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Article: Less common neoplasms of the pancreas.

Mulkeen, Abby-L / Yoo, Peter-S / Cha, Charles

2005 Volume 12, Issue 20, Page(s) 3180–3185

Abstract: ... squamous cell carcinoma, primary lymphoma of the pancreas, and metastatic lesions to the pancreas. These less common ... increase. This review article discusses the clinical course, diagnosis, and treatment of these less common ... Recently, there has been an increased recognition of neoplasms of the pancreas other than ductal ...

Abstract	Recently, there has been an increased recognition of neoplasms of the pancreas other than ductal adenocarcinoma. Although not as well studied or characterized as pancreatic adenocarcinoma there are many distinct lesions which exhibit diverse biological behaviors and varying degrees of malignancy. These lesions include: endocrine neoplasms, cystic tumors, solid pseudopapillary tumors, acinar cell carcinoma, squamous cell carcinoma, primary lymphoma of the pancreas, and metastatic lesions to the pancreas. These less common neoplasms are being diagnosed more frequently as the number and sensitivity of diagnostic imaging studies increase. This review article discusses the clinical course, diagnosis, and treatment of these less common, but quite relevant, neoplasms of the pancreas.
MeSH term(s)	Adenocarcinoma, Mucinous/diagnosis ; Adenocarcinoma, Mucinous/therapy ; Carcinoma, Acinar Cell/diagnosis ; Carcinoma, Acinar Cell/therapy ; Carcinoma, Papillary/diagnosis ; Carcinoma, Papillary/therapy ; Carcinoma, Squamous Cell/diagnosis ; Carcinoma, Squamous Cell/therapy ; Cystadenoma, Mucinous/diagnosis ; Cystadenoma, Mucinous/therapy ; Cystadenoma, Serous/diagnosis ; Cystadenoma, Serous/therapy ; Endocrine Gland Neoplasms/diagnosis ; Endocrine Gland Neoplasms/therapy ; Humans ; Lymphoma/diagnosis ; Lymphoma/therapy ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/therapy
Language	English
Publishing date	2005-07-20
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2185929-2
ISSN	2219-2840 ; 1007-9327
ISSN (online)	2219-2840
ISSN	1007-9327
DOI	10.3748/wjg.v12.i20.3180
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Article ; Online: Pancreatic Cysts - Part 2: Should We Be Less Cyst Centric?

Lennon, Anne Marie / Canto, Marcia Irene

Pancreas

2017 Volume 46, Issue 6, Page(s) 745–750

Abstract: The management of pancreatic cysts is a common problem faced by physicians and surgeons ... often misdiagnosed as branch duct intraductal papillary mucinous neoplasms. Although most are MPCs ...

Abstract	The management of pancreatic cysts is a common problem faced by physicians and surgeons. Pancreatic cysts are important because some of them are mucin-producing cysts (MPCs), which may harbor or develop pancreatic ductal adenocarcinoma. Thus, accurate classification of pancreatic cysts and diagnosis of MPCs offer a potential for the prevention or early detection of pancreatic cancer. However, the diagnosis and management of asymptomatic pancreatic cysts are complicated by 2 factors. First, incidentally detected pancreatic cysts are often misdiagnosed as branch duct intraductal papillary mucinous neoplasms. Although most are MPCs, there are other types of cysts, such as serous cystadenomas, which are managed differently. Second, only a minority of MPCs will ultimately develop into invasive pancreatic ductal adenocarcinoma. Thus, on the one hand, pancreatic cysts offer a unique opportunity to identify precursors to pancreatic cancer and improve outcomes. On the other hand, misdiagnosis and overzealous testing or unnecessary surgery may lead to high cost and harm to patients. Several guidelines have been developed by various groups for the management of pancreatic cysts. In this article, we review the strengths and weaknesses of the American Gastroenterology Association guidelines, highlight key recommendations requiring further validation, and provide our balanced approach to diagnosing and managing pancreatic cysts.
MeSH term(s)	Biomarkers, Tumor/analysis ; Biomarkers, Tumor/genetics ; Consensus ; Diagnosis, Differential ; Diagnostic Imaging/standards ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/standards ; Evidence-Based Medicine/standards ; Gastroenterology/standards ; Humans ; Incidental Findings ; Neoplasms, Cystic, Mucinous, and Serous/diagnosis ; Neoplasms, Cystic, Mucinous, and Serous/therapy ; Pancreatic Cyst/diagnosis ; Pancreatic Cyst/therapy ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/therapy ; Practice Guidelines as Topic ; Predictive Value of Tests ; Risk Factors ; Treatment Outcome
Chemical Substances	Biomarkers, Tumor
Language	English
Publishing date	2017
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	632831-3
ISSN	1536-4828 ; 0885-3177
ISSN (online)	1536-4828
ISSN	0885-3177
DOI	10.1097/MPA.0000000000000841
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Article ; Online: Imaging features of the less common pancreatic masses.

