Intraductal tubulopapillary neoplasm (ITPN) of the pancreas with invasive cancer misdiagnosed as a mesenteric cyst for 12 years: a case report and literature review.

INTRODUCTION: An intraductal tubulopapillary neoplasm (ITPN) depicts a distinct entity in the subgroup of premalignant epithelial tumors of the pancreas. Due to the rarity of ITPN, information regarding the disease is currently limited. We present herein a case of pancreatic ITPN with invasive cancer that was misdiagnosed as a mesenteric cyst during a 12-year follow-up period. CASE REPORT: A 23-year-old female initially presented with an incidental asymptomatic 4-cm retroperitoneal cystic lesion in 2005. For 12 years of surveillance, the lesion remained largely unchanged in size (4-5 cm). In 2017, the cystic lesion was found to have grown to 9 cm. The pre-operative diagnosis was highly suggestive of a benign lesion. However, after total resection of the mass was performed, the final diagnosis was pancreatic ITPN with invasive cancer. The patient recovered uneventfully and is disease-free without recurrence at the time of this report (12 months post-surgery). CONCLUSION: The clinicopathologic features of ITPN remain unclear due to its rarity, thus making diagnosis difficult. Clinicians should always consider the possibility of ITPN for cystic lesions located at the retroperitoneum near the tail of the pancreas. More data are needed to understand the disease's long-term outcome to identify clinical and radiological features that can be useful for its diagnosis.

Evaluation of the Combination of Methylprednisolone and Tranilast after Spinal Cord Injury in Rat Models

OBJECTIVE: The aim of our study was to evaluate the neuroprotective functions of the combination therapy using methylprednisolone (MP) and tranilast (TR) after spinal cord injury (SCI) in adult rats. METHODS: Spinal cord compression injury model was achieved using Yasargil aneurysm clip. Rats were divided into control group, MP group, TR group, and combination therapy group using TR and MP. Rat models were assessed for locomotor functional recovery using Basso, Beattie, and Bresnahan (BBB) score, spinal cord water content and myeloperoxidase (MPO) activity 24 hours post SCI, haematoxylin and eosin staining and glial fibrillary acid protein (GFAP) staining at 7 and 14 days post SCI. RESULTS: The spinal cord water content and MPO activity in the combination therapy group was significantly lower than the control group and the individual therapy groups p0.05). At 2 weeks after SCI there was a slight decrease in GFAP expression compared to the first week but the difference was not statistically significant (p>0.05), GFAP expression between the groups was not statistically significant p>0.05. CONCLUSION: Combining MP and TR is therapeutically more effective in improving functional recovery, inhibiting inflammation and glial scar formation after acute SCI.

[A study of correlation between the blood supply types of PHcc on spiral CT and the level of VEGF expression in PHcc].

OBJECTIVE: To study the correlation between the blood supply types of primary hepatocellar carcinoma (PHcc) on Spiral CT and the level of vascular endothelial growth factor (VEGF) expression in PHcc for improvement in treatment strategies and prognostication. METHODS: Forty-five cases of PHcc identified by operation and pathology were investigated. Immunohistochemistry staining in SP was performed. The relationships between blood supply types of PHcc on Spiral CT during dual-phase scanning and the expression levels of VEGF in well-differentiated, moderately differentiated and poorly differentiated PHcc were analyzed. RESULTS: There were four blood supply types of PHcc on Spiral CT. Both the strong positive staining and the positive staining were most frequently seen in the hepatic artery blood supply type, and then were frequently in the double blood supply type, i. e. the hepatic arterial supply combining with the portal blood supply type. The positive staining results were rarely seen in the portal blood supply type and poor blood supply type (P<0.001). And with the escalation of the Edmonson- Steiner histological grades, the VEGF expression levels were shown to increase correspondingly (P < 0.05). CONCLUSION: We can ascertain the blood supply type of PHcc and infer the VEGF expression levels that reflect the PHcc angiogenesis condition and the histological grades by means of Spiral CT during dual- phase scanning. Hence this method is useful for the selection of PHcc treatment plans, including anti-angiogenesis and evaluating the prognosis.