A Case of Biliary Cystadenocarcinoma Mistaken for Liver Abscess / 대한소화기학회지

No abstract available.

Neoplasias quísticas pancreáticas / Cystic neoplasms of the pancreas

BACKGROUND: Cystic neoplasms of the pancreas represent between 5% and 10% of all pancreatic tumors. Due to their malignant potential, surgery is indicated. Because of the uncommon nature of this pathology, the aim of this study was to present a series of six patients who were operated on for a cystic tumor and to analyze the morphological characteristics, surgical experience and follow-up. METHODS: This was a retrospective study. Clinical files were studied, as well as surgical and pathological registries from patients diagnosed with cystic neoplasms of the pancreas. Five females and one male were included with a mean age of 54 +/- 15 years. The main symptom was abdominal pain. RESULTS: Clinical course and CT scan results were the criteria for suspecting the diagnosis. In 4/6 patients, the tumor was located within the body and tail of the pancreas. The most frequent intervention was distal pancreatectomy. There was no mediate operative mortality in a 30-day period. Histopathological diagnoses were three serum cystadenomas, two mucinous cystadenomas and one cystadenocarcinoma. After a 4-year follow-up, no tumor recurrences have been reported in the surviving patients. CONCLUSIONS: The natural history of cystic neoplasms of the pancreas is generally benign, but complications may occur by direct invasion of neighboring structures. Clinical course, tomography, pancreatography and punction are fundamental for its treatment.

Bile Duct Cystadenocarcinoma / 대한간학회지

No abstract available.

Neoplasia "borderline" do ovário e gestação: relato de caso / Ovary borderline tumor with pregnancy: a case report

Os autores relatam um caso de uma paciente de 35 anos de idade, tercípara e com história de incompetência istmo-cervical que, durante exames obstétricos iniciais, apresentou massa pélvica à esquerda. A paciente foi encaminhada para o departamento de diagnóstico por imagem, onde se submeteu a avaliação por ultra-sonografia e ressonância magnética. Foi indicada a cirurgia e o tumor foi ressecado, com diagnóstico final de cistadenoma seroso borderline ou de baixo potencial de malignidade. Os principais achados de imagem são descritos e discutidos, associados com breve revisão de literatura.

A case of borderline serous cystadenoma in a 35 years pregnancy woman with previous history of cervix incompetence is reported. This tumor was discovered during initial obstetric exams, and evaluated by ultrasound and magnetic resonance imaging scans. Theauthors describe the clinical and diagnostic finding with a brief review of the literature.

Biliary Cystic Neoplasm: Biliary Cystadenoma and Biliary Cystadenocarcinoma / 대한소화기학회지

Biliary cystic tumors, such as cystadenoma and cystadenocarcinoma, are rare cystic tumors of liver accounting for fewer than 5% of all intrahepatic cysts of biliary origin. Most biliary cystic tumors arise from intrahepatic bile duct and 10-20% arise from extrahepatic bile duct like common hepatic duct, common bile duct, and gallbladder. The first case report of biliary cystic neoplasm in Korea dated back to 1975 by Bae et al, and over 40 cases of cystadenoma and 35 cases of cystadenocarcinoma were reported since then. These tumors usually present in middle-aged women with a mean age of 50 years. Biliary cystadenomas are lined by single layer of cuboidal or columnar epithelium and are very often multilocular with septal or papillary foldings. Over 80% of cystadenoma have dense mesenchymal stroma composed of dense spindle cells, like ovary. The epithelial lining of cystadenocarcinoma exhibits cellular atypia, mitotic activity, and infiltrative growth, but part of lining epithelium retain the feature of cystadenoma, which support the adenoma-carcinoma sequence. The size of tumors varies from 1.5 to 35 cm. Many patients are asymptomatic, except for the presence of palpable mass. When symptoms are present, they include epigastric or right upper quadrant pain or jaundice by enlarged mass. Biliary cystic tumor should be considered when a single or multilocular cystic lesion with papillary infoldings is detected in the liver by computed tomogram (CT) or ultrasound (US). Cystic wall and internal foldings can be seen enhanced by enhanced CT. US reveals a hypoechoic cystic mass with echogenic septation or papillary infoldings. Cystadenocarcinoma should be suspected when there is elevated mass or nodule in the wall or foldings, or thickened cystic wall on CT or US. But it is extremely difficult to differentiate between cystadenoma and cystadenocarcinoma by imaging alone. Increased tumor markers, carcinoembryonic antigen and carbohydrate antigen 19-9, in serum or cystic fluid have been reported in biliary cystic tumor. But tumor markers cannot distinguish cystadenocarcinoma from cystadenoma or both from other cystic lesions of liver. Malignant cells are not usually recovered in patients with cystadenocarcinoma who underwent cystic fluid cytology before and during surgery. The treatment of choice is radical excision of the mass by means of lobectomy or wide tumor excision. Aspiration, marsupialization, and drainage must be avoided. Inadequate excision of both cystadenoma and cystadenocarcinoma may lead to recurrence. Prognosis after complete excision is excellent.

