Objective： To summarize experience in the diagnosis and treatment of pancreatic cystic neoplasms.Methods： This is a retrospective study of 207 patients who were diagnosed with pancreatic cystic tumors at Peking Unio...Objective： To summarize experience in the diagnosis and treatment of pancreatic cystic neoplasms.Methods： This is a retrospective study of 207 patients who were diagnosed with pancreatic cystic tumors at Peking Union Medical College Hospital between Jan 2009 and Mar 2014. Clinical data, such as clinical manifestations, radiologieal and pathological images and surgical recordings, were collected. Results： Of the 207 included patients, females accounted for 76.81%, and the mean patient age was 52.04 years. Malignancy was more common in older patients who presented with marasmus and jaundice. Other risk factors included solid components in the tumor, a large tumor size, and elevated levels of tumor markers. Surgical treatment was required when a malignant tumor was suspected. The operation approach was selected based on the location, size and characteristics of the tumor. The position of the tumor relative to the pancreatic duct also played a significant role.展开更多
Pancreatic pseudocysts are the most common cystic lesions of the pancreas and may complicate acute pancreatitis, chronic pancreatitis, or pancreatic trauma. While the majority of acute pseudocysts resolve spontaneousl...Pancreatic pseudocysts are the most common cystic lesions of the pancreas and may complicate acute pancreatitis, chronic pancreatitis, or pancreatic trauma. While the majority of acute pseudocysts resolve spontaneously, few may require drainage. On the other hand, pancreatic cystic tumors, which usually require extirpation, may disguise as pseudocysts. Hence, the distinction between the two entities is crucial for a successful outcome. We conducted this study to highlight the fundamental differences between pancreatic pseudocysts and cystic tumors so that relevant management plans can be devised. We reviewed the data of patients with pancreatic cystic lesions that underwent intervention between June 2007 and December 2010 in our hospital. We identified 9 patients(5 males and 4 females) with a median age of 40 years(range, 30–70 years). Five patients had pseudocysts, 2 had cystic tumors, and 2 had diseases of undetermined pathology. Pancreatic pseudocysts were treated by pseudocystogastrostomy in 2 cases and percutaneous drainage in 3 cases. One case recurred after percutaneous drainage and required pseudocystogastrostomy. The true pancreatic cysts were serous cystadenoma, which was treated by distal pancreatectomy, and mucinous cystadenocarcinoma, which was initially treated by drainage, like a pseudocyst, and then by distal pancreatectomy when its true nature was revealed. We conclude that every effort should be exerted to distinguish between pancreatic pseudocysts and cystic tumors of the pancreas to avoid the serious misjudgement of draining rather than extirpating a pancreatic cystic tumor. Additionally, percutaneous drainage of a pancreatic pseudocyst is a useful adjunct that may substitute for surgical drainage.展开更多
Because of the aging of the population,prevalence of medical checkups,and advances in imaging studies,the number of pancreatic cystic lesions detected has increased. Once these lesions are detected,neoplastic cysts sh...Because of the aging of the population,prevalence of medical checkups,and advances in imaging studies,the number of pancreatic cystic lesions detected has increased. Once these lesions are detected,neoplastic cysts should be differentiated from non-neoplastic cysts. Furthermore,because of the malignant potential of some neoplastic pancreatic cysts,further differentiation between benign and malignant cysts should be made regardless of their size. Although endoscopic ultrasound(EUS) has a very high diagnostic performance for pancreatic cystic lesions among the various imaging modalities,EUS findings alone are insufficient for the differentiation of pancreatic cysts and diagnosis of malignancy. In addition,cytology by EUS-guided fine-needle aspiration(FNA) has a high specificity but a low sensitivity for diagnosing malignancy in pancreatic cystic tumors. The levels of amylase,lipase,and tumor markers in pancreatic cystic fluid are considered auxiliary parameters for diagnosis of benign and malignant cysts,and a definitive diagnosis of malignancy using these parameters is difficult. Thus,in addition to EUS,cytology by EUS-FNA,and cystic fluid analysis,new techniques based on EUS-guided through-the-needle imaging,such as confocal laser endomicroscopy and cystoscopy,have been explored in recent years.展开更多
