scholarly journals Solid-Pseudopapillary Tumor of the Pancreas: A Single Center Experience

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Valentina Beltrame ◽  
Gioia Pozza ◽  
Enrico Dalla Bona ◽  
Alberto Fantin ◽  
Michele Valmasoni ◽  
...  
Keyword(s):  
Preoperative Diagnosis ◽  
Abdominal Ultrasound ◽  
Diagnostic Tools ◽  
Solid Pseudopapillary Tumor ◽  
Sufficient Information ◽  
Cystic Neoplasms ◽  
Single Center Experience ◽  
Positron Emission ◽  
Institutional Experience ◽  
Solid Pseudopapillary Tumors

Aim of this study was to review the institutional experience of solid-pseudopapillary tumors of the pancreas with particular attention to the problems of preoperative diagnosis and treatment. From 1997 to 2013, SPT was diagnosed in 18 patients among 451 pancreatic cystic neoplasms (3.7%). All patients underwent preoperative abdominal ultrasound, computed assisted tomography, and tumor markers (CEA and CA 19-9) determinations. In some instances, magnetic resonance, positron emission tomography, and endoscopic ultrasound with aspiration cytology were performed. There were two males and 16 females. Serum CA 19-9 was slightly elevated in one case. Preoperative diagnosis was neuroendocrine tumor (n=2), mucinous tumor (n=2), and SPT (n=14). Two patients underwent previous operation before referral to our department: one explorative laparotomy and one enucleation of SPT resulting in surgical margins involvement. All patients underwent pancreatic resection associated with portal vein resection (n=1) or liver metastases (n=1). One patient died of metastatic disease, 77 months after operation, and 17 are alive and free with a median survival time of 81.5 months (range 36–228 months). Most of SPT can be diagnosed by CT or MRI, and the role of other diagnostic tools is very limited. We lack sufficient information regarding clinicopathologic features predicting prognosis. Caution is needed when performing limited resection, and long and careful follow-up is required for all patients after surgery.

Systematic Review Comparing Open versus Endoscopic Surgery in Clival Chordomas and a 10-Year Single-Center Experience

2021 ◽  
Author(s):  
Ravindran Visagan ◽  
Asfand Baig Mirza ◽  
Mohamed Okasha ◽  
Timothy Martyn Boardman ◽  
Eleni Maratos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Management ◽  
Open Surgery ◽  
Literature Search ◽  
Optimal Management ◽  
Total Resection ◽  
Single Center Experience ◽  
Institutional Experience ◽  
Open Versus ◽  
Slow Growing

Abstract Objectives Chordomas are rare, slow-growing, and osteo-destructive tumors of the primitive notochord. There is still contention in the literature as to the optimal management of chordoma. We conducted a systematic review of the surgical management of chordoma along with our 10-year institutional experience. Design A systematic search of the literature was performed in October 2020 by using MEDLINE and EMBASE for articles relating to the surgical management of clival chordomas. We also searched for all adult patients surgically treated for primary clival chordomas at our institute between 2009 and 2019. Participants Only articles describing chordomas arising from the clivus were included in the analysis. For our institution experience, only adult primary clival chordoma cases were included. Main Outcome Measures Patients were divided into endoscopic or open surgery. Rate of gross total resection (GTR), recurrence, and complications were measured. Results Our literature search yielded 24 articles to include in the study. Mean GTR rate among endoscopic cases was 51.9% versus 41.7% for open surgery. Among the eight cases in our institutional experience, we found similar GTR rates between endoscopic and open surgery. Conclusion Although there is clear evidence in the literature that endoscopic approaches provide better rates of GTR with fewer overall complications compared to open surgery. However, there are still situations where endoscopy is not viable, and thus, open surgery should still be considered if required.

scholarly journals Surgery for Cystic Pancreatic Lesions in the Post-Sendai Era: A Single Institution Experience

HPB Surgery ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Jörg Kleeff ◽  
Christoph Michalski ◽  
Bo Kong ◽  
Mert Erkan ◽  
Susanne Roth ◽  
...  
Keyword(s):  
Preoperative Diagnosis ◽  
Postoperative Morbidity ◽  
Intraepithelial Neoplasia ◽  
Cystic Tumor ◽  
Diagnostic Challenge ◽  
Branch Duct ◽  
Cystic Neoplasms ◽  
Biological Behaviour ◽  
Risk Of Malignancy ◽  
Cystic Pancreatic Lesions

