Unicentric Castleman disease presenting as a retroperitoneal peripancreatic mass:A report of two cases and review of literature

Castleman disease(CD) is a rare disorder of lymph nodes and related tissues. CD generally occurs in the mediastinum, as well as in cervical, retroperitoneal and axillary regions. The disease is classified into two major types: unicentric CD(UCD) and multicentric CD. The occurrence of UCD in the retroperitoneal peripancreatic region is quite rare. We encountered two cases of retroperitoneal peripancreatic UCD in our hospital during the past three years. Following a series of medical examinations, including magnetic resonance imaging, computed tomography, ultrasonography and postoperative histopathological examination, these two patients were diagnosed with UCD,which presented as a retroperitoneal peripancreatic mass.The mass in each patient was completely excised,and no postoperative radiochemotherapy was administered.Both patients recovered well without recurrence during a follow-up period of 30 mo and 8 mo.

Surgical method choice and coincidence rate of pathological diagnoses in transduodenal ampullectomy: A retrospective case series study and review of the literature

BACKGROUND Transduodenal ampullectomy(TDA) is not in wide clinical use due to its low radical effect and a high recurrence rate of tumors. However,TDA is still an effective treatment method; it has great clinical value in cases of duodenal benign tumors,precancerous lesions,and benign and malignant borderline tumors,and can avoid the risks associated with pancreaticoduodenectomy with larger resection range and greater thoroughness than endoscopic papillectomy.AIM To investigate the surgical method choice and the coincidence rate of pathological diagnoses in TDA for ampullary neoplasms.METHODS Ten patients with ampullary neoplasms underwent TDA based on the fact that their endoscopic biopsy results suggested benign lesions,and the endoscopic ultrasound(EUS)-assessed tumors were resectable. All cases underwent duodenal ampullary lesion endoscopic biopsy,intraoperative frozen-section pathological examination,and postoperative pathological examination.RESULTSThis study included seven patients with benign tumors and three with malignant tumors(1 pTis,2 pT1),according to the postoperative pathology results. The coincidence rate of the postoperative pathology results with the intraoperative frozen-section biopsy results was 100%(10/10),and the coincidence rate with the endoscopic biopsy results was 70%(7/10) based on pathological characteristics.The endoscopic biopsy false-negative rate was 30%(3/10). All patients were followed for 6 to 70 mo without tumor recurrence or metastasis.CONCLUSION The coincidence rate of postoperative pathology results,intraoperative frozensection pathology results,and endoscopic biopsy results is the restraining factor of TDA clinical application. Endoscopic biopsy results and EUS have importance relevance to surgical planning. Intraoperative frozen-section pathology results have a significant influence on the choice of surgical procedure.