Mucinous cystic tumor of the gallbladder is an extremely rare benign tumor,with potential for malignant degeneration.Mucinous cystic tumors of the cystic duct are divided into mucinous cystadenoma and mucinous cystade...Mucinous cystic tumor of the gallbladder is an extremely rare benign tumor,with potential for malignant degeneration.Mucinous cystic tumors of the cystic duct are divided into mucinous cystadenoma and mucinous cystadenocarcinoma.Currently,cystadenoma is generally considered to be a precancerous lesion of cystadenocarcinoma.At present,there are few cases reported worldwide,and there are no relevant guidelines for diagnosis and treatment of this disease.This article presents the collected clinical data of a patient with mucinous cystic tumor of the gallbladder who was admitted to the First Affiliated Hospital of Hunan Normal University,with the characteristics of the disease summarized in combination with a focused literature review.展开更多
Pancreatic cystic tumors(PCTs)comprise a heterogeneous group of entities,accounting for 2%to 10%of pancreatic lesions.The most common types are intraductal papillary mucinous neoplasms(IPMNs),mucinous cystic neoplasm(...Pancreatic cystic tumors(PCTs)comprise a heterogeneous group of entities,accounting for 2%to 10%of pancreatic lesions.The most common types are intraductal papillary mucinous neoplasms(IPMNs),mucinous cystic neoplasm(MCN),and serous cystic neoplasm(SCN),which account for approximately 90%of PCTs.This review discusses updates in pathologic features,malignant transformation,biologic behavior,and molecular evolution of PCTs.IPMN includes main duct and branch duct types.These can also be classified into 4 histologic subtypes based on cell lineages of differentiation,and may be associated with different tumorigenic pathways and clinicopathologic characteristics.The gastric type is the most common and is rarely associated with carcinomas,whereas the pancreatobiliary type is significantly more associated with invasive carcinoma.MCN is a mucinous cystic lesion with the presence of ovarian-type pericystic stroma.Prognosis of the resected non-invasive MCN is excellent,but the long-term survival of MCNs with invasive carcinoma may be poor.SCN includes microcystic adenoma,macrocystic adenoma,and solid variant serous adenoma.Serous cystadenocarcinoma is defined by the presence of distant metastases,which is rare in literature.Intraductal tubulopapillary neoplasm is characterized by uniformly high-grade dysplasia and ductal differentiation without overt production of mucin,with high risk for developing invasion.Acinar cell cystadenoma is a rare benign lesion with acinar differentiation.In addition,some pancreatic neuroendocrine tumors may assume a cystic configuration,sometimes referred to as cystic pancreatic endocrine neoplasm tumor,with a lower pathologic stage.Solid pseudopapillary tumor is composed of poorly cohesive monomorphic epithelial cells forming solid and pseudopapillary structures,with excellent prognosis.展开更多
Pancreatic cystic neoplasms present a complex diagnostic scenario encompassing low-and high-grade malignancies.Their prevalence varies widely,notably increasing with age,reaching 75%in individuals older than 80 years....Pancreatic cystic neoplasms present a complex diagnostic scenario encompassing low-and high-grade malignancies.Their prevalence varies widely,notably increasing with age,reaching 75%in individuals older than 80 years.Accurate diagnosis is crucial,as errors occur in approximately one-third of resected cysts discovered incidentally.Various imaging modalities such as computed tomography,magnetic resonance imaging,and endoscopic techniques are available to address this challenge.However,risk stratification remains problematic,with guideline inconsistencies and diagnostic accuracy varying according to cyst type.This review proposed a stepwisemanagement approach,considering patient factors,imaging results,and specific features.This patient-centered model offers a structured framework for optimizing the care of individuals with pancreatic cystic neoplasms.展开更多
Desmoid tumors(DTs)are nonmetastatic,locally aggressive neoplasms with a high rate of postoperative recurrence.Pancreatic DTs are especially rare;only a few cases have been reported to date.This paper describes a case...Desmoid tumors(DTs)are nonmetastatic,locally aggressive neoplasms with a high rate of postoperative recurrence.Pancreatic DTs are especially rare;only a few cases have been reported to date.This paper describes a case of a sporadic cystic DT of the pancreas managed successfully with central pancreatectomy,with no signs of recurrence 40 mo after surgery.According to the literature,this is the first reported case in China of a pancreatic DT presenting as a solid cystic lesion,as well as the first pancreatic DT managed with central pancreatectomy and pancreaticogastrostomy.We report the case for its rarity and emphasize disease management by concerted application of clinical,pathological,radiological and immunohistochemical analyses.展开更多
