One case report of CT and MR features of pancreatic schwannoma / 中华内分泌外科杂志

Pancreatic schwannoma is extremely rare. In this paper, the clinical, pathological and imaging features of a case of pancreatic schwannoma were retrospectively analyzed and the literatures were reviewed to improve the diagnostic ability.

Value of predictive liver metastasis in pancreatic neuroendocrine neoplasms based on ultrasonographic radiomics / 中华超声影像学杂志

Objective:To explore the predictive value of ultrasound-based radiomics for liver metastasis in pancreatic neuroendocrine tumors (pNEN).Methods:A retrospective analysis was conducted on clinical, pathological, and ultrasound data of 269 pNEN patients confirmed by pathology at Tianjin Medical University Cancer Institute and Hospital from January 2012 to June 2022, including 94 patients with liver metastasis and 175 without liver metastasis. The regions of interest (ROI) were delineated on the maximum diameter section of the tumor using ITKSNAP software, and radiomics features were extracted using Pyradiomics. Radiomics features with an intra-group correlation coefficient greater than 0.90 were retained, and the optimal features were selected using the maximum relevance minimum redundancy (MRMR) algorithm. The dataset was randomly divided into a training set and a validation set in a ratio of 7∶3, and the random forest algorithm (Rfs) was used to predict pNEN liver metastasis. Three models were constructed, including the clinical ultrasound model, the radiomics model, and the comprehensive model that combined clinical ultrasound and radiomics features. The predictive performance of different models for pNEN liver metastasis was analyzed using the ROC curve, and the predictive performance of different models was compared using the Delong test.Results:A total of 874 features were extracted from the ROI, and 12 highly robust radiomics features were retained for model construction based on inter- and intra-observer correlation grading and feature selection. The area under curve(AUC), sensitivity, specificity, and accuracy of the radiomics model, the clinical ultrasound model, and the comprehensive model for predicting liver metastasis in pNEN patients were 0.800, 0.574, 0.789, 0.714; 0.780, 0.596, 0.874, 0.777; and 0.890, 0.694, 0.874, 0.810, respectively. The Delong test showed that the comprehensive model had the best predictive performance, with an AUC superior to that of radiomics model ( Z=3.845, P=0.000 12) and clinical ultrasound model ( Z=3.506, P=0.000 45). Conclusions:The radiomics model based on ultrasound has good performance in predicting liver metastasis in pNEN, and the comprehensive model that combines clinical ultrasound and radiomics features can further improve the predictive performance of the model.

The Outcome of Patients with Different Pancreatic Tumors Treated by Whipple’s Operation at Bangabandhu Sheikh Mujib Medical University

Background: Whipple’s Operation was first introduced by Allan Whipple in the 1930s. During 1960s and 1970’s the mortality rate for the Whipple operation was very high. Pancreatic tumors are one of the important indications for Whipple’s operation. About 85% of patients had adenocarcinoma tumor of the pancreas. 15% of patients had other tumors in the head region. In the Whipple’s operation the head of the pancreas, a portion of the bile duct, the gallbladder and the duodenum is removed. The aim of the study was to find the outcome of patients with different benign and malignant pancreatic tumor who undergone Whipple’s surgery and compare the preoperative finding and postoperative complication.Material & Methods:This study was a cross-sectional observational study which was carried out at the Department of Hepatobiliary and Pancreatic Surgery in Bangabandhu Sheikh Mujib Medical University (B.S.M.M.U), Dhaka, Bangladesh. The study was conducted during the period of August 2010 to July 2012. There were a total of 20 cases.Results:100% having solid pseudo papillary tumor age below 35yrs. After Whipple’s operation for solid pseudo papillary tumor of the pancreas, or benign tumor group, 25% of patients had developed wound infection. But in the case of Whipple’s operation for adenocarcinoma pancreas, 62.25% of patients developed wound infection. At a follow-up after 1 year of Whipple’s surgery, none of the benign tumor cases needed readmission, as all 100% had normal liver function tests, normal levels of CA 19-9, and normal USG findings in the abdomen. On the other hand, 25% of the malignant tumor cases had some form of complication and needed readmission.Conclusion:Most pancreatic tumors were located in the head of the pancreas which can be treated by Whipple’s operation. Adenocarcinoma of the head is the most common indication of surgery and is surgically resect able.

