• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제18권4호
• /
• pp.280-285
• /
• 2015

Heterotopic pancreas (HP) is defined as pancreatic tissue lacking anatomic and vascular continuity with the main body of the pancreas. Most are asymptomatic, but can cause ulcer, bleeding, intussusception, and mechanical obstruction. Herein, we presented one case of HP presented as duodenal tumor causing duodenal obstruction. A 7-year-old girl visited the emergency room for abdominal pain with vomiting for 24 hours. Computed tomography and upper gastrointestinal series revealed a polypoid mass with short stalk in the 2nd portion of duodenum. We attempted an endoscopic removal. However, the lumen was nearly obstructed by the mass and the stalk was too broad and hard to excise. The mass was surgically removed via duodenotomy. It was confirmed as a HP with ductal and acini components (type 2 by Heinrich classification). Postoperatively, the patient has been well without any complication and recurrence.

• Advances in pediatric surgery
• /
• 제1권1호
• /
• pp.79-84
• /
• 1995

Two cases with papillary cystic neoplasm of the pancreas are reviewed and discussed. Up to recently, the tumors have been misclassified as nonfunctioning islet cell tumor or carcinoma, acinar cell carcinoma, papillary cystadenocarcinoma, or pancreatoblastoma. It frequently has been managed with aggressive surgery such as pancreatoduodenectomy. The tumors are well encapsulated and the cut surfaces are characteristically solid and hemorrhagic. Ultrasonography and CT scan are the most useful tools for the diagnosis. The neoplasms usually behave like a very low grade malignancy, so complete removal is the treatment of choice for the tumor arising anywhere in the pancreas. We have a boy and a girl who have papillary cystic neoplasm. The boy was 12 years old and the girl was 14 years old. Both underwent distal pancreatectomy and the progress were uneventful. We have a boy and a girl who have papillary cystic neoplasm. The boy was 12 years old and the girl was 14 years old. Both underwent distal pancreatectomy and the progress were uneventful.

• 대한영상의학회지
• /
• 제81권2호
• /
• pp.418-422
• /
• 2020

췌장의 장액성 낭성 종양은 일반적으로 양성 질환으로 알려져 있으나 드물게 악성화를 보이는 사례들이 보고되고 있다. 영운에서 췌장 미부에 발생한 장액성 낭성 종양을 수술로 제거한 후 추적 관찰 중 국소 재발과 함께 간으로의 원격전이가 발생한 증례를 경험하여 보고하고자 한다.

• Journal of Digestive Cancer Reports
• /
• 제9권1호
• /
• pp.8-18
• /
• 2021

Although many guidelines for pancreatic cystic neoplasms focus on the management of intraductal papillary mucinous neoplasm of the pancreas (IPMN) at the highest oncological risk, there are many issues that surgeons need to consider at the time to plan the surgical procedures based on characteristics of IPMN subtypes, such as multiplicity of branch duct-IPMN (BD-IPMN) and intraductal spreading of main duct-IPMN (MD-IPMN). For multifocal BD-IPMN, partial pancreatectomy would be selected to remove BD-IPMN with predictors of malignancy, while the other lesions without risk factors can be left, although total pancreatectomy might be considered if the patients have a strong family history of pancreatic cancer. Partial pancreatectomy would be also adequate procedure for MD-IPMN if negative surgical margin for high-grade dysplasia or invasive carcinoma were achieved. It has become to be well-known that patients with BD-IPMN are at increased risk for developing not only IPMN-associated pancreatic ductal adenocarcinoma (PDAC) but also PDAC independent from the IPMN. Hence, the detection of a concomitant PDAC is also an important focus for strategies after resection of BD-IPMNs. Our recent analysis of patients after partial pancreatectomy for MD-IPMN with negative surgical margin identified an unexpected recurrence pattern, which we called "monoclonal skip" recurrence. MD-IPMN seems to be disseminated in the pancreatic ductal systems and MD-IPMN with identical genetic background was detected in the remnant pancreas even in a long time after index surgery. We proposed strategies of postoperative surveillance based on characteristics and natural history of each morphological subtype.

• 대한세포병리학회지
• /
• 제3권2호
• /
• pp.60-66
• /
• 1992

Islet cell neoplasms (ICNs) of pancreas are uncommon, and the cytologic features of ICN are not well delineated. We report a case of islet cell tumor with lymph node metastasis, describing the cytologic, histologic, and immunohistochemical findings. A 40-year-old woman was admitted due to upper gastrointestinal bleeding of 2 days' duration. Computed tomography of the abdomen showed a diffusely infiltrating bulky mass in the body and tail of the pancreas. The fine needle aspirate showed moderate to high cellularity, monotonous cell population, single ceil predominance over small cell clusters, and eccentrically located nuclei. Although the definite diagnosis of ICN on the cytologic basis is difficult, the cytomorphologic features are sufficiently distinctive to suggest the diagnosis.