Hammond, Nancy A / Miller, Frank H / Day, Kevin / Nikolaidis, Paul

Abdominal imaging

2013 Volume 38, Issue 3, Page(s) 561–572

Abstract: ... benign and malignant, pancreatic neoplasms. ... frequently seen pancreatic adenocarcinoma, neuroendocrine tumors of the pancreas and cystic lesions ... in the pancreas. The purpose of this pictorial essay is to review the imaging findings of a variety of uncommon ...

Abstract	Contrast-enhanced multiphase CT and dynamic gadolinium-enhanced MR have been validated in the literature as outstanding modalities for the evaluation of pancreatic pathology. In addition to the more frequently seen pancreatic adenocarcinoma, neuroendocrine tumors of the pancreas and cystic lesions such as serous and mucinous cystadenomas and IPMNs, a variety of benign and malignant lesions may occur in the pancreas. The purpose of this pictorial essay is to review the imaging findings of a variety of uncommon, benign and malignant, pancreatic neoplasms.
MeSH term(s)	Adenocarcinoma, Mucinous/diagnosis ; Carcinoma, Acinar Cell/diagnosis ; Cholangiopancreatography, Magnetic Resonance ; Giant Cell Tumors/diagnosis ; Humans ; Lipoma/diagnosis ; Magnetic Resonance Imaging ; Pancreatic Neoplasms/diagnosis ; Plasmacytoma/diagnosis ; Tomography, X-Ray Computed
Language	English
Publishing date	2013-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1144553-1
ISSN	1432-0509 ; 0942-8925
ISSN (online)	1432-0509
ISSN	0942-8925
DOI	10.1007/s00261-012-9922-2
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Article ; Online: Less Aggressive Surgical Procedure for Treatment of Solid Pseudopapillary Tumor: Limited Experience from a Single Institute.

Zhang, Chi / Liu, Fangfeng / Chang, Hong / Li, Hongguang / Zhou, Xu / Lu, Jun / Qin, Chengkun / Sun, Yongjie / Sun, Huidong / Lin, Jianbo

PloS one

2015 Volume 10, Issue 11, Page(s) e0143452

Abstract: ... of the tumor was 7.2 cm (range: 3-15 cm), and most tumor were commonly located in the head of pancreas (n = 29 ... malignant tumor with excellent prognosis. If feasible, less aggressive resection without regular ...

Abstract	Objectives: To evaluate the clinical characteristics and radiological features of solid pseudopapillary tumor (SPT) and assess surgical therapy strategy. Methods: A retrospective review was performed in 62 patients pathologically confirmed of SPT treated between 2003 and 2014. The clinical features, radiological examinations and surgical strategies were analyzed. Results: 56 females and 6 males were included in this study, mean age was 26 years old (range: 8-66 years old) with mean size of the tumor was 7.2 cm (range: 3-15 cm), and most tumor were commonly located in the head of pancreas (n = 29). Among all the cases, 3 patients had liver metastasis and underwent resection of SPT and liver metastasis. Furthermore, we performed 29 cases of local tumor excision; other patients underwent pancreaticoduodenectomy, middle pancreatectomy, middle pancreatectomy with splenectomy, distal pancreatectomy with spleen preservation, distal pancreatectomy with splenectomy and duodenum-preserving pancreatic head resection. No patient suffered from lymph node metastases. After median follow-up of 46 months (range: 2-135 months), no mortality or local recurrence or distant metastasis was found. Conclusions: Solid pseudopapillary tumor is a latent malignant tumor with excellent prognosis. If feasible, less aggressive resection without regular lymphadenectomy is recommended for treatment of patients with SPT.
MeSH term(s)	Adolescent ; Adult ; Aged ; Carcinoma, Papillary/diagnostic imaging ; Carcinoma, Papillary/surgery ; Child ; Demography ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/surgery ; Preoperative Care ; Radiography, Abdominal ; Survival Analysis ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2015
Publishing country	United States
Document type	Journal Article
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0143452
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Article: Magnetic resonance imaging of less common pancreatic malignancies and pancreatic tumors with malignant potential.