Introduction. The management of cystic pancreatic lesions has changed in recent years as a result of increasing knowledge of their biological behaviour, better diagnostic options, and international guidelines. Methods. Retrospective analysis of a cohort of 86 patients operated for cystic pancreatic lesions during a seven-year period (2007–2014). Results. Final histopathology revealed 53 intraductal papillary mucinous neoplasms (19 branch duct IPMNs, 15 mixed type IPMNs, and 19 main duct IPMNs), 14 serous and 13 mucinous cystic neoplasms, 3 solid pseudopapillary neoplasms, and 3 other lesions. 4 cases displayed high grade intraepithelial neoplasia and 2 cases displayed invasive cancer. A pylorus-preserving partial duodenopancreatectomy was carried out in 27 patients, a total pancreatectomy was carried out in 9 patients, a left resection was carried out in 42 patients, and segmental resections and enucleations were carried out in 4 patients each. Overall postoperative morbidity and mortality were 40% and 2.3%, respectively. The preoperative diagnosis of a specific cystic tumor was accurate in 79% of patients and 9 patients (10%) could have avoided surgery with the correct preoperative diagnosis. Conclusion. Cystic pancreatic lesions are still a diagnostic challenge, requiring a dedicated multidisciplinary approach. The rate of malignancy is relatively small, whereas postoperative morbidity is substantial, underscoring the importance of adequate patient selection considering both the risk of surgery and the long term risk of malignancy.

The Differentiation between Pancreatic Neoplastic Cysts and Pancreatic Pseudocyst

2005 ◽  
Vol 94 (2) ◽  
pp. 161-164 ◽  
Author(s):  
J. Sand ◽  
I. Nordback
Keyword(s):  
Pancreatic Pseudocyst ◽  
Emission Tomography ◽  
Cystic Lesions ◽  
Imaging Studies ◽  
Cystic Neoplasms ◽  
Fluid Analysis ◽  
Positron Emission ◽  
Serous Cystadenomas ◽  
History Of ◽  
Quality Imaging

The number of small and often asymptomatic cystic lesions detected in pancreas has increased during the last decade. Historically the vast majority of the pancreatic cystic lesions were considered pseudocysts, but in recent series the incidence of various neoplastic cysts, such as intraductal papillary mucinous neoplasm, serous cystadenomas and cystic endocrine tumours, has increased. The possible malignant potential in these cystic neoplasms warrants careful diagnostic workup to choose the optimal treatment for each patient. Patient's age, symptoms and a possible history of acute or chronic pancreatitis with known aetiology together with high quality imaging studies are important in the differential diagnosis between pseudocysts and neoplastic cysts. Endoscopic ultrasound, cyst fluid analysis and positron emission tomography may be used in selected patients, but the accuracy of these methods needs further investigation.

scholarly journals An update on preoperative assessment of the resectability of advanced ovarian cancer

2019 ◽  
Vol 41 (3) ◽  
Author(s):  
Philippe Kadhel ◽  
Aurélie Revaux ◽  
Marie Carbonnel ◽  
Iptissem Naoura ◽  
Jennifer Asmar ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Residual Disease ◽  
Advanced Ovarian Cancer ◽  
Preoperative Assessment ◽  
Complete Cytoreduction ◽  
Sufficient Information ◽  
Positron Emission ◽  
Composite Models ◽  
Improving Accuracy

AbstractThe best prognosis for advanced ovarian cancer is provided by no residual disease after primary cytoreductive surgery. It is thus important to be able to predict resectability that will result in complete cytoreduction, while avoiding unnecessary surgery that may leave residual disease. No single procedure appears to be sufficiently accurate and reliable to predict resectability. The process should include a preoperative workup based on clinical examination, biomarkers, especially tumor markers, and imaging, for which computed tomography, as well as sonography, magnetic resonance imaging and positron-emission tomography, can be used. This workup should provide sufficient information to determine whether complete cytoreduction is possible or if not, to propose neoadjuvant chemotherapy which is preferable in this case. For the remaining patients, laparoscopy is broadly recommended as an ultimate triage step. However, its modalities are still debated, and several scores have been proposed for standardization and improving accuracy. The risk of false negatives requires a final assessment of resectability as the first stage of cytoreductive surgery by laparotomy. Composite models, consisting of several criteria of workup and, sometimes, laparoscopy have been proposed to improve the accuracy of the predictive process. Regardless of the modality, the process appears to be accurate and reliable for predicting residual disease but less so for predicting complete cytoreduction and thus avoiding unnecessary surgery and an inappropriate treatment strategy. Overall, the proposed procedures are heterogeneous, sometimes unvalidated, or do not consider advances in surgery. Future techniques and/or models are still needed to improve the prediction of complete resectability.

scholarly journals Guidance on the use of PET for treatment planning in radiotherapy clinical trials

2019 ◽  
Vol 92 (1103) ◽  
pp. 20190180
Author(s):  
Lucy C Pike ◽  
Christopher M Thomas ◽  
Teresa Guerrero-Urbano ◽  
Andriana Michaelidou ◽  
Tony Greener ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Quality Assurance ◽  
Research Network ◽  
Sufficient Information ◽  
Design Data ◽  
Imaging Protocol ◽  
Positron Emission ◽  
National Cancer Research Institute ◽  
Resource Requirements ◽  
High Level

The aim of this article is to propose meaningful guidance covering the practical and technical issues involved when planning or conducting clinical trials involving positron emission tomography (PET)-guided radiotherapy. The complexity of imaging requirements will depend on the study aims, design and PET methods used. Where PET is used to adapt radiotherapy, a high level of accuracy and reproducibility is required to ensure effective and safe treatment delivery. The guidance in this document is intended to assist researchers designing clinical trials involving PET-guided radiotherapy to provide sufficient information about the appropriate methods to complete PET-CT imaging to a consistent standard at participating centres. The guidance is divided into six categories: application of PET in radiotherapy, resource requirements, quality assurance, imaging protocol design, data management and image processing. Each section provides an overview of the recent literature to support the specific recommendations. This guidance builds on previous recommendations from the National Cancer Research Institute PET Research Network and has been produced in collaboration with the National Radiotherapy Trials Quality Assurance Group.

