Cases reported "Pancreatic Neoplasms"

Filter by keywords:



Filtering documents. Please wait...

1/580. A huge pancreatic cystic adenoma misdiagnosed as an ovarian cyst.

    pancreatic cyst mimicking an ovarian cyst ultrasonographically has not yet been reported. We report an elderly woman with such a huge pancreatic cyst whose initial presentation was low abdominal pain. Ultrasound showed a hypoechoic cyst measuring 13.6 x 13.2 x 11.8 cm occupying pelvic cavity. She received laparotomy under the impression of ovarian cyst. Interestingly, the cyst was found to have originated from the pancreas. Total cyst excision was performed and pathologic report was pancreatic microadenoma. The patient's postoperative course was unremarkable.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

2/580. Treatment of metastatic vipoma by liver transplantation.

    We report the first case of metastatic vipoma treated by orthotopic liver transplantation. A woman with explosive secretory diarrhea causing hypokalemic acidosis was diagnosed as having a vasoactive intestinal peptide secreting tumor with widespread hepatic metastases. The symptoms were initially controlled for 9 months with increasing doses of long-acting somatostatin analogue (Sandostatin, Sandoz Ltd, UK). Alpha interferon was not tolerated, causing an acute paranoid psychosis. Eventually orthotopic liver transplantation was performed with the removal of the primary tumor from the distal pancreas. Postoperatively, complications were associated with the distal pancreatectomy. The patient has no evidence of tumor recurrence on imaging or serum VIP level 12 months posttransplantation.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

3/580. Complete clinical remission in a patient with advanced pancreatic cancer using mitomycin C-based chemotherapy: the role of adjunctive heparin.

    In a patient with advanced pancreatic cancer, with a hypercoagulable state, a complete clinical response was obtained with a mitomycin-based regimen plus adjunctive heparin. The patient converted from a partial response to a complete response with the addition of heparin, raising the possibility that heparin was somehow involved in the process. Recent studies have reported prolongation of survival in patients with cancer who were given heparin along with chemotherapy. The known antiangiogenic and antiproliferative action of heparin may explain this possible synergism. If heparin is, in fact, synergistic with cytotoxic cancer drugs, a fertile field of investigation is open to cooperative groups, especially because long-term heparin therapy is now feasible and safe, the low-molecular-weight heparins even more so.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

4/580. Efficacy of applied cardiovascular surgery techniques for extended resection in hepato-biliary-pancreatic malignancies.

    The application of extracorporeal circulation (ECC) and vascular surgery techniques provide the possibility to resect severely advanced hepato-biliary-pancreatic (HBP) malignancies that had been adjudged unresectable hitherto. In this paper, recent two successful cases are reported for the purpose of indicating the efficacy of ECC and vascular surgery techniques in HBP surgery. Two patients had a cholangiocellular carcinoma and a carcinoma of the pancreatic head, those metastatic lymph nodes invaded to the portal veins and the hepatic arteries. These tumors could be resected en bloc with these Glissonian vessels using a centrifugal pump through veno-venous bypass. Reconstruction of these portal veins was performed with autologous external iliac vein graft. Postoperative angiographies showed no anastomotic leakage or occlusion on vascular anastomotic sites in both cases, and they have gone on uneventful postoperative courses. Application of cardiovascular techniques in the field of HBP surgery might expand surgical indication for advanced malignancies.
- - - - - - - - - -
ranking = 2
keywords = operative
(Clic here for more details about this article)

5/580. Pancreaticobiliary carcinoma associated with a large choledochal cyst: role of MRI and MR cholangiopancreatography in diagnosis and preoperative assessment.

    The role of magnetic resonance (MR) imaging and MR cholangiopancreatography is demonstrated in a case of pancreaticobiliary carcinoma associated with a large choledochal cyst. The size of the cyst presented considerable difficulty in evaluation with both endoscopic retrograde cholangiopancreatography and computed tomography.
- - - - - - - - - -
ranking = 4
keywords = operative
(Clic here for more details about this article)

6/580. 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 = 2
keywords = operative
(Clic here for more details about this article)

7/580. 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 = 1
keywords = operative
(Clic here for more details about this article)

8/580. Intra-operative color Doppler ultrasonography for assessing splenic blood supply during spleen-preserving distal pancreatectomy: a case report.