Franz, D / Esposito, I / Kapp, A-C / Gaa, J / Rummeny, E J

European journal of radiology open

2014 Volume 1, Page(s) 49–59

Abstract: ... In this article we present a selection of less common malignant and potentially malignant pancreatic neoplasms ... Pancreatic tumors are an increasingly common finding in abdominal imaging. Various kinds ... of pathologies of the pancreas are well known, but it often remains difficult to classify the lesions ...

Abstract	Pancreatic tumors are an increasingly common finding in abdominal imaging. Various kinds of pathologies of the pancreas are well known, but it often remains difficult to classify the lesions radiologically in respect of type and grade of malignancy. Magnetic resonance imaging (MRI) is the method of choice for the evaluation of pancreatic pathologies due to its superior soft tissue contrast. In this article we present a selection of less common malignant and potentially malignant pancreatic neoplasms with their characteristic appearance on established MRI sequences with and without contrast enhancement.
Language	English
Publishing date	2014-09-27
Publishing country	England
Document type	Journal Article ; Review
ISSN	2352-0477
ISSN	2352-0477
DOI	10.1016/j.ejro.2014.09.002
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Article ; Online: Less morbidity after pancreaticoduodenectomy of patients with pancreatic cancer.

Satoi, Sohei / Takai, Soichiro / Matsui, Yoichi / Terakawa, Naoyoshi / Iwaki, Ryuji / Fukui, Jyunichi / Yanagimoto, Hiroaki / Takahashi, Kanji / Toyokawa, Hideyoshi / Araki, Hiroshi / Kwon, A-Hon / Kamiyama, Yasuo

Pancreas

2006 Volume 33, Issue 1, Page(s) 45–52

Abstract: ... with pancreatic cancer. Among all complications evaluated, pancreatic fistula and abdominal abscess were found less ...

Abstract	Objectives: The pancreaticoduodenectomy with extended resection has been frequently performed in patients with pancreatic cancer in Japan. One result of this additional surgical stress may be that postoperative complications in patients with pancreatic cancer are more frequent than in patients with periampullary cancer. Methods: The 198 patients with pancreatic and periampullary cancer underwent pancreaticoduodenectomy. The operative mortality and morbidity between patients with pancreatic and periampullary cancer were compared, and the risk factors of postoperative complications and in-hospital death were determined. Results: Patients with pancreatic and periampullary cancer made up 52% and 48% of total patients. The duration of surgery and volume of intraoperative blood loss were significantly higher in patients with pancreatic cancer than in patients with periampullary cancer. Additional organ resections were frequently performed in patients with pancreatic cancer. However, significantly lower morbidity rates were observed in patients with pancreatic cancer. Among all complications evaluated, pancreatic fistula and abdominal abscess were found less frequently in patients with pancreatic cancer. Logistic regression analyses showed a positive correlation between periampullary cancer and an increased risk of complications, pancreatic fistula, and abdominal abscess. The in-hospital mortality rate has significantly reduced since 2000. When pancreatic fistula was clinically diagnosed, we immediately started a closed lavage using continuous administration of natural saline at 1000 to 4000 mL/d, after exchange of a nasogastric tube drain. Conclusion: Pancreaticoduodenectomy for patients with pancreatic cancer can be a safe procedure in spite of surgical stress. Further surgical strategies will be needed to reduce postoperative complications, especially in patients with periampullary cancer.
MeSH term(s)	Abdominal Abscess/epidemiology ; Abdominal Abscess/mortality ; Adult ; Aged ; Aged, 80 and over ; Ampulla of Vater ; Common Bile Duct Neoplasms/mortality ; Common Bile Duct Neoplasms/surgery ; Female ; Hospital Mortality ; Humans ; Incidence ; Male ; Middle Aged ; Pancreatic Fistula/epidemiology ; Pancreatic Fistula/mortality ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/surgery ; Pancreaticoduodenectomy ; Postoperative Complications/epidemiology ; Postoperative Complications/mortality ; Reoperation ; Retrospective Studies ; Risk Factors
Language	English
Publishing date	2006-07
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	632831-3
ISSN	1536-4828 ; 0885-3177
ISSN (online)	1536-4828
ISSN	0885-3177
DOI	10.1097/01.mpa.0000234645.64483.5c
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Article ; Online: Magnetic resonance imaging of less common pancreatic malignancies and pancreatic tumors with malignant potential