Significances of Serum Level and Immunohistochemical Stain of CA19-9 in Simple Hepatic Cysts and Intrahepatic Biliary Cystic Neoplasms / 대한소화기학회지

BACKGROUND/AIMS: In spite of various diagnostic modalites, biliary cystic neoplasms (biliary cystadenoma and cystadenocarcinoma) remain to be difficult to diagnose preoperatively. Recently, there are some reports that elevated CA19-9 level in serum and/or cystic fluid could be a useful finding in the differential diagnosis of biliary cystic neoplasm. This study aimed to evaluate the expression of CA19-9 and to elucidate its significances in intrahepatic biliary cystic neoplasms and simple hepatic cysts. METHODS: In 8 patients with biliary cystic neoplasms and 6 simple hepatic cysts, symptoms, radiologic and laboratory findings were reviewed retrospectively. In 5 biliary cystic neoplasms (4 bililary cystadenomas, 1 biliary cystadenocarcinoma) and 5 simple hepatic cysts, immunohistochemical stainings for CA19-9 were performed with formalin-fixed, paraffin-embedded tissues. RESULTS: In 8 biliary cystic neoplasms, two cases were suspected as biliary cystadenoma preoperatively and 6 cases could not be distinguished from simple cysts or cholangiocarcinoma preoperatively. In 6 simple hepatic cysts, 3 cases were diagnosed preoperatively and 3 cases could not be distinguished from biliary cystadenoma or pancreatic pseudocyst preoperatively. Expression of CA19-9 in simple hepatic cysts and biliary cystic neoplasms were 80% in both groups. Expression of CA19-9 is not related to the elevated level of CA19-9 in serum. CONCLUSINOS: Our data suggests that the elevated level of CA19-9 in serum may not be helpful in the preoprative diagnosis of biliary cystic neoplasm.

Hilar biliary cystadenocarcinoma: an uncommon hepatic neoplasm.

Biliary cystadenocarcinoma (BCAC) is a rare cystic tumour of the liver; with its benign counterpart, it accounts for <5% of non-parasitic hepatic cysts. Preoperative diagnosis of BCAC is difficult; complete surgical excision is recommended to prevent recurrence or metastasis. We present the case of a 67-year-female with centrally located BCAC involving the right hepatic duct and distorting the hepatic hilum. This report highlights the difficulties in diagnosis, surgical resection, subsequent biliary reconstruction and its outcome.

Combined hepatocellular and cystadenocarcinoma presenting as a giant cyst of the liver--a case report.

Primary cystic lesions of the liver are very rare. Most of the solid tumours are hepatocellular carcinomas (HCC) with a smaller number being cholangiocarcinomas. The association of HCC with other primary liver malignancies is also extremely rare. This case report is about a 27 year old male patient who presented with a giant cystic lesion of the left liver. A CT scan showed a cystic lesion with internal septations and a thrombus in the main portal vein. The patient underwent an extended left hepatectomy and a portal venotomy with removal of the thrombus. Coexistent hepatocellular and cystadenocarcinoma were reported on histopathological examination. The patient was put on 5-FU postoperatively. He is doing well 11 months after surgery.

Pseudomixoma peritoneal y mucocele apendicular secundario a cistadenoma y cistadenocarcinoma del apéndice cecal. Informe de dos pacientes / Peritoneal pseudomyxoma and appendicular mucocele due to cystadenoma and cystadenocarcinoma of the cecal appendix: Report of two patients

Objetivo. Informar nuestra experiencia con dos enfermos de mucocele del apéndice cecal, secundario uno a cistadenocarcinoma y el otro a cistadenoma mucinosos. Sede Hospital General de Zona, segundo nivel de atención médica. Descripción de los casos. Se trató de dos pacientes del sexo femenino, de 54 años de edad, a quienes se les practicó cirugía urgente por abdomen agudo secundario a apendicitis aguda complicada. Las dos presentaron apéndice cecal con gran dilatación, perforación y múltiples adherencias interasa debido a la reacción plastica asociada: en ambas se realizó hemicolectomía derecha con ileostomía debido a que el ciego y colon ascendente se encontraban involucrados. La evolución fue defierente en cada enferma, una de las pacientes requirió de dos reintervenciones quirúrgicas por sepsis residual. El estudio histopalológico informó en una paciente cistadenoma mucinoso y en la otra cistadenocarcinoma también mucinoso. Discusión. El mucocele apendicular es una entidad poco frecuente, está asociado a la formación de quistes de retención, que se generan a partir de neoplasias productoras de mucina como los que se presentan en este informe, las complicaciones incluyen: pseudomixoma y la presencia de gran reacción peritoneal con múltiples adherencias. El tratamiento consiste generalmente en la apendicectomía, sin embargo, en algunos pacientes debe asociarse la hemicolectomía con ileostomía por invasión directa al ciego y colon. Conclusión. Se trata de un problema de aparación espóradica que en muchas ocasiones resulta grave por dificulatades técnicas y manejo quirrúgico