Pancreatic tumor with lung tumor: a case report

According to the global cancer observatory (GLOBOCAN), there were 16,485 new cases of pancreatic cancer in Southeast Asia in 2020, with men (9458 cases) having the highest incidence compare to woman (8320 cases). The death rate from 16,485 cases was 16,167cases (98%). A person's chance of developing pancreatic cancer in addition to other cancers is between 1% to 20%. In this study, we reported a case of pancreatic tumor with lung tumor. A 68 years old woman presented with right quadrant abdominal pain since 1 month ago. The pain occurs randomly, but mostly occur during night. The pain didn’t occur after eat fatty food and during exercise. The pain didn’t relieve by rest. The patient also experienced nausea and vomit. The vomit consist of food and blood. Shecomplains black colored stools and dark yellow urine. She also lost weight from 62 kg to 47 kg. There was history of gastric bleeding in 4 month ago. She was passive smoker. We then did several tests such as complete blood count, blood chemistry, serology, chest x-ray and abdominal CT-scan. The test showed pancreatic tumor with suggestive primary lung tumor. Patient with multiple primary tumor are an extremely rare type of cancer, which need comprehensive approach to both diagnosis and treatment of these numerous primary tumors.

Glucagonoma del páncreas: la piel puede llevarnos al diagnóstico / Pancreatic glucagonoma: observing the skin can lead to diagnosis

Resumen Presentamos el caso de una paciente que tenía un tumor del páncreas -denominado glucagonoma- y cuyo diagnóstico se sospechó por las manifestaciones cutáneas, las cuales nos condujeron realizar una tomografía axial computarizada (TAC). En ella se halló una masa. La paciente se remitió a cirugía y presentó una buena evolución.

Abstract This is a case report of a patient with a pancreatic tumor, known as glucagonoma, whose diagnosis was suspected because of skin manifestations which led to performing a CT scan, finding the mass. She underwent surgery with satisfactory results.

Application perspective of large pathological section coupled with artificial intelligence in the diagnosis of pancreatic tumors / 中华胰腺病杂志

Large pathological sections can display tumors and the para-tumor tissues holistically and completely on one slice, which is beneficial to the whole observation and evaluation of tumors and their surrounding microenvironments, thus gaining a comprehensive understanding about the disease. With the gradual realization of digital pathology and advancement in computational pathology, artificial intelligence has made it possible to achieve accurate and individualized diagnosis and treatment of pancreatic tumors by linking up morphologies of different tumor cells and surrounding microenvironments with various types of data including image omics, gene proteomics and clinical data, which is both an opportunity and a challenge for Chinese researchers.

Laparoscopic spleen-preserving distal pancreatectomy in the treatment of pancreatic benign and borderline tumors / 中华肝胆外科杂志

Objective To study the safety and feasibility of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) in the treatment of pancreatic benign and borderline tumors.Methods The clinical data of 15 patients with preoperative diagnoses of pancreatic benign or borderline tumors who underwent LSPDP in the Jinhua Hospital,Zhejiang University from March 2013 to March 2017 were retrospectively analyzed.The diameter of tumors ranged from 2.6 to 6.8 cm,with an average of 4.4 cm.Results 15 patients were successfully treated with LSPDP.Twelve patients underwent splenic vessels preservation and 3 without splenic vessels preservation.The average operation time was 215 min (160 ～ 270 min).The mean intraoperative blood loss was 340 ml (180 ～700 ml),and the average postoperative hospital stay was 10.5 days (7 ～ 16 days).There was no patient with postoperative abdominal hemorrhage.Three patients developed postoperative pancreatic fistula and they were treated successfully with conservative therapy.Two patients developed splenic infarction,and the splenic infarction improved markedly after two months on CT.The pathological diagnoses showed 9 patients with serous cystadenoma,4 patients with mucinous cystadenoma,1 patient with a pancreatic neuroendocrine tumor and 1 patient with a solid pseudopapillary tumor.There was no recurrence on follow-up which ranged from 6 to 24 months.Conclusions Laparoscopic spleen-preserving distal pancreatectomy was safe and feasible in the treatment of pancreatic benign or borderline tumors.The Kimura procedure should be performed in preference to the Warshaw procedure.