D. Franz / I. Esposito / A.-C. Kapp / J. Gaa / E.J. Rummeny

European Journal of Radiology Open, Vol 1, Iss C, Pp 49-

2014 Volume 59

Abstract	Pancreatic tumors are an increasingly common finding in abdominal imaging. Various kinds of pathologies of the pancreas are well known, but it often remains difficult to classify the lesions radiologically in respect of type and grade of malignancy. Magnetic resonance imaging (MRI) is the method of choice for the evaluation of pancreatic pathologies due to its superior soft tissue contrast. In this article we present a selection of less common malignant and potentially malignant pancreatic neoplasms with their characteristic appearance on established MRI sequences with and without contrast enhancement.
Keywords	Medical physics. Medical radiology. Nuclear medicine ; R895-920
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
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Article ; Online: High-grade dysplasia and adenocarcinoma are frequent in side-branch intraductal papillary mucinous neoplasm measuring less than 3 cm on endoscopic ultrasound.

Wong, Joyce / Weber, Jill / Centeno, Barbara A / Vignesh, Shivakumar / Harris, Cynthia L / Klapman, Jason B / Hodul, Pamela

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2012 Volume 17, Issue 1, Page(s) 78–84; discussion p.84–5

Abstract: Background: Surgical resection for intraductal papillary mucinous neoplasm (IPMN) of the pancreas ... of life, and there was a slight female predominance (55 vs. 45 %). The most common presenting symptom was ... for resection, indications for resection of side-branch IPMN (SDIPMN) have been less clear. We reviewed ...

Abstract	Background: Surgical resection for intraductal papillary mucinous neoplasm (IPMN) of the pancreas has increased over the last decade. While IPMN with main duct communication are generally recommended for resection, indications for resection of side-branch IPMN (SDIPMN) have been less clear. We reviewed our single institutional experience with SDIPMN and indications for resection. Methods: Patients who underwent resection for IPMN were identified from a prospectively maintained IRB-approved database. Patients with main pancreatic duct communication were excluded. Outcome, clinical and pathologic characteristics were correlated with endoscopic ultrasound (EUS) findings. Results: From 2000 to 2010, 105 patients who underwent preoperative EUS evaluation and resection for SDIPMN were identified. The mean age was within the sixth decade of life, and there was a slight female predominance (55 vs. 45 %). The most common presenting symptom was abdominal pain (N = 47, 45 %), followed by jaundice (N = 24, 23 %) and weight loss (N = 24, 23 %). Only ten patients (10 %) were asymptomatic at presentation; seven (70 %) had suspicious features on EUS. Of the total cohort, few patients had intracystic septations (N = 27, 26 %) or presence of mural nodules (N = 2, 2 %) on EUS. Of 39 patients who had invasive pancreatic ductal adenocarcinoma (PDAC) on final pathology, EUS-fine needle aspiration (EUS-FNA) demonstrated malignancy in only 21 (54 %). An additional seven (18 %) had EUS-FNA findings of atypia or concern for mucinous neoplasm. EUS evaluation of cyst size was correlated with final pathology. Of 70 patients with EUS cyst size <3 cm, 12 (17 %) had a preoperative EUS diagnosis of malignancy. Final pathology revealed 24 (34 %) to have PDAC: 1 of 7 (14 %) patients with cyst size <1 cm, 2 of 19 (11 %) with cyst size 1-2 cm, and 21of 44 (48 %) with cyst size 2-3 cm. Fifteen of 35 (43 %) patients with cyst size >3 cm had PDAC on final pathology. Of the patients with cyst size <3 cm, 16 (23 %) had high-grade dysplasia on final pathology: 3 of 7 (43 %) with cyst size <1 cm, 3 of 19 (16 %) with cyst size 1-2 cm, and 10 of 44 (23 %) with cyst size 2-3 cm. Seven of 35 (20 %) patients with cyst size >3 cm had high-grade dysplasia on final pathology. Although overall survival (OS) at 48 months stratified by EUS cyst size did not significantly differ between groups, patients with PDAC on final pathology had significantly worse OS compared to noninvasive pathology. A total of eight patients (8 %) developed recurrent disease, all of whom had PDAC on final pathology. Conclusion: EUS is a helpful modality for the diagnostic evaluation of SDIPMN. Considering the high incidence of malignancy as well as high-grade dysplasia in SDIPMN greater than 2 cm, EUS features should be used in conjunction with other clinical criteria to guide management decisions. Patients with SDIPMN greater than 2 cm that do not undergo surgical resection may benefit from more intensive surveillance.
MeSH term(s)	Aged ; Carcinoma, Pancreatic Ductal/diagnostic imaging ; Carcinoma, Pancreatic Ductal/mortality ; Carcinoma, Pancreatic Ductal/pathology ; Carcinoma, Pancreatic Ductal/surgery ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Endosonography ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Grading ; Pancreatectomy ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery ; Pancreaticoduodenectomy ; Preoperative Care ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Tumor Burden
Language	English
Publishing date	2012-09-05
Publishing country	United States
Document type	Evaluation Study ; Journal Article
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-012-2017-0
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Article: The mode of lymphatic and local spread of pancreatic carcinomas less than 4.0 cm in size.