Neoplasia cistica diagnosticada como pseudocisto de pancreas: estudo de cinco casos e revisao da literatura / Cystic tumors mistaken for pancreatic pseudocystic: study of 5 cases and review of literature

Os tumores cisticos do pancreas representam cerca de 9 por cento a 13 por cento de todas lesoes cisticas do pancreas, cerca de 1 por cento das neoplasias pancreaticas e sao predominantes em pacientes do sexo feminino. Uma falha em reconhecer a natureza neoplasica de uma lesao cistica do pancreas pode levar a uma terapeutica incorreta. Este trabalho tem o objetivo de relatar cinco pacientes com tumor cistico que foram erroneamente tratados inicialmente como pseudocisto do pancreas. A idade dos pacientes variou entre 21 e 71 anos, com media de 46 anos. Dos cinco pacientes, tres eram portadores de cistadenoma mucinoso e dois eram portadores de cistadenocarcinoma....

Utilidad del doppler color transvaginal en el diagnóstico de lesiones ováricas / Utility of the transvaginal color Doppler in the ovarian injuries diagnosis

La evaluación de la resistencia vascular por velocimetría doppler es un método de amplio uso en la investigación y clínica. Las lesiones neoplásicas presentan un crecimiento acelerado y gran cantidad de vasos de neoformación. La presencia de estos vasos produce un aumento del área de sección trnsversal del árbol vascular tumoral y por ende una caída de la resistencia. El objetivo de este trabajo es demostrar la utilidad de la velocimetría doppler como factor predictor de malignidad en lesiones tumorales de ovario. Se evaluaron 18 pacientes portadoras de lesiones tumorales de ovario cuyas edades fluctuaban entre 21 y 67 años, promedio=43. Se evaluó por medio de ultrasonido trnasvaginal con velocimetría doppler color y pulsado, el volumen tumoral y la resistencia de los vasos que irrigaban la lesión. Se utilizó para ello el índice pulsatilidad SD/media. Para el análisis estadístico de los datos se utilizó paquete estadístico stat view en un computador macintoch LC II para la prueba de chi cuadrado. Los resultaron mostraron la presencia de tres lesiones tumorales malignas, tres lesiones de bajo potencial maligno y 12 lesiones benignas. Las edades fueron significativamente diferentes entre los grupos benignos y malignos 40,7 vs 52 años, p<0,001. El volumen tumoral fue en promedio 65 ml= 17-225 ml en el grupo de lesiones benignas, y de un promedio de 951 ml= 141-3143 en el grupo de lesiones malignas p<0,001. El índice de pulsatilidad en el grupo benigno fue en promedio 3,48=2,16-6,52 y en el maligno fue 1,54=0,7-3,67 con p<0,02. El análisis de los resultados demuestra que las lesiones tumorales malignas son mas frecuentes en la quinta década de la vida y se presentan mayoritariamente en etapa post-menopáusica. Demuestran, además, que la evaluación de la resistencia vascular tumoral por medio de la velocimetría doppler es un método útil para predecir la malignidad o benignidad de las lesiones tumorales de ovario

Immuno-histological characterization of OVS1 and OVS2 monoclonal antibodies recognizing human ovarian mucinous cystadenocarcinoma.

OVS1 and OVS2 monoclonal antibodies (MAbs) were established by fusing murine myeloma cell line NS1/1-Ag4-1 with mouse spleen cells immunized with fresh human ovarian mucinous-cystadenocarcinoma tissue. The selection of the MAbs was assayed by an immuno-histological (streptavidin-biotin) staining of the specific antigen antibody reaction localized on frozen sections of the same tumor. Other paraffin sections and established cell lines were also screened by immuno-histological staining in order to characterize the specificity and sensitivity of these two MAbs. OVS1 MAb showed 96% specificity and 67% sensitivity to mucinous cystadenocarcinoma with no cross reactions to normal tissue, benign tissue, other cancers, or any established cell lines. OVS2 MAb revealed only 8% specificity but 78% sensitivity to mucinous cystadenocarcinoma, however, a cross reaction to some normal and benign tissues or other cancers was shown. The data suggested that OVS1 and OVS2 MAbs could be used in combination to detect ovarian mucinous cystadenocarcinoma.

Estudo ecográfico dos cistadenomas e cistadenocarcinoma do pâncreas / Ecographic study of cystadenomas and cystadenocarcinomas of the pancreas

Os autores estudam os aspectos ultra sonográficos dos cistadenomas e cistadenocarcinomas do pâncreas observando suas apresentaçöes mais freqüentes. Dividem as alteraçöes em císticas, mistas e sólidas e estabelecem correlaçäo destes tipos com a possibilidade de serem lesöes benignas ou malignas. Säo analisados seus diagnósticos diferenciais mais importantes. Säo descritas outras anomalidades, observadas nestes tumores como trombose de veia esplénica, dilataçäo da árvore biliar e calcificaçöes . Concluem pela importância da ecografia no diangóstico de tumores císticos do pâncreas por contribuir para o estabelecimento da conduta terapêutica adequada