AIM: To outline the feasibility, safety, adverse events and early results of endoscopic ultrasound(EUS)-radiofrequency ablation(RFA) in pancreatic neoplasms using a novel probe. METHODS: This is a multi-center, pilot ...AIM: To outline the feasibility, safety, adverse events and early results of endoscopic ultrasound(EUS)-radiofrequency ablation(RFA) in pancreatic neoplasms using a novel probe. METHODS: This is a multi-center, pilot safety feasibility study. The intervention described was radiofrequency ablation(RF) which was applied with an innovative monopolar RF probe(1.2 mm Habib EUS-RFA catheter) placed through a 19 or 22 gauge fine needle aspiration(FNA) needle once FNA was performed in patients with a tumor in the head of the pancreas. The HabibTM EUSRFA is a 1 Fr wire(0.33 mm, 0.013") with a working length of 190 cm, which can be inserted through the biopsy channel of an echoendoscope. RF power is applied to the electrode at the end of the wire to coagulate tissue in the liver and pancreas.RESULTS: Eight patients [median age of 65(range 27-82) years; 7 female and 1 male] were recruited in a prospective multicenter trial. Six had a pancreatic cysticneoplasm(four a mucinous cyst, one had intraductal papillary mucinous neoplasm and one a microcystic adenoma) and two had a neuroendocrine tumors(NET) in the head of pancreas. The mean size of the cystic neoplasm and NET were 36.5 mm(SD ± 17.9 mm) and 27.5 mm(SD ± 17.7 mm) respectively. The EUSRFA was successfully completed in all cases. Among the 6 patients with a cystic neoplasm, post procedure imaging in 3-6 mo showed complete resolution of the cysts in 2 cases, whilst in three more there was a 48.4% reduction [mean pre RF 38.8 mm(SD ± 21.7 mm) vs mean post RF 20 mm(SD ± 17.1 mm)] in size. In regards to the NET patients, there was a change in vascularity and central necrosis after EUS-RFA. No major complications were observed within 48 h of the procedure. Two patients had mild abdominal pain that resolved within 3 d. CONCLUSION: EUS-RFA of pancreatic neoplasms with a novel monopolar RF probe was well tolerated in all cases. Our preliminary data suggest that the procedure is straightforward and safe. The response ranged from complete resolution to a 50% reduction in size.展开更多
BACKGROUND:Carcinoid tumors of the extrahepatic biliary tree are extremely rare malignancies,accounting for 0.2%-2%of all gastrointestinal carcinoid tumors,while carcinoids of the cystic duct are an uncommon entity an...BACKGROUND:Carcinoid tumors of the extrahepatic biliary tree are extremely rare malignancies,accounting for 0.2%-2%of all gastrointestinal carcinoid tumors,while carcinoids of the cystic duct are an uncommon entity and an extremely unusual cause of bile duct obstruction.METHODS:After an extensive literature review,we retrospectively analysed 61 cases of carcinoid tumor of the biliary tree as well as one additional case of a 60-yearold female with symptoms and laboratory/imaging examination findings compatible with those of a malignant biliary tract obstruction.At laparotomy,resection of the gallbladder and common bile duct was performed.Histological study revealed a well-differentiated neuroendocrine carcinoma of the cystic duct.The patient remained disease-free at 16 months.RESULTS:Our presentation is the seventh case reported in the world literature.Compared to cholangiocarcinoma,analysis of the reviewed group indicates an increased incidence of extrahepatic carcinoid tumors in younger persons along with a slight female predominance.Statistically,the most common anatomic location is the common bile duct,followed by the perihilar region and the cystic duct.Jaundice is the most common finding.Curative surgery was realized in the majority of cases and longterm disease-free survival was achieved when surgery was curative.CONCLUSIONS:Carcinoid tumors obstructing the biliary tree are extremely difficult to diagnose preoperatively,and nearly impossible to differentiate from non-neuroendocrine tumors.As surgery offers the only potential cure for both biliary carcinoids and cholangiocarcinoma,we recommend aggressive surgical therapy as the treatment of choice in every case of potentially resectable biliary tumor.展开更多
