• Title/Summary/Keyword: Pancreatic mass

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Two Cases of Repeated Pancreatectomy for Pancreatic Cancer Developing in the Remnant Pancreas after a Resection of Pancreatic Cancer - Repeated Pancreatectomy of Pancreatic Cancer - (췌장암 절제 후 잔여췌장에 발생한 췌장암에 대한 반복절제를 시행한 2례 - 췌장암의 반복절제 -)

  • Young-Il Kim;Sang Myung Woo;Woo Jin Lee
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.43-47
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    • 2013
  • There have been very few reports related to pancreatic cancer developing in the remnant pancreas after a resection for pancreatic cancer. We report two cases of repeated pancreatectomy for second primary pancreatic cancer. A 58-year-old man with a 2.3 cm sized low attenuated pancreatic tail mass on abdomen CT scan, received a distal pancreatectomy (adenosquamous carcinoma, stage IIB) and adjuvant chemoradiotherapy. A follow-up abdomen CT scan revealed a 2.0 cm sized pancreatic head mass in the remnant pancreas at 35 months after the distal pancreatectomy. He received a pancreaticoduodenectomy and diagnosed as ductal adenocarcinoma (stage IIA). Another 62-year-old female was declared pancreatic head mass on a regular health examination. An abdomen CT scan revealed a 3.6 cm sized mixed solid and cystic mass. She received a pylorus-preserving pancreaticoduodenectomy (ductal adenocarcinoma, stage IB) and adjuvant chemoradiation therapy. At 20 months after the resection, a 1.8 cm sized ill-defined low attenuated mass developing in the tail of remnant pancreas was detected on a follow-up abdomen CT scan. The patient received a distal pancreatectomy and diagnosed as ductal adenocarcinoma (stage IIA).

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A Case of Primary Pancreatic Lymphoma Presenting with Obstructive Jaundice

  • Ga Young Kim;Min Keun, Kim;Dong Wook Lee;Ho Gak Kim
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.101-104
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    • 2015
  • A 55-year-old man was admitted to the hospital for jaundice. Computed tomography (CT) scans showed a diffuse mass in the pancreas and peripancreatic area, with infiltration to of the whole pancreas, and overall reduced enhancement compared to normal pancreas. Esophagogastroduodenoscopy revealed elevated mucosal lesion covered hyperemic mucosa at duodenal bulb and ulcerative lesion at body of stomach. Endoscopic ultrasonography revealed an irregular mass with unclear boundaries was observed within the pancreas. Abrupt narrowing of mid to distal common bile duct was seen and the stricture was caused by compression of pancreatic mass. Plastic stent was inserted and clinical improvement was achieved including resolution of jaundice. The patient is currently being treated with combination of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone. We report a case of primary pancreatic lymphoma presenting with obstructive jaundice.

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A Case of Pancreatic Neuroendocrine Tumor Accompanied by a Cystic Change in Early Stage

  • Sang Soo Bae;Eun Jeong Kim;Dong Wook Lee;Ho Gak Kim;Jimin Han
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.50-54
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    • 2017
  • Pancreatic neuroendocrine tumors are rare pancreatic neoplasms comprising 1-2% of all pancreatic tumors and typically present high attenuating mass on arterial and venous phase images, due to their rich capillary network. A 70-year-old South Korean female visited our hospital presenting with jaundice and dark urine color. She had received an operation for treatment of small bowel perforation seven years ago. On physical examination, icteric sclera was observed but otherwise unremarkable. Laboratory tests were abnormal liver function test and suspected obstructive jaundice. Computed tomography revealed 4 cm sized cystic mass lesion with homogeneous low attenuation in the head of pancreas and distal common bile duct was compressed by the mass. During review of past medical records, we found that the mass was observed and measured about 1.7 cm seven years ago. To resolve obstructive jaundice, pylorus preserving pancreaticoduodenectomy was performed and diagnosed with well differentiated pancreatic neuroendocrine carcinoma with intermediate grade.

