ABSTRACT
Adenocarcinoma of the pancreas presents a major threat with a 5-years survival rate of 5%. Whipple pancreaticoduodenectomy (PD) is the standard procedure for cephalo-pancreatic neoplasm. After an extended resection and reconstruction of superior gastrointestinal tract the digestive physiology might be heavily disrupted. A literature review of metabolic alterations of patients who suffered a major pancreatic resection is performed, regarding micronutrients, lipid absorption and pancreatogenic diabetes. Long-term survivors following PD generally have a satisfactory nutritional status although with subclinical iron, vitamin D and selenium deficiency. These patients should be followed-up also regarding these micronutrients and properly dietary supplemented when necessary, also considering the increased life expectancy. Approximately 17-25% of patients will develop insulin-dependent diabetes but pancreatogenic diabetics have elevated levels of serum insulin and minimal or absent response to food intake, as opposed to a type I diabetics, where insulin serum is normal or elevated and there is an exaggerated response to ingestion of sugar.
Subject(s)
Adenocarcinoma/surgery , Metabolic Diseases/drug therapy , Metabolic Diseases/etiology , Micronutrients/deficiency , Nutritional Status , Pancreatic Neoplasms/surgery , Pancreaticoduodenectomy/adverse effects , Diabetes Mellitus/drug therapy , Diabetes Mellitus/etiology , Eating , Humans , Life Expectancy , Lipid Metabolism , Metabolic Diseases/mortality , Postoperative Period , Quality of Life , Trace Elements/administration & dosage , Vitamins/administration & dosageABSTRACT
Castleman's disease is a rare disorder characterized by proliferation of the lymphoid tissue. Castleman's disease affects both males and females, and may occur at any age. Little is known about how often Castleman's disease actually occurs, other than it is rare, or what causes the disease. The most frequent location of the disease is the mediastinum. The location of the disease in the retroperitoneum is rare and it is usually associated with the generalized form of the disease. We report a case of a 34-year old man with isolated retroperitoneum Castleman's disease of the hyaline-vascular type, which presented as a palpable abdominal mass. The final diagnosis was reached after exploratory laparotomy and resection of the tumor.