Calcifying cystic odontogenic tumor (CCOT) is an uncommon benign cystic neoplasm of the jaw that develops from the odontogenic epithelium. It is clinically characterized as a painless—slow-growing tumor that affects ...Calcifying cystic odontogenic tumor (CCOT) is an uncommon benign cystic neoplasm of the jaw that develops from the odontogenic epithelium. It is clinically characterized as a painless—slow-growing tumor that affects the maxilla as well as the mandible, and generally occurs in young adults in the third or fourth decade of life. Herein, we present the case of a 16-year-old Japanese boy who showed a CCOT in the maxillary sinus. Panoramic radiography showed a unilocular lesion in the left maxillary sinus. Computed tomography showed an approximately 5-cm well-defined unilocular expansile lesion with multiple radiopaque calcific specks, arising from the left maxillary alveolar ridge. The lesion was surgically removed, under general anesthesia, and the patient was followed up for 3 years after the surgery, and there have not been any signs of recurrence.展开更多
The calcifying odontogenic cyst was first reported by Gorlin et al. in 1962. At that time, it was classified as a cyst related to the odontogenic apparatus, although it was later renamed as a calcifying cystic odontog...The calcifying odontogenic cyst was first reported by Gorlin et al. in 1962. At that time, it was classified as a cyst related to the odontogenic apparatus, although it was later renamed as a calcifying cystic odontogenic tumor by the WHO calcification in 2005 due to its histological complexity, morphological diversity and aggressive proliferation [2]. Here, we describe a case of a calcifying cystic odontogenic tumor in a 4- year-old boy. The lesion was surgically removed, and the histopathological examination revealed it to be a cystic tumor with ghost cells, a stellate reticulum and small amount of dentinoid tissue in the cystic wall.展开更多
Background: Massive cystic degeneration of the uterine myoma might mimic an ovarian tumor, especially a malignant ovarian tumor, causing misdiagnosis. We present a case of a woman with marked cystic degeneration of a ...Background: Massive cystic degeneration of the uterine myoma might mimic an ovarian tumor, especially a malignant ovarian tumor, causing misdiagnosis. We present a case of a woman with marked cystic degeneration of a uterine leiomyoma mimicking an ovarian neoplasm. Case: A 65-year-old woman (gravida 6, para 6) visited us due to an abdominal tumor. Clinical examination and radiology exploration suggested the presence of an ovarian tumour. The patient underwent a total abdominal hysterectomy with bilateral adnexectomy. Histopathology confirmed a final diagnosis of a degenerated leiomyoma. The patient’s postoperative course was uneventful and she was discharged on her 5<sup>th</sup> post-operative day. Conclusions: When a patient has a huge abdomino-pelvic mass, mimicking an ovarian tumor, cystic degeneration of uterine myoma should be considered as a differential diagnosis.展开更多
Cystic nephromas (CNs) are uncommon, benign renal neoplasms reported in infants/young children of both genders and in adult females, concerning the pediatric population few studies have been conducted. The diagnosis o...Cystic nephromas (CNs) are uncommon, benign renal neoplasms reported in infants/young children of both genders and in adult females, concerning the pediatric population few studies have been conducted. The diagnosis of cystic nephroma is based on clinical signs, imaging tests, and anatomo-pathological study. In children, CNs can appear as a palpable abdominal mass in most of cases, hematuria or recurrent urinary infections. They are characterized by multycystic architecture and the exclusive presence of mature nephrogenic elements. Treatment is surgical with a very good prognosis in most of cases. We are going to report a case of a 13-month-old girl child diagnosed with Cystic nephromas who presented to pediatric emergency with unexplained crying episodes in order to increase clinicians awareness about this rare tumor.展开更多
Background: Cystic hygromas are primarily found in the cervicofacial, thoracic, and abdominal regions, with limited occurrences in other areas. Despite existing literature on this condition, comprehensive descriptions...Background: Cystic hygromas are primarily found in the cervicofacial, thoracic, and abdominal regions, with limited occurrences in other areas. Despite existing literature on this condition, comprehensive descriptions and MRI findings of cystic hygromas in the extremities are rare. Aim: This case report aims to present a unique instance of a cystic hygroma in the left thigh. The objective is to provide detailed insights into the characteristics of this atypical presentation. Case Presentation: The case involves a 2-year-10 month-old girl with a cystic hygroma in her left thigh. The report includes a comprehensive description of the lesion’s clinical features and diagnostic evaluation, emphasizing the MRI findings to enhance understanding of this rare occurrence. Conclusion: This case report highlights the rarity of cystic hygromas outside the cervicofacial, thoracic, and abdominal regions, explicitly focusing on the occurrence in the left thigh. By presenting detailed insights into the clinical features, MRI findings, histopathological findings, and the surgical approach employed, this report contributes to the existing knowledge on this condition in atypical locations and informs future treatment strategies.展开更多
