Papillary Cystic and Solid Tumour of Pancreas.

A 15-year old female presented with a progressively increasingly right hypochondrial mass since 3 months. CECT abdomen showed a large well-defined, heterogeneous lesion with specks of calcification and areas of cystic degeneration in the region of head of pancreas. Successful enucleation of the tumour from the head of pancreas was achieved. Histopathology confirmed solid cystic papillary epithelial cystadenoma of pancreas.Papillary cystic and solid tumours of pancreas are a rare, low-grade malignant tumour, typically found in young women. The etiology and cell of origin of this tumour are still not clear. It is important to differentiate this tumour from other pancreatic tumours, as this tumour is amenable to cure after complete surgical resection.

Solid and Papillary Cystic Neoplasm of Pancreas in Children

Solid and papillary cystic neoplasm of pancreas is an uncommon low grade malignant tumor found predominantly in young female in their second or third decade of life, and amenable cure by surgical treatment. The authors report two cases of solid and papillary neoplasm of pancreas pathologically verified at Kyung Hee university hospital. The first case was 11-years old male patient and the other case was 12-years old male patient. Symptoms of two patients were abdominal discomfort, nausea and vomiting and abdominal pain in the female patient. CT finding of solid and papillary neoplasm of pancreas depict a well-demarcated mass with solid and cystic necrosis component. In female patient, large hematoma was shown. Gross findings of tumor revealed apparent encapsulation, cystic degeneration and hemorrhagic necrosis. Microscopically the tumors were characterized by distinctive solid and papillary patterns of cellular arrangement without local invasion. All patients were discharged and follow up without any problem.

Papillary Cystic and Solid Neoplasm of the Pancreas

BACKGROUND: Papillary cystic and solid neoplasm of the pancreas is a relatively rare tumor that usually occurs in young adult women. This tumor is distinct from the usual ductal adenocarcinoma in clinical and histologic features. It has a much more favorable prognosis than other tumors of the pancreas due to a low incidence of metastasis and good resectability. METHODS: We reviewed eight patients who were treated at the Department of Surgery of PNUH (Pusan National University Hospital) from Jan. 1985 to Dec. 1996. RESULTS: Seven patients were women, and one patient was a man; the mean age of the patients was 26.8 years (range: 14 years to 39 years). Their chief complaints were epigastric pain (75%), palpable mass (37.5%), left upper quadrant pain (25%), nausea, and dyspepsia. The results of laboratory studies, including tumor markers (CEA, CA-19-9), were all negative and nonspecific. Although these tumors can occur in any portion of the pancreas, they are usually located in the tail and the body. We also identified these tumors in the tail and the body of the pancreas. In our cases, we treated these tumor by a distal pancreatectomy, a distal pancreatectomy with splenectomy, a Roux-en-Y cystojejunostomy, and enucleation; we didn't observe any morbidity or mortality. After discharge, there was no recurrence. CONCLUSIONS: There is no specifically known orgin or pathogenesis of this tumor, but it is well controlled by surgical removal. At the same time, it is important to do a more aggressive diagnostic work up and to make greater effort, with attention given to papillary cystic and solid tumors, when we meet any cystic tumors of the pancreas.

A Case of a Papillary Cystic Neoplasm of the Pancreas, Communicated by Main Pancreatic Duct / 대한소화기내시경학회지

Papillary cystic neoplasms of the pancreas are uncommon. They occurs almost entirely in young women. Generally, the lesion averages 10 cm 17 size and are usually located in the pancreatic tail, resulting in displacement of the pancreatic duct. A varialbe amount of hemorrhage and liquefaction necrosis occurs, resulting in pseudopapillae cysts. Resection of the tumor is usually associated with a excellent prognosis because of the lack of metastases and rare recurrences. In this report present a case of a papillary cystic neoplasm of the pancreas with a review of references. Unlike most, the neoplasm we discovered was small (about 1.5 x 1.5 cm), and, occured in the pancreatic head of eldcrly woman. Moreover it was communicated by the main pancreatic duct via a side branch.

Two Cases of Papillary Cystic Neoplasm of the Pancreas

Two cases with papillary cystic neoplasm of the pancreas are reviewed and discussed. Up to recently, the tumors have been misclassified as nonfunctioning islet cell tumor or carcinoma, acinar cell carcinoma, papillary cystadenocarcinoma, or pancreatoblastoma. It frequently has been managed with aggressive surgery such as pancreatoduodenectomy. The tumors are well encapsulated and the cut surfaces are characteristically solid and hemorrhagic. Ultrasonography and CT scan are the most useful tools for the diagnosis. The neoplasms usually behave like a very low grade malignancy, so complete removal is the treatment of choice for the tumor arising anywhere in the pancreas. We have a boy and a girl who have papillary cystic neoplasm. The boy was 12 years old and the girl was 14 years old. Both underwent distal panereatectomy and the progress were uneventfuL We have a boy and a girl who have papillary cystic neoplasm. The boy was 12 years old and the girl was 14 years old. Both underwent distal pancreatectomy and the progress were uneventful.

Correlation between proliferating index and prognostic factors in papillary cystic tumors of the pancreas

Fifteen cases of papillary cystic tumor of the pancreas (PCTP) were studied (14 female patients, one male patient; mean age: 23.5 years). Most tumors developed in the head of the pancreas as a well circumscribed large mass. The tumor had a mean diameter of 6.7 cm(range; 2 to 15 cm). Histopathologically abundant delicate papillary fragments, monomorphic tumor cells and degenerative changes of the solid area of the tumor were characteristic. All but two cases had completely circumscribed capsules. Two cases had duodenal invasion; one of all cases had cul de sac metastasis. Compared with 12 non-aggressive tumors, the aggressive cases had larger tumor size (more than 9 cm) with a thicker capsule (more than 2 mm). In studies to investigate the prognostic index using nucleolar organizing region (NOR), proliferating cell nuclear antigen (PCNA) and flow cytometry as well as nuclear grade and mitotic index, we could not find the useful parameter to detect the malignant potential of PCTP. In the flow cytometric analysis of cellular DNA contents, two invasive cases and the only one case of the male patient among the non-aggressive group were aneuploid. In conclusion, although it is hard to predict the prognosis by microscopic findings only, those with a thick capsule and aneuploidy tend to be related to malignant potential.

A Case of Bilateral Ureterocele Combined with Bladder Stone and Papillary, Cystic, Glandular Metaplasia / 대한비뇨기과학회지

Ureterocele, cystic dilatation of the lower end of the ureter, is not a common urogenital disease and occuring more frequently in female than in male. One case of bilateral ureterocele, combined with bladder stone and papillary, cystic, glandular metaplasia, was presented with a brief review of the literature.