Robot-assisted distal pancreatectomy: a study on 61 patients / 中华肝胆外科杂志

Objective To study the effect of robot-assisted distal pancreatectomy.Methods 63 patients who were originally scheduled for robot-assisted distal pancreatectomy were vetrospectively analyzed from July 2013 to June 2017 in Changhai Hospital.Results The operations were successfully carried out in 61 patients.One patient was converted to open surgery because of extensive adhesions,and another patient underwent local excision of a pancreatic tumor.17 patients underwent robot-assisted spleen-preserving distal pancreatectomy,and 44 patients robot-assisted distal splenopancreatectomy.The mean operative time was 164.1 minutes.The intraoperative blood loss was 153.7 ml.Only 1 patient received 400 ml.of blood transfusion.The rate of postoperative pancreatic fistula was 45.9％.The rates of biochemical fistula and level B fistula were 37.7％ and 8.2％,respectively.No level C fistula was observed.Conclusion Robot-assisted distal pancreatectomywas an efficacious and safe technique with its unique advantages in spleen-preserving operations.

Bazo accesorio intrapancreático que imita tumor de cola de páncreas / Intrapancreatic accessory spleen mimicking a tumor of the pancreatic tail

La presencia de bazos accesorios en la cavidad abdominal es relativamente frecuente (10-15% de la población general). De esos, el 1,7 % puede ser de localización intrapancreática. La existencia de un bazo accesorio intrapancreático obliga a hacer el diagnóstico diferencial con tumores sólidos de la cola de páncreas. Presentamos un caso, resuelto mediante pancreatectomia corporocaudal laparoscópica y realizamos una revisión bibliográfica.

Accessory spleens in the abdominal cavity are relatively frequent (10-15% of the general population). Of these, 1.7% may present intrapancreatic localization. An accessory spleen located in the pancreas requires making a differential diagnosis with solid tumors of the tail of the pancreas. We report on a case treated by laparoscopic pancreatectomy.

Diagnosis and treatment of solid-pseudopapillary tumor of pancreas / 中国现代普通外科进展

Objective:To explore the clinical characteristics,imaging features,biological characteristics,treatment and prognosis of solid-pseudopapillary tumor of pancreas(SPT).Methods:Retrospectively reviewed and analyzed clinical and pathological data of 49 cases of SPT from 2007.3 to 2017.3.Results:Among 49 SPT patients,11 males and 38 females,male-to-female ratio was 1∶3.5,with a mean age of (31.4 ± 13.2)years old.There was nonspecific symptoms among patients.Preoperative imaging help to determine the location of the tumor and make the correct diagnosis,but the nature of the tumor remains to be pathologically confirmed.All of patients renceived surgery,47 patients were treated by radical tumor resection,21 patients presented with postoperative complications,the most common complication was pancreatic fistula.Conclusion:Solid pseudopapillary tumor(SPT) is a rare low grade malignancy more frequent in young women with non-specific clinical characteristics.Preoperative imaging has important significance in the preoperative and differential diagnosis.Most of patients can receive radical resection and have good prognosis.

Initial Experiences using Robot-assisted Distal Pancreatectomy: A Single Institution Study of 28 Patients

PURPOSE: Surgical procedures using robot-assisted surgery, including pancreatic surgery, have recently become popular. This study aimed to report our initial experiences with distal pancreatectomy procedures using the robot-assisted surgery system. METHODS: The clinical records of 28 patients who underwent robot-assisted distal pancreatectomy (RDP) between July 2012 and January 2016 were reviewed. RESULTS: Of the 28 patients, 5 (17.9%) were male and 23 (82.1%) were female. Their ages ranged from 11 to 78 years, with a median age of 44.5 years. The mean diameter of the pancreatic tumors was 3.6 cm. The median operative time was 192.5 (range, 100~390) minutes, and the median blood loss was 200 (range, 50~1,900) ml. All of the 28 RDPs were successfully completed. Spleen preservation was achieved in 16 (57.1%) patients. Clinically significant postoperative pancreatic fistula was detected in 4 (14.3%) patients. Postoperative complications were evident in 5 (17.9%) of the 28 patients. CONCLUSION: Our experiences suggest that RDP is feasible for patients with benign or borderline tumors at the body or tail of the pancreas. It may be considered as an effective surgical procedure for benign or borderline tumors of the pancreas in the future; however, further studies to confirm this are warranted.

