Résumé
Acinar cell carcinoma of the pancreas is a rare tumor that constitutes 1~2% of all pancreatic cancers. The clinical and radiologic findings are inconclusive when diagnosing this disease. Acinar cell carcinoma progresses rapidly and metastasizes early, resulting in a poor prognosis. A 41-year-old man was admitted for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography (PET)-CT showed a splenic mass involving the pancreatic tail with increased 18F-fluorodeoxyglucose (18F-FDG) uptake. A primary radical distal pancreatectomy and splenectomy were carried out. The pathology revealed acinar cell carcinoma of the pancreas. Three months later, a gastric recurrence was detected and a total gastrectomy was performed. Four months later, multiple hepatic metastases were found and a left hepatectomy was carried out. During treatment with capecitabine, no evidence of tumor progression was observed for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma that did not progress for 14 months with capecitabine treatment.
Sujets)
Adulte , Humains , Douleur abdominale , Cellules acineuses , Carcinome à cellules acineuses , Désoxycytidine , Fluorouracil , Gastrectomie , Hépatectomie , Métastase tumorale , Pancréas , Pancréatectomie , Tumeurs du pancréas , Tomographie par émission de positons , Pronostic , Récidive , Splénectomie , CapécitabineRésumé
Acinar cell carcinoma is a rare tumor that represents 1~2% of all pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease. Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-old man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased 18F-fluorodeoxyglucose (FDG) uptake. Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the pancreas. The patient underwent a total gastrectomy three months later because of gastric recurrence. Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy. During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabine.
Sujets)
Adulte , Humains , Douleur abdominale , Cellules acineuses , Carcinome à cellules acineuses , Désoxycytidine , Électrons , Fluorouracil , Gastrectomie , Hépatectomie , Métastase tumorale , Pancréas , Pancréatectomie , Tumeurs du pancréas , Récidive , Splénectomie , CapécitabineRésumé
Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its pathogenesis, optimal treatment, and prognosis. A 29-year-old pregnant woman (21 weeks) presented with abdominal discomfort. CA 19-9, CA 125, and CEA were normal. Abdominal CT scanning revealed a 19x15x13 cm retroperitoneal tumor. Exploratory laparotomy and tumor excision were performed. Mucinous retroperitoneal implants were removed as completely as possible. Histologically, the tumor showed focal areas of capsular invasion, but free resection margins. The uterus and both ovaries were normal in appearance. No adjuvant therapy was pursued. Six months later, peritoneal and bilateral ovarian metastases were discovered.Hence, we report the details of this case of primary retroperitoneal mucinous cystadeno-carcinoma and present a review of the literature.
Sujets)
Adulte , Femelle , Humains , Cystadénocarcinome , Cystadénocarcinome mucineux , Laparotomie , Mucines , Métastase tumorale , Ovaire , Femmes enceintes , UtérusRésumé
Cholesterol granuloma is usually described in association with middle ear diseases, but has also been reported to be found in the paranasal sinuses and orbit. It is currently thought that impaired drainage, hemorrhage and inadequate ventilation play significant roles in its pathogenesis. Histopathologic examination of cholesterol granuloma shows abundant foreign body giant cells, cholesterol crystal clefts, histiocytes surrounded by a dense fibrous capsule. We report our endoscopic surgical experience in one female patient with a large cholesterol granuloma of the sphenoid sinus presenting bilateral visual involvement and brain invasion.
Sujets)
Femelle , Humains , Encéphale , Cholestérol , Drainage , Oreille moyenne , Cellules géantes à corps étrangers , Granulome , Hémorragie , Histiocytes , Orbite , Sinus de la face , Sinus sphénoïdal , VentilationRésumé
Somatostatin analogue octreotide is commonly used for the treatment of carcinoid syndrome. Octreotide also has an antiproliferative effect in neuroendocrine tumors and has demonstrated tumor reduction in patients having advanced carcinoid tumor. This is a case report of a patient who had metastatic liver carcinoid tumor and showed marked regression of liver metastasis after octreotide therapy.