基金supported by grants from the Research Special Fund for the Public Welfare Industry of Health (201202007)the National Science & Technology Pillar Program during the Twelfth Five-year Plan Period (2014BAI09B11)+2 种基金the National Natural Science Foundation of China (81472327)the Fundamental Research Funds for the Central Universitiesthe PUMC Youth Fund (3332015004)
文摘Objective： To summarize experience in the diagnosis and treatment of pancreatic cystic neoplasms.Methods： This is a retrospective study of 207 patients who were diagnosed with pancreatic cystic tumors at Peking Union Medical College Hospital between Jan 2009 and Mar 2014. Clinical data, such as clinical manifestations, radiologieal and pathological images and surgical recordings, were collected. Results： Of the 207 included patients, females accounted for 76.81%, and the mean patient age was 52.04 years. Malignancy was more common in older patients who presented with marasmus and jaundice. Other risk factors included solid components in the tumor, a large tumor size, and elevated levels of tumor markers. Surgical treatment was required when a malignant tumor was suspected. The operation approach was selected based on the location, size and characteristics of the tumor. The position of the tumor relative to the pancreatic duct also played a significant role.
文摘Pancreatic pseudocysts are the most common cystic lesions of the pancreas and may complicate acute pancreatitis, chronic pancreatitis, or pancreatic trauma. While the majority of acute pseudocysts resolve spontaneously, few may require drainage. On the other hand, pancreatic cystic tumors, which usually require extirpation, may disguise as pseudocysts. Hence, the distinction between the two entities is crucial for a successful outcome. We conducted this study to highlight the fundamental differences between pancreatic pseudocysts and cystic tumors so that relevant management plans can be devised. We reviewed the data of patients with pancreatic cystic lesions that underwent intervention between June 2007 and December 2010 in our hospital. We identified 9 patients(5 males and 4 females) with a median age of 40 years(range, 30–70 years). Five patients had pseudocysts, 2 had cystic tumors, and 2 had diseases of undetermined pathology. Pancreatic pseudocysts were treated by pseudocystogastrostomy in 2 cases and percutaneous drainage in 3 cases. One case recurred after percutaneous drainage and required pseudocystogastrostomy. The true pancreatic cysts were serous cystadenoma, which was treated by distal pancreatectomy, and mucinous cystadenocarcinoma, which was initially treated by drainage, like a pseudocyst, and then by distal pancreatectomy when its true nature was revealed. We conclude that every effort should be exerted to distinguish between pancreatic pseudocysts and cystic tumors of the pancreas to avoid the serious misjudgement of draining rather than extirpating a pancreatic cystic tumor. Additionally, percutaneous drainage of a pancreatic pseudocyst is a useful adjunct that may substitute for surgical drainage.
文摘Because of the aging of the population,prevalence of medical checkups,and advances in imaging studies,the number of pancreatic cystic lesions detected has increased. Once these lesions are detected,neoplastic cysts should be differentiated from non-neoplastic cysts. Furthermore,because of the malignant potential of some neoplastic pancreatic cysts,further differentiation between benign and malignant cysts should be made regardless of their size. Although endoscopic ultrasound(EUS) has a very high diagnostic performance for pancreatic cystic lesions among the various imaging modalities,EUS findings alone are insufficient for the differentiation of pancreatic cysts and diagnosis of malignancy. In addition,cytology by EUS-guided fine-needle aspiration(FNA) has a high specificity but a low sensitivity for diagnosing malignancy in pancreatic cystic tumors. The levels of amylase,lipase,and tumor markers in pancreatic cystic fluid are considered auxiliary parameters for diagnosis of benign and malignant cysts,and a definitive diagnosis of malignancy using these parameters is difficult. Thus,in addition to EUS,cytology by EUS-FNA,and cystic fluid analysis,new techniques based on EUS-guided through-the-needle imaging,such as confocal laser endomicroscopy and cystoscopy,have been explored in recent years.