Diagnosis and treatment of 48 patients with intraductal papillary mucinous neoplasms of the pancreas / 中华肝胆外科杂志

Objective To investigate the diagnosis and treatment of intraductal papillary mucinous neoplasm (IPMN) of the pancreas.Methods The clinical data of patients with pathologically verified IPMN who underwent surgical treatment between January 2006 to April 2014 in the First Affiliated Hospital of Harbin Medical University were studied retrospectively.There were 27 males and 21 females.The average age was (57.8 ± 8.8) years old.The average caliber of the main pancreatic duct was (1.1 ± 0.6) cm.The average size of the branch duct IPMN was (4.6 ± 1.5) cm.Results 35 patients underwent pancreaticoduodenectomy.Eight patients underwent distal pancreatectomy.Two patients underwent duodenum-preserving pancreatic head resection.Two patients underwent splenic-preserving distal pancreatectomy and one patient underwent total pancreatectomy.No patient died in perioperative period,and the median length of hospital stay after surgery was 14.3 days.Postoperative pathological examination revealed 5 (10.4％) adenoma,12 (25.0％) moderate-grade dysplasia,14 (29.2％) high-grade dysplasia and 17 (35.4％) invasive carcinoma.The postoperative complication rate was 22.9％.The mean follow up period for the noninvasive tumors was 48.9 months,with no recurrence or deaths.The mean follow up period of the invasive tumors was 43.2 months,with 1 death and no recurrence.Conclusions The indications for resection of IPMN should be based on treatment guidelines and on the patient' s general condition.It is suggested that the diagnosis and treatment of IPMN should be conducted in specialized pancreatic surgery centers.

Effective of anticancer mouse monoclonal antibody against hMIC-1 targets pancreatic tumor for nude mice in vivo / 中国比较医学杂志

Objective To investigate a antitumor effects of mouse original monoclonal antibody against hMIC -1 as intravenous administration with human pancreatic tumor in vivo and providing experimental data .Methods The fourty-eight mice were randomized into eight groups for loaded with two pancreatic tumor cell lines panc -1 or sw1990 respectively , and individual tumor growth was observed , antitumor efficacy was evaluated after using mouse original monoclonal antibody against hMIC-1 by intravenous administration .The pathological change with formalin fixed , paraffin embedded tissues section was viewed .Results There was a significant difference in tumor volume and weigt in intravenous injection of mouse original monoclonal antibody against hMIC-1 on load pancreatic tumor with nude mice group compared with that in the control group after four week treatment , and the mouse original monoclonal antibody against hMIC-1 demonstrated a close association between inhibition of tumor volume growth and dose-effective in the two xenograft models examined .Under examined microscope , the pancreatic tumor tissue was destroyed evidently in mouse original monoclonal antibody against hMIC-1 group.Conclusions The antitumor effect of intravenous injection for mouse original monoclonal antibody against hMIC-1 is better than that of systemic using gemcitabine .

Insulinoma, a propósito de dos casos / Insulinoma, a propos of two cases

El Insulinoma es el tumor neuroendocrino pancreático más frecuente. Se manifiesta por signos adrenérgicos y de neuroglucopenia. Su diagnóstico se confirma documentando la existencia de hipoglucemia junto a una inapropiada secreción de insulina. Se desarrollan a partir de las células de los islotes de Langerhans. Tanto los funcionantes como los no funcionantes son embriológica e histológicamente muy similares y sólo difieren en su capacidad para producir o no hormonas. Presentamos 2 casos de insulinomas cuya localización tumoral no fue posible con técnicas de imagen convencionales, pero sí con ultrasonografía transoperatoria. La evolución fue favorable con remisión total de los síntomas(AU)

Insulinoma is the most common neuroendocrine pancreatic tumor. It manifests with adrenergic and neuroglycopenia signs. Its diagnosis is confirmed by documenting the existence of hypoglycemia together with inadequate insulin secretion. They developed from Langerhans islet cells and both functioning and non-functioning ones are embryologically and histologically very similar and just differ in their capacity to produce hormones or not. Here are two insulinoma cases where tumoral location was not possible with the conventional imaging techniques but with transoperative ultrasonography. The progression was favorable with total remission of symptoms(AU)