    A 67 year-old Japanese woman presented with a cystic tumorous lesion, measuring 5 cm in diameter, in the tail of the pancreas. She underwent a spleen-preserving distal pancreatectomy (SPDP), in which the splenic artery and vein were divided because they were involved in scar formation around the lesion. Intra-operative color Doppler ultrasonography (CDUS) confirmed that splenic circulation via collaterals (short gastric and left gastroepiploic vessels) was preserved throughout the salvaged spleen. histology of the resected specimen showed localized pancreatitis with a pseudocyst without neoplastic tissue. The patient's post-operative course was uneventful with no evidence of splenic failure and she was discharged 20 days after the operation. A literature review suggests that SPDP without preserving the splenic artery and vein may result in failure of the preserved spleen due to inadvertent injury to the remaining collaterals. Based on the experience of our case, we think that intra-operative CDUS is useful for assessing splenic circulation after SPDP with division of the splenic artery and vein.
- - - - - - - - - -
ranking = 7
keywords = operative
(Clic here for more details about this article)

9/580. Microcystic adenoma of the pancreas: cytologic appearance on percutaneous and endoscopic ultrasound-guided fine-needle aspiration: report of a case.

    Microcystic adenoma is an uncommon neoplasm of the pancreas usually affecting older people. Its histologic features have been well characterized. The cytologic appearance of this tumor has been described only rarely, however, Microcystic adenomas may enlarge considerably and often produce symptoms related to their compression to adjacent anatomic structures. The fact that this neoplasm is almost always benign indicates the need for accurate preoperative diagnosis to differentiate it from other, more common, malignant or potentially malignant tumors of the pancreas. We present a case of pancreatic microcystic adenoma initially diagnosed by percutaneous image-guided fine-needle aspiration cytologic examination and core biopsy and further evaluated by endoscopic ultrasound-guided fine-needle aspiration on follow-up. This case report illustrates that microcystic adenoma of the pancreas can be accurately diagnosed by aspiration cytology. Fine-needle aspiration--percutaneous, guided by computerized tomography, or endoscopically guided by ultrasonography--constitutes a reliable and cost-efficient diagnostic tool associated with minimal trauma to the patient.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

10/580. Nonoperative management of pancreatic pseudocysts. Problems in differential diagnosis.

    CONCLUSION: The evaluation of pancreatic cystic lesions entails a misdiagnosis risk. awareness of the problem, knowledge of the natural history of these lesions, and meticulous posttreatment follow-up can reduce the consequences of diagnostic errors. If all these precautions are adopted, pancreatic pseudocysts can be safely treated nonoperatively. BACKGROUND: The accurate diagnosis of pancreatic cystic lesions remains a problem. The aim of this study was to ascertain the incidence of and the reasons the diagnostic errors occurred in a series of pseudocysts drained percutaneously and to compare these data to those reported in the literature. methods: Data from 70 patients bearing one or more pseudocysts who underwent a percutaneous drainage were reviewed. The pretreatment workup included medical history, physical examination, ultrasound (US) and computed tomography (CT) scans, amylase assay in both the serum and the cystic fluid, culture and cytology of the cystic fluid. After removal of the drainage, the minimum follow-up period was 12 mo. RESULTS: Four patients died, and two cancer-associated pseudocysts were identified before removal of the drainage. Sixty-four patients were followed up for a mean of 51.9 mo (range 12-154 mo). A third cancer and a mucinous cystic tumor, fully communicating with the main duct, were further detected during this period.
- - - - - - - - - -
ranking = 5
keywords = operative
(Clic here for more details about this article)
| Next ->


Leave a message about 'Pancreatic Neoplasms'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.