基金This work was financially supported by following funds:Huxiang Youth Talent Support Program(Grant No.2020RC3066)Postdoctoral Innovation Talents Project(Grant No.2020RC2064)+1 种基金Hunan Provincial Natural Science Foundation of China(Grant No.2019JJ50320/2020JJ5610)The Project of Improving the Diagnosis and Treatment Capacity of Hepatobiliary,Pancreas and Intestine Disease in Hunan Province(Xiangwei[2019]Grant No.118).
文摘Mucinous cystic tumor of the gallbladder is an extremely rare benign tumor,with potential for malignant degeneration.Mucinous cystic tumors of the cystic duct are divided into mucinous cystadenoma and mucinous cystadenocarcinoma.Currently,cystadenoma is generally considered to be a precancerous lesion of cystadenocarcinoma.At present,there are few cases reported worldwide,and there are no relevant guidelines for diagnosis and treatment of this disease.This article presents the collected clinical data of a patient with mucinous cystic tumor of the gallbladder who was admitted to the First Affiliated Hospital of Hunan Normal University,with the characteristics of the disease summarized in combination with a focused literature review.
文摘Pancreatic cystic tumors(PCTs)comprise a heterogeneous group of entities,accounting for 2%to 10%of pancreatic lesions.The most common types are intraductal papillary mucinous neoplasms(IPMNs),mucinous cystic neoplasm(MCN),and serous cystic neoplasm(SCN),which account for approximately 90%of PCTs.This review discusses updates in pathologic features,malignant transformation,biologic behavior,and molecular evolution of PCTs.IPMN includes main duct and branch duct types.These can also be classified into 4 histologic subtypes based on cell lineages of differentiation,and may be associated with different tumorigenic pathways and clinicopathologic characteristics.The gastric type is the most common and is rarely associated with carcinomas,whereas the pancreatobiliary type is significantly more associated with invasive carcinoma.MCN is a mucinous cystic lesion with the presence of ovarian-type pericystic stroma.Prognosis of the resected non-invasive MCN is excellent,but the long-term survival of MCNs with invasive carcinoma may be poor.SCN includes microcystic adenoma,macrocystic adenoma,and solid variant serous adenoma.Serous cystadenocarcinoma is defined by the presence of distant metastases,which is rare in literature.Intraductal tubulopapillary neoplasm is characterized by uniformly high-grade dysplasia and ductal differentiation without overt production of mucin,with high risk for developing invasion.Acinar cell cystadenoma is a rare benign lesion with acinar differentiation.In addition,some pancreatic neuroendocrine tumors may assume a cystic configuration,sometimes referred to as cystic pancreatic endocrine neoplasm tumor,with a lower pathologic stage.Solid pseudopapillary tumor is composed of poorly cohesive monomorphic epithelial cells forming solid and pseudopapillary structures,with excellent prognosis.
文摘Pancreatic cystic neoplasms present a complex diagnostic scenario encompassing low-and high-grade malignancies.Their prevalence varies widely,notably increasing with age,reaching 75%in individuals older than 80 years.Accurate diagnosis is crucial,as errors occur in approximately one-third of resected cysts discovered incidentally.Various imaging modalities such as computed tomography,magnetic resonance imaging,and endoscopic techniques are available to address this challenge.However,risk stratification remains problematic,with guideline inconsistencies and diagnostic accuracy varying according to cyst type.This review proposed a stepwisemanagement approach,considering patient factors,imaging results,and specific features.This patient-centered model offers a structured framework for optimizing the care of individuals with pancreatic cystic neoplasms.
文摘Desmoid tumors(DTs)are nonmetastatic,locally aggressive neoplasms with a high rate of postoperative recurrence.Pancreatic DTs are especially rare;only a few cases have been reported to date.This paper describes a case of a sporadic cystic DT of the pancreas managed successfully with central pancreatectomy,with no signs of recurrence 40 mo after surgery.According to the literature,this is the first reported case in China of a pancreatic DT presenting as a solid cystic lesion,as well as the first pancreatic DT managed with central pancreatectomy and pancreaticogastrostomy.We report the case for its rarity and emphasize disease management by concerted application of clinical,pathological,radiological and immunohistochemical analyses.