Tumor sólido pseudopapilar del páncreas: estudio descriptivo de una serie de casos / Solid pseudopapilary tumors of the pancreas: descriptive study of a case series

Background: Rare neoplasm that occurs most often in young women, neoplasm with low degree of malignancy. Aim: to describe the clinical characteristics and postoperative results and long-term in a series of patients. Material and Methods: Descriptive study of patients with confirmed histological diagnosis operated at our hospital between January 2000 and June 2011. Biodemographical, preoperative, clinical, surgical technique and postoperative results were recorded. Results: 11 patients, ten of them female, with an average age of 28 years (14-43 years). The most common symptom was abdominal pain. Nine patients had lesions of the body and tail of pancreas and 2 patients had lesions in head of pancreas. Corporo-caudal pancreatectomia were done in 9 cases (6 laparoscopic surgeries) and 2 pancreatoduodenectomy (1 totally laparoscopic). The average size of tumors was 5.5 cm (2.2-13 cm), the margin was negative in all cases and no positive lymph nodes. Six patients had a complication: 4 pancreatic fistulas (type A) which were controlled with drainage installed during surgery. One patient had postoperative abdominal collection requiring laparoscopic drainage. There was no operative mortality in this series. The average follow-up was 21 months (5-93 months). There was no recurrence or mortality at the end of follow-up. Conclusions: Is an uncommon neoplasm and occurs primarily in young women. The complete surgical resection is the best treatment, and can be done by lapa-roscopy surgery with low morbidity.

Introducción: Es una neoplasia poco frecuente, con bajo grado de malignidad, se presenta principalmente en mujeres jóvenes. El objetivo de este estudio es describir las características clínicas y los resultados postoperatorios a corto y largo plazo de una serie de pacientes intervenidos en nuestro centro. Material y Método: Estudio descriptivo de pacientes con diagnóstico histológico confirmado, operados en nuestro hospital entre enero de 2000 y junio de 2011. Se consignaron variables biodemográficas, estudio preoperatorio, manifestaciones clínicas, técnica quirúrgica y resultados postoperatorios. Resultados: La serie está constituida por 11 pacientes, diez de ellas de sexo femenino y con una edad promedio de 28 años (14-43 años). El síntoma más frecuente fue el dolor abdominal. Nueve pacientes presentaron lesiones córporocaudales del páncreas y 2 tumores de la cabeza del páncreas. Se realizaron 9 pancreatectomías córporocaudales (6 laparoscópicas) y 2 duodenopancreatectomías (1 totalmente laparoscópica). El tamaño promedio de los tumores fue 5,5 cm (2,2-13 cm), el margen fue negativo en todos ellos y no había linfonodos positivos. Seis pacientes presentaron alguna complicación: 4 fístulas pancreáticas (tipo A) que fueron controladas con el drenaje instalado durante la cirugía. Un paciente presentó una colección abdominal postoperatoria que requirió de drenaje laparoscópico. No hubo mortalidad operatoria en esta serie. El seguimiento promedio fue de 21 meses (5-93 meses). No hubo recurrencia ni mortalidad al cierre del seguimiento. Conclusión: El TSP es una neoplasia infrecuente. La resección quirúrgica completa es el tratamiento de elección, puede ser laparoscópica.

Tumor sólido-pseudopapilar del páncreas presentación de 3 casos clínicos / Solid-pseudopapillary tumor of the pancreas presentation of 3 clinical cases

El tumor sólido-pseudopapilar del páncreas (TSPP) es una neoplasia infrecuente (1-2% de los tumores exocrinos), que afecta predominantemente a mujeres jóvenes, con bajo potencial de malignidad (15% da metástasis). Su diagnóstico preoperatorio es difícil, principalmente debido a que a la imagenología no tiene una característica que la pueda diferenciar de otros quistes pancreáticos, por lo que generalmente es un hallazgo histopatológico. El tratamiento quirúrgico presenta buena sobrevida, incluso en presencia de metástasis. Presentamos 3 casos con cuadro clínico, imagenología, tratamiento e histopatología, con el fin de aportar más información, sobre esta infrecuente patología.

