gray scale echographic appearance of biliary cystadenoma/cystadenocarcinoma is described. The characteristic findings are a cystic, multiloculated intrahepatic mass with thick, highly echogenic internal septations. Findings are similar to those in pancreatic and ovarian cystadenomas/cystadenocarcinomas.- - - - - - - - - - ranking = 3keywords = adenoma (Clic here for more details about this article) |
5/333. Primary smooth muscle tumor of the liver encasing hepatobiliary cystadenoma without mesenchymal stroma.We describe a 59-year-old Japanese woman with a large mass of her liver encasing cystic components. Radiologic imaging showed the mass to be hypervascular, and surgical resection disclosed a white tumor. The solid portion was immunohistochemically characterized as a smooth muscle tumor. The cystic components were multilocular and lined with columnar epithelium, consistent with a hepatobiliary cystadenoma. The epithelium strongly stained for CA19-9. The subepithelial space was occupied by collagenous connective tissue interspersed with a small number of spindle-shaped cells. The cystic lesions lacked the mesenchymal stroma between the epithelium and connective tissue layer. There have been no previous reports of a hepatic smooth muscle tumor encasing a hepatobiliary cystadenoma. Because of the pathogenesis of the cystadenoma, it is possible to assume that the smooth muscle tumor also arose from the cells composing the biliary duct in association with the development of the cystadenoma.- - - - - - - - - - ranking = 4keywords = adenoma (Clic here for more details about this article) |
6/333. Lymphoepithelial cyst of the pancreas. No evidence for Epstein-Barr virus-related pathogenesis.Compared to pseudocyst formation after prior pancreatitis, true cysts of the pancreas are rare. Pancreatic cysts with irregular wall components or a mucinous content raise the suspicion for the presence of a cystic neoplasm, and surgical resection is recommended. A case of a patient with a history of prostate cancer is described in whom a cyst of the pancreatic tail was discovered incidentally. Based on the radiographic features, which did not support the presence of a serous cystadenoma, a spleen-preserving distal pancreatectomy was performed. Histologic features were characteristic for a lymphoepithelial cyst (LEC) of the pancreas, lined with thinned squamous epithelium surrounded by benign lymphoid tissue. Since LECs of the parotid gland, which are associated with acquired human immunodeficiency, are frequently related to Epstein-Barr virus (EBV) infection, EBV in situ hybridization was performed and did not reveal evidence for EBV. Twenty-eight instances of pancreatic LECs have been reported, primarily affecting adult males, without evidence of increased numbers of EBV-positive cells. The pathogenesis, differential diagnosis, and clinical implications of lymphoepithelial pancreatic cysts are discussed.- - - - - - - - - - ranking = 0.52404220722819keywords = adenoma, gland (Clic here for more details about this article) |
7/333. Hepatobiliary cystadenoma presenting with intermittent inferior vena caval obstruction.Hepatobiliary cystadenomas are rare benign tumours. They form as multilocular cysts in and around the liver. Their presentation is usually at a late stage when their size causes symptoms. We report a case of a 44-year-old woman presenting with abdominal pain, which was attributed to a multiloculate liver cyst. After intially refusing surgery she relented once intermittent inferior vena caval obstruction had developed. The cyst was found to be a hepatic cystadenoma.- - - - - - - - - - ranking = 3keywords = adenoma (Clic here for more details about this article) |
8/333. ovarian cysts in childhood.This is a review of cases of ovarian cyst encountered in childhood in the Manchester children's hospitals. The patients presented with acute or recurrent abdominal pain or an abdominal or pelvic mass. The commonest cyst found was a teratoma, which was discovered because of its size or because of a complication. All but one of the girls with teratomas had not reached puberty. After puberty the cysts were follicular or luteal in type, although there was one case of cystadenoma. Complications in the form of torsion, rupture which haemoperitoneum or haemorrhage into the cyst were common. Treatment consisted of ovarian cystectomy, oophorectomy or salpingo-oophorectomy, and the results were satisfactory.- - - - - - - - - - ranking = 0.5keywords = adenoma (Clic here for more details about this article) |
9/333. Intraoral papillary cystadenoma lymphomatosum.The literature related to intraoral papillary cystadenoma lymphomatosum is critically reviewed and the reported cases analyzed to determine the average age, sex, and race of patients, and the site distribution of this curious lesion. Two new cases are reported. The histogenesis and differential diagnosis from cystadenocarcinoma are briefly discussed.- - - - - - - - - - ranking = 2.5keywords = adenoma (Clic here for more details about this article) |
10/333. A chylous cyst of the mesentery: report of a case.A case is presented of an adult chylous cyst of the mesentery that was preoperatively diagnosed to be a pancreatic cystadenoma. A 66-year-old asymptomatic male was followed up for 15 months under the diagnosis of a benign pancreatic cyst. On October 1997, computed tomography showed a 45 x 40 mm cystic mass in the upper abdomen which came in contact with the pancreas. Endoscopic ultrasonography revealed a multilocular mass with a 7 x 4 mm elevated lesion. Endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography revealed the cystic mass to be unrelated to the pancreatic duct. The preoperative diagnosis was a pancreatic cystadenoma or cystadenocarcinoma. A laparotomy showed a 50 x 40 mm cystic mass containing chylous fluid, that arose from the mesentery of the upper part of the jejunum. The pathological diagnosis was a chylous cyst of the mesentery. The preoperative diagnosis in this case was very difficult because the chylous cyst appeared to be attached to the pancreas and this phenomenon is considered to be extremely rare.- - - - - - - - - - ranking = 1keywords = adenoma (Clic here for more details about this article) |
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