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Partial Pancreatectomy Using Ultrasonic Scalpel for Exocrine Pancreatic Ductal Papillary Carcinoma in a Cat

  • Park, Jiyoung;Lee, Young Won;Lee, Hae-Beom;Jeong, Seong Mok
    • Journal of Veterinary Clinics
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    • v.35 no.6
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    • pp.294-298
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    • 2018
  • This report presents a rare case of feline exocrine pancreatic ductal carcinoma including treatment and prognosis. A 4.6-year-old castrated male American Shorthair cat, weighing 5 kg was presented with intermittent vomiting, diarrhea and loss of appetite. Through physical examination and radiography, a cranial abdominal mass was identified. Exploratory laparotomy was carried out. The largest mass was connected to the left lobe of the pancreas, and there were several small, nodular masses scattered along the abdominal lining. The pancreatic mass was removed using an ultrasonic scalpel, and the patient recovered favorably. Histopathologically, the resected lesion was diagnosed as an exocrine pancreatic ductal papillary carcinoma. The patient was maintained with conservative therapy and euthanized on post-operative day 262. Partial pancreatectomy using an ultrasonic scalpel was accomplished safely without evidence of pancreatic leakage.

Serous cystic neoplasm: Do we have to wait till it causes trouble? Season 2

  • Min Chul Shin;Hye Yeon Yang;Ji Su Kim;Chang Moo Kang
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.217-219
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    • 2023
  • A 50-year-old male presented gradually growing pancreatic body mass. An abdominal computed tomography showed a 9.9-cm mass, larger than the 8.9-cm mass one year ago. As the patient did not have complaints for any symptomatic problems, the gastroenterologist decided to check it with regular follow-up. However, as the tumor grew faster than expected, the patient was recommended for surgical resection. Laparoscopic pylorus preserving pancreaticoduodenectomy was done. Since the tumor abutted to the superior mesenteric vein and the portal vein, wedge resection of vessel was inevitable. Pathology was serous cystadenoma. The patient was discharged without postoperative complications. Herein, we report this case with asymptomatic large serous cystic neoplasm treated by laparoscopic approach. The appropriateness of current guidelines for surgery in serous cystic neoplasm is also discussed.

Walled-off Pancreatic necrosis in a Dog

  • Hwang, Tae-sung;Park, Su-jin;Lee, Jae-hoon;Jung, Dong-in;Lee, Hee Chun
    • Journal of Veterinary Clinics
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    • v.35 no.4
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    • pp.146-149
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    • 2018
  • A 7-year-old, castrated, male Maltese dog presented with hyporexia and depression for 3 days. Elevated serum amylase, lipase activities, and liver enzyme values were found upon blood examination. An abdominal mass was seen on radiographs caudal to the gastric body in the left middle abdomen. In the left middle abdomen, abdominal ultrasonography also revealed a massive, irregularly marginated, heterogeneous mass of unknown origin, and in the right cranial abdomen, heterogeneously hypoechoic pancreatic tissue and hyperechoic change of adjacent mesenteric fat were observed. Contrast-enhanced computed tomography showed an irregular contour of the left pancreatic limb as well as heterogeneously enhanced parenchyma. A low-attenuating peripancreatic fluid collection with a thin and irregular wall was also seen. Based on these findings, an atypical pancreatic abscess with necrotizing pancreatitis which manifested as walled-off necrosis was suspected. The mass was excised, and the pancreatic abscess was confirmed by histopathologic examination. No complications were found in the patient after two months of follow-up examination.

Treatment Experience of Solid Pseudopapillary Tumor of the Pancreas in Children (소아의 췌장의 고형성 가유두상 종양)

  • Kim, Seong-Min;Oh, Jung-Tak;Han, Seok-Joo;Choi, Seung-Hoon
    • Advances in pediatric surgery
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    • v.12 no.2
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    • pp.221-231
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    • 2006
  • Solid pseudopapillary tumor (SPT) of the pancreas occurs most frequently in the second or third decades of life, and is prevalent in females. Unlike other pancreatic malignancy, SPT usually has a low malignancy potential. This study reviews our clinical experience and surgical treatment of pancreatic SPT. Admission records and follow-up data were analyzed retrospectively for the period between January 1996 and January 2003. Five patients with a pancreatic mass were operated upon and SPT was confirmed by pathology in each case. The male to female ratio was 1: 4. The median age was 13.8 years. Findings were vague upper abdominal pain (n=5, 100 %) and an abdominal palpable mass (n=3, 60 %). The median tumor diameter was 6.8cm and the locations were 2 in the pancreatic head (40 %) and 3 in the pancreatic tail (60 %). Extra-pancreatic invasion or distant metastasis was not found at the initial operation in all five cases. A pyloruspreserving pancreaticoduodenectomy (n=1) and a mass enucleation (n=1) were performed in two patients of pancreatic head tumors. For three cases of tumors in pancreatic tail, distal pancreatectomy (n=2) and combined distal pancreatectomy and splenectomy (n=1) were performed. The median follow-up period was 60 months(12-117month). During the follow-up period, there was no local recurrence, nor distant metastasis. Postoperative adjuvant chemotherapy or radiotherapy was not carried out. All five children were alive during the follow up period without any evidence of disease relapse. SPT of the pancreas in childhood has good prognosis and surgical resection of the tumor is usually curative.