The solid-pseudopapillary tumors of the pancreas (TSPP) are a uncommon neoplasm (1-2% of exocrine tumors). Are more frequent in young women and presents a low malignant potential (15% develop metastases). Its preoperative diagnosis is very difficult, because these tumors haven`t radiological features that makes distinguish from the other pancreatic cysts tumors. Usually are a histopathological finding. Surgical therapy provides good survival, even in the presence of metastases. We present 3 cases with clinical, imaging, treatment and histopathology to provide more information about this rare disease.

Manejo paliativo endoscópico de tumor de páncreas con compromiso biliar y duodenal: reporte de un caso / Palliative endoscopic management of pancreatic tumor with biliary and duodenal involvement: a case report

Las neoplasias de la región periampular engloban una serie de lesiones que por su cercanía se comportan de manera similar. Entre ellas encontramos a las neoplasias malignas de la ampolla de váter, del duodeno, del colédoco y del páncreas, de éstas el 95% son adenocarcinomas. El síndrome ictérico obstructivo es la forma de presentación más frecuente. Otras de las formas de presentación es la obstrucción de tracto de salida gástrico debido a infiltración del duodeno en cerca del cinco 5% de los pacientes. En la actualidad, la única opción curativa para esta enfermedad es la resección quirúrgica: la pancreatoduodenectomía. El tratamiento paliativo de elección, desde la descripción realizada por Soehendra para el manejo de la obstrucción biliar, en la actualidad es el drenaje endoscópico...

Periampullary region neoplasm`s encompasses a series of injuries, because of its proximity they behave similarly. Among them we find malignant neoplasm of the ampulla of Vater, duodenum, bile duct and pancreas; 95% of these are adenocarcinomas. Pancreatic cancer is the most common of these tumors, constituting the fifth leading cause of cancer deaths. The obstructive jaundice syndrome is the most common presentation. Other presentation is the obstruction of gastric outflow due to infiltration of the duodenum in about 5% of patients. Currently, the only curative option for this disease is surgical resection (pancreaticoduodenectomy), the palliative treatment of choice...

Value of proteomics technology in diagnosis of pancreatic cancer / 国际外科学杂志

Pancreatic cancer is a highly malignant tumor of digestive tract which early diagnose is very difficult and has low rate of surgical resection of advanced pancreatic cancer. However, the rate of postoperative recurrence and metastas is high. Its prognosis is poor. To improve the prognosis of pancreatic cancer , it is necessary to improve its early diagnosis and effective prediction of postoperative recurrence and metastasis. In recent years, with the development of proteomics, the early diagnosis of pancreatic cancer and its early diagnosis of recurrence and metastasis was possible. Wsing proteomics technology for protein differences screening, isolation and identification is conductive to early detection of pancreatic proteome changes and establishment of the markers for early diagnosis, and recurrence and metastasis of pancreatic cancer.

A Case of Atypical Solid-pseudopapillary Tumor of the Pancreas / 대한소화기학회지

Solid-psudopapillary tumor is an uncommon pancreatic neoplasm of low malignant potential that most frequently affect young woman. Solid-psudopapillary tumor are histologically, clinically, and prognostically quite distinct from the more common ductal adenocarcinoma. Recently, we experienced a 36-year-old male who was suspected to have extrapancreatic tumor based on atypical radiologic imaging study, young age, and male sex, and finally diagnosed as solid-psudopapillary tumor on immunohistochemical stain examination. We report this case with review of the relevant literatures.

F-18 FDG PET/CT Finding in Solid Pseudo-papillary Tumor of the Pancreas 6 years After Initial Diagnosis / 핵의학분자영상

Solid pseudo-papillary tumor (SPT) is a rare pancreatic neoplasm with low malignant potential, which tends to occur predominantly in younger females. Only a few cases of SPT seen on F-18 FDG PET scan have been reported, and the findings are not fully evaluated. A 33 year-old woman underwent F-18 FDG PET/CT study for staging of renal cell carcinoma. She was diagnosed with SPT of the pancreas 6 years ago, and has not had any treatment so far. Recent PET/CT showed marked F-18 FDG uptake in the peripheral solid portion and relatively less F-18 FDG uptake to the central calcified portion of SPT. We report one case of SPT of the pancreas on F-18 FDG PET/CT.