Solid pseudopapillary neoplasm of pancreas with distant metastasis during pregnancy: a diagnostic and treatment challenge

2020 ◽  
Vol 13 (12) ◽  
pp. e237309
Author(s):  
Diogo Santos ◽  
Ana Calhau ◽  
Filipe Bacelar ◽  
Joaquim Vieira
Keyword(s):  
Distant Metastasis ◽  
Partial Gastrectomy ◽  
Female Child ◽  
Disease Recurrence ◽  
Team Approach ◽  
Cystic Neoplasms ◽  
Ct Guided ◽  
First Case ◽  
Positron Emission ◽  
Chemotherapy Protocol

Solid pseudopapillary neoplasms (SPNs) are rare pancreatic cystic neoplasms occurring predominantly in young women and diagnosis is often a challenge. This report describes the case of a 23-year-old primigravida who presented with abnormally elevated liver blood tests at 24 weeks of gestation. Imaging studies were suggestive of SPN with metastatic liver disease. A multidisciplinary team approach decided on a preterm caesarean delivery of a healthy female child at 36 weeks of gestation. Subsequently, a CT-guided biopsy was performed, with confirmation of SPN in the anatomopathological study. Subpartial pancreatectomy, partial gastrectomy, cholecystectomy, total splenectomy and partial hepatectomy were successfully performed. A 3-month control CT scan and positron emission tomography-CT studies revealed disease recurrence with pulmonary and liver metastatic disease. The patient was started on a palliative chemotherapy protocol with good tolerance. To our knowledge this is the first case of a SPN described in pregnancy with distant metastasis and disseminated recurrence after surgical treatment.

scholarly journals Cystic intra-abdominal masses in children

2017 ◽  
Vol 9 (3) ◽  
Author(s):  
Luisa Ferrero ◽  
Riccardo Guanà ◽  
Giulia Carbonaro ◽  
Maria Grazia Cortese ◽  
Luca Lonati ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Abdominal Distension ◽  
Abdominal Ultrasound ◽  
Mesenteric Cyst ◽  
Diagnostic Tools ◽  
Surgical Approaches ◽  
Radical Excision ◽  
Palpable Mass ◽  
Abdominal Masses

Benign intra-abdominal cystic masses in infancy are fairly uncommon and their etiopathogenesis, histology and clinical presentation differ significantly. Our aim is to report our experience in their treatment in order to discuss the best diagnostic and treatment modality. The medical records of 5 children (2M, 3F) with cystic intraabdominal masses referred to our hospital between November 2012 and September 2016, were retrospectively reviewed. All patients underwent open surgery and subsequent histopathologic analysis. Different clinical presentations, localizations of the masses, diagnostic tools, surgical approaches, histological examinations and outcomes were reviewed. Patients mean age was 5.4 years (range: 8 months-9 years). Two patients presented recurrent abdominal pain and abdominal distension; 1 patient had a palpable mass discovered incidentally and 2 complained acute abdominal pain. Routine laboratory tests, tumor markers and abdominal ultrasound were immediately done in all patients. Three patients underwent MRI and 1 abdominal CT. At laparotomy 2 hepatic cysts, 2 mesenteric cyst and 1 retroperitoneal cyst were discovered. Histology reports described: 1 hepatobiliary cystadenoma, 1 benign hepatic hamartoma and 3 cystic lymphangiomas (1 retroperitoneal and 2 mesenteric). There were no major postoperative complications, deaths, or recurrences in our series (follow-up 3-24 months). Despite the rarity of these lesions, benign cystic abdominal masses in children are not so uncommon and should be considered as causes of acute abdominal pain. The differential diagnosis is not always possible preoperatively. In our series, radical excision of the lesions was possible in all cases, allowing reliable histological results and avoiding recurrences.

EUS-FNA of Solid Pseudopapillary Tumors of the Pancreas: A Single Center Experience

2006 ◽  
Vol 63 (5) ◽  
pp. AB268 ◽  
Author(s):  
Niraj Jani ◽  
Asif Khalid ◽  
Debra Brody ◽  
Kenneth Lee ◽  
Kevin Mcgrath
Keyword(s):  
Single Center ◽  
Single Center Experience ◽  
Solid Pseudopapillary Tumors
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