• 대한세포병리학회지
• /
• 제16권2호
• /
• pp.88-92
• /
• 2005

Mucious cystic neoplasm of pancreas is a cystic neoplasm composed of columnar, mucin-producing epithelium and is supported by ovarian-type stroma. The key to the cytologic evaluation of pancreatic cystic lesions is to recognize the cytologic components as being diagnostic of a mucin-producing cystic neoplasm, as all of these neoplasms need to be resected. We report the use of fine needle aspiration cytology in the diagnosis of an invasive mucinous cystic carcinoma confirmed by partial pancreatectomy. The cytologic specimen showed a abundant mucin background and sheets or papillae of neoplastic cells. There are mucin-containing columnar cells that show a variable degree of cytologic atypia.

• 대한세포병리학회지
• /
• 제6권2호
• /
• pp.125-132
• /
• 1995

Cytodiagnosis of pleural and ascitic fluid is a commonly performed laboratory examination. Especially, positivity for malignant cells in effusion cytology is very effective and also presents the first sign of malignancy in unknown primary site of the tumor. We examined each 34 cases of pleural and ascitic fluid cytologic specimen diagnosed as metastatic tumor, which was selected among 964 pleural fluid cytology cases and 662 ascitic fluid cytology cases from September 1989 to June 1995. Among the pleural fluid cytology specimens examined, 34 specimens were positive in 27 patients. The lung was the most frequent primary site(44%), followed by the stomach (12%), lymphoreticular neoplasm(12%), pancreas(3%) and colon(3%). And the cases of unknown primary site with positive pleural biopsy alone were 24%. Among trio ascitic fluid cytology specimens examined, 34 specimens were positive in 29 patients. The most common primary neoplasms. were carcinomas of ovary(32%), stomach(22%), colon(6%), breast(3%), pancreas(3%), and lung(3%) and lymphoreticular neoplasms(3%) The metastatic tumor was predominantly adenocarcinoma type in both pleural(82%) and ascitic(91%) fluid. The study of metastatic adeno- carcinoma in effusion from lung, ovary, and stomach was undertaken to find distinctive features for the identification of the primary site. The smears of metastatic pulmonary adenocarcinoma had a tendency to show high grade pleomorphism and many large tight cell clusters, whereas that of the ovarian adenocarcinoma showed low grade pleomorphism with abundant intracytoplasmic vacuoles in relatively clear background. That of the stomach revealed the intermediate features.

• 한국간담췌외과학회지
• /
• 제27권2호
• /
• pp.141-150
• /
• 2023

Pancreatic carcinosarcoma is a very rare malignancy with a poor prognosis. Because of these characteristics, a treatment strategy for it has not been established yet. The aim of this study was to establish a therapeutic strategy for pancreatic carcinosarcoma. We reviewed data of a 65-year-old female patient who was diagnosed with pancreatic carcinosarcoma through endoscopic ultrasound-guided fine needle aspiration biopsy before surgery. For literature review, we searched PubMed using terms of "Pancreatic" or "Pancreas" and "carcinosarcoma" or "carcinosarcomatous". The patient received 11 cycles of neoadjuvant treatment with leucovorin, fluorouracil, irinotecan, oxaliplatin and pembrolizumab because the tumor was borderline resectable. She underwent stereotactic ablative body radiotherapy (SABR) with 35 Gy in 5 fractions, followed by robotic pylorus-preserving pancreaticoduodenectomy. After surgery, the patient received adjuvant chemotherapy in the same regimen as before surgery. She is alive without any recurrence. Among 48 patients within 33 available papers, the median survival time was 15 months. The survival rate of patients who received adjuvant chemotherapy tended to be higher than that of those who did not receive adjuvant chemotherapy, although the difference was not statistically significant (median survival, 47 vs. 15 months; p = 0.485). Three patients who received neoadjuvant chemotherapy had a survival period of 13-23.5 months. Surgery with lymphadenectomy, adjuvant therapy, and neoadjuvant therapy are thought to help improve survival outcomes. Modern treatment approaches for conventional pancreatic ductal adenocarcinoma could be applied to pancreatic carcinosarcoma.

• 대한영상의학회지
• /
• 제82권1호
• /
• pp.194-200
• /
• 2021

신경초종은 슈반세포에서 기원하는 양성 종양이며 말초신경집에서 생기는 가장 흔한 종양이다. 신경초종은 신체 어디에서나 발견될 수 있으나, 보통 머리와 목, 그리고 사지의 굽힘 면에서 흔하게 보일 수 있는 종양이다. 췌장은 신경초종이 드물게 생기는 위치이며 적은 수의 증례가 보고되었다. 보고된 신경초종 증례의 약 3분의 2 정도에서 낭성변화를 동반한다. 따라서 적절한 진단과 치료를 위해서는 췌장에서 발견되는 낭성변화를 동반한 고형 종양의 경우 신경초종이 감별진단에 포함되어야 한다. 이에 저자들은 병리학적으로 진단된 낭성변화를 동반한 췌장의 신경초종을 문헌고찰과 함께 보고하고자 한다.

• Korean Journal of Radiology
• /
• 제20권1호
• /
• pp.5-17
• /
• 2019

The diagnosis and management of pancreatic neuroendocrine neoplasms (NENs) have evolved significantly in recent years. There are several diagnostic and therapeutic challenges and controversies regarding the management of these lesions. In this review, we focus on the recent significant changes and controversial issues regarding the diagnosis and management of NENs and discuss the role of imaging in the multidisciplinary team approach.