Ohta, T / Nagakawa, T / Ueno, K / Kayahara, M / Mori, K / Kobayashi, H / Takeda, T / Miyazaki, I

International surgery

1993 Volume 78, Issue 3, Page(s) 208–212

Abstract: ... the histopathology of 33 patients with invasive ductal adenocarcinoma of the head of the pancreas less than 4 cm ... 8% (28 of 33) patients. Invasion to the common hepatic artery was identified in 9.1% (3 of 33 ... Thus, even patients with small pancreatic cancers which were macroscopically confined to the pancreas showed ...

Abstract	To clarify the mode of lymphatic and local spread of small pancreatic carcinomas, we studied the histopathology of 33 patients with invasive ductal adenocarcinoma of the head of the pancreas less than 4 cm in diameter. Microscopically, lymph node metastases were found in 72.7% (24 of 33) of the patients: 17 patients had lymph node metastases at the first barrier and 7 patients had lymph node metastases at the second barrier. Capsular invasion was present in 21.2% (7 of 33) patients, retroperitoneal invasion in 84.8% (28 of 33) patients. Invasion to the common hepatic artery was identified in 9.1% (3 of 33) patients, and invasion to the portal vein system in 24.2% (8 of 33) patients. In addition, five of the seven patients with lymph node metastases at the second barrier had spread to the periaortic lymph nodes. Thus, even patients with small pancreatic cancers which were macroscopically confined to the pancreas showed microscopic extrapancreatic tumor extension, especially invasion to the retroperitoneal tissues and to the periaortic lymph nodes. This suggests that an aggressive surgical approach, including complete resection of surrounding connective tissues in the retroperitoneum and extensive lymph node dissection, is necessary to improve the surgical therapeutic results even for small pancreatic cancers.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Carcinoma, Ductal, Breast/mortality ; Carcinoma, Ductal, Breast/pathology ; Carcinoma, Ductal, Breast/secondary ; Carcinoma, Ductal, Breast/surgery ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery ; Prognosis ; Survival Rate
Language	English
Publishing date	1993-07
Publishing country	Italy
Document type	Journal Article
ZDB-ID	80343-1
ISSN	0020-8868
ISSN	0020-8868
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Article ; Online: Sarcomatoid carcinoma of the common bile duct presenting as painless jaundice.

Chan, Rachael / Stueck, Ashley / Stewart, Michael / Kohansal, Ali

BMJ case reports

2023 Volume 16, Issue 11

Abstract: A woman in her 70s presented with painless jaundice and index biopsy of a common bile duct (CBD ... to add to the limited literature surrounding this rare CBD neoplasm. ...

Abstract	A woman in her 70s presented with painless jaundice and index biopsy of a common bile duct (CBD) mass obtained by endoscopic retrograde cholangiopancreatography was suspicious for malignant peripheral nerve sheath tumour. Treatment consisted of pancreaticoduodenectomy, and final pathology results were consistent with sarcomatoid carcinoma. Postoperative complications included pancreaticojejunal leak, surgical wound infection, bacteraemia, myocardial injury, and significant ulceration and stricturing of the oesophagus. 14 weeks post-pancreaticoduodenectomy, the patient was found to have a perforated viscus, gastroduodenal leak and diffuse small bowel ischaemia-the patient passed away following emergent laparotomy. We aim to add to the limited literature surrounding this rare CBD neoplasm.
MeSH term(s)	Female ; Humans ; Carcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct/surgery ; Jaundice/etiology ; Pancreas ; Aged
Language	English
Publishing date	2023-11-09
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2023-257167
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