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The Effect of Dietary Fat on Insulin Secretion and Pancreatic β-Cell Mass in 90% Pancreatectomized Diabetic Rats (식이 지방이 췌장 90%를 제거한 당뇨 흰쥐의 인슐린 분비능과 췌장 베타세포의 양에 미치는 영향)

  • Park, Sun-Min;Park, Chun-Hee;Hong, Sang-Mee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.2
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    • pp.186-193
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    • 2007
  • The prevalence of diabetes has increased to 8% of population. Unlike type 2 diabetes in the western countries, Korean diabetic patients are nonobese and have low serum insulin levels. As the increased prevalence of diabetes and the peculiar characteristics may be related to dietary fat contents, we determined their effects on insulin resistance, insulin secretion and pancreatic $\beta-cell$ mass in 90% pancreatectomized (Px) diabetic rats in the present study. The rats were provided with low fat diet (LF, 10 energy% fat), moderate fat diet (MF, 25 energy% fat) and high fat diet (HF, 40 energy% fat) for 6 months. HF increased body weight and epidydimal fat pads parallel with increased food intake compared to LF and MF. Fasting serum glucose and insulin levels and homeostasis model assessment of insulin resistance were higher in HF, compared to LF and MF, indicating that HF increased insulin resistance. Rats fed LF and MF diets reduced insulin resistance, but only rats fed MF improved pancreatic $\beta-cell$ mass and insulin secretion capacity, measured by hyperglycemic clamp and in situ pancreatic perfusion. LF had low insulin secretion capacity and pancreatic $\beta-cell$ mass, indicating the increased possibility of diabetic prevalence and progression. MF increased $\beta-cell$ mass by stimulating $\beta-cell$ proliferation and neogenesis and reducing $\beta-cell$ apoptosis. In conclusion, MF is effective for the prevention of prevalence and progression of diabetes.

Diagnosis and resolution of pancreatic pseudocysts with percutaneous ultrasound-guided aspiration in two dogs (개 췌장 위낭종에서 초음파 유도 흡인 생검을 통한 진단 및 치료 2례)

  • Choi, Jihye;Kim, Hyunwook;Seo, Jeemin;Lee, Minjung;Kim, Junyoung;Yoon, Junghee
    • Korean Journal of Veterinary Research
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    • v.47 no.3
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    • pp.341-347
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    • 2007
  • Pancreatic pseudocyst is one of the most common pancreatic mass lesions developed following acute or chronic pancreatitis. Two dogs were presented with nonspecific clinical signs such as abdominal pain, vomiting and depression and diagnosed as pancreatic pseudocysts through percutaneous ultrasound-guided aspiration. Pancreatic pseudocyst may contain pancreatic juice, so leads the deteriorate state of patient through pertinent inflammation and autodigestion of pancreas. In this study, the clinical signs and pancreatic lesion were improved after aspiration. Percutaneous ultrasound-guided aspiration can provide the diagnostic information through cytology and lipase and amylase concentration, and be selected as the first choice for treatment.

An Imported Case of Cystic Echinococcosis in the Liver

  • Ahn, Keun Soo;Hong, Sung-Tae;Kang, Yu Na;Kwon, Jung Hyeok;Kim, Mi Jeong;Park, Tae Jun;Kim, Yong Hoon;Lim, Tae Jin;Kang, Koo Jeong
    • Parasites, Hosts and Diseases
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    • v.50 no.4
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    • pp.357-360
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    • 2012
  • A 25-year-old Uzbek male presented with right upper abdominal pain for 20 days. On radiologic studies, a huge cystic mass was noticed in the right liver which was suspected as parasitic. The patient received right hepatic segmentectomy (segment 7), and the surgically resected mass was confirmed as cystic echinococcosis (CE), measuring 10.5 cm in its diameter. The inner surface of the cyst was bile-stained. The patient was discharged on the 8th hospital day, and was rechecked 6 months after the surgical intervention without any evidence of recurrence. The present report describes findings of an imported case of CE which represented ultrasound images of the 'ball of wool'.