文摘AIM: To outline the feasibility, safety, adverse events and early results of endoscopic ultrasound(EUS)-radiofrequency ablation(RFA) in pancreatic neoplasms using a novel probe. METHODS: This is a multi-center, pilot safety feasibility study. The intervention described was radiofrequency ablation(RF) which was applied with an innovative monopolar RF probe(1.2 mm Habib EUS-RFA catheter) placed through a 19 or 22 gauge fine needle aspiration(FNA) needle once FNA was performed in patients with a tumor in the head of the pancreas. The HabibTM EUSRFA is a 1 Fr wire(0.33 mm, 0.013") with a working length of 190 cm, which can be inserted through the biopsy channel of an echoendoscope. RF power is applied to the electrode at the end of the wire to coagulate tissue in the liver and pancreas.RESULTS: Eight patients [median age of 65(range 27-82) years; 7 female and 1 male] were recruited in a prospective multicenter trial. Six had a pancreatic cysticneoplasm(four a mucinous cyst, one had intraductal papillary mucinous neoplasm and one a microcystic adenoma) and two had a neuroendocrine tumors(NET) in the head of pancreas. The mean size of the cystic neoplasm and NET were 36.5 mm(SD ± 17.9 mm) and 27.5 mm(SD ± 17.7 mm) respectively. The EUSRFA was successfully completed in all cases. Among the 6 patients with a cystic neoplasm, post procedure imaging in 3-6 mo showed complete resolution of the cysts in 2 cases, whilst in three more there was a 48.4% reduction [mean pre RF 38.8 mm(SD ± 21.7 mm) vs mean post RF 20 mm(SD ± 17.1 mm)] in size. In regards to the NET patients, there was a change in vascularity and central necrosis after EUS-RFA. No major complications were observed within 48 h of the procedure. Two patients had mild abdominal pain that resolved within 3 d. CONCLUSION: EUS-RFA of pancreatic neoplasms with a novel monopolar RF probe was well tolerated in all cases. Our preliminary data suggest that the procedure is straightforward and safe. The response ranged from complete resolution to a 50% reduction in size.
文摘BACKGROUND:Carcinoid tumors of the extrahepatic biliary tree are extremely rare malignancies,accounting for 0.2%-2%of all gastrointestinal carcinoid tumors,while carcinoids of the cystic duct are an uncommon entity and an extremely unusual cause of bile duct obstruction.METHODS:After an extensive literature review,we retrospectively analysed 61 cases of carcinoid tumor of the biliary tree as well as one additional case of a 60-yearold female with symptoms and laboratory/imaging examination findings compatible with those of a malignant biliary tract obstruction.At laparotomy,resection of the gallbladder and common bile duct was performed.Histological study revealed a well-differentiated neuroendocrine carcinoma of the cystic duct.The patient remained disease-free at 16 months.RESULTS:Our presentation is the seventh case reported in the world literature.Compared to cholangiocarcinoma,analysis of the reviewed group indicates an increased incidence of extrahepatic carcinoid tumors in younger persons along with a slight female predominance.Statistically,the most common anatomic location is the common bile duct,followed by the perihilar region and the cystic duct.Jaundice is the most common finding.Curative surgery was realized in the majority of cases and longterm disease-free survival was achieved when surgery was curative.CONCLUSIONS:Carcinoid tumors obstructing the biliary tree are extremely difficult to diagnose preoperatively,and nearly impossible to differentiate from non-neuroendocrine tumors.As surgery offers the only potential cure for both biliary carcinoids and cholangiocarcinoma,we recommend aggressive surgical therapy as the treatment of choice in every case of potentially resectable biliary tumor.
文摘Calcifying cystic odontogenic tumor (CCOT) is an uncommon benign cystic neoplasm of the jaw that develops from the odontogenic epithelium. It is clinically characterized as a painless—slow-growing tumor that affects the maxilla as well as the mandible, and generally occurs in young adults in the third or fourth decade of life. Herein, we present the case of a 16-year-old Japanese boy who showed a CCOT in the maxillary sinus. Panoramic radiography showed a unilocular lesion in the left maxillary sinus. Computed tomography showed an approximately 5-cm well-defined unilocular expansile lesion with multiple radiopaque calcific specks, arising from the left maxillary alveolar ridge. The lesion was surgically removed, under general anesthesia, and the patient was followed up for 3 years after the surgery, and there have not been any signs of recurrence.
文摘The calcifying odontogenic cyst was first reported by Gorlin et al. in 1962. At that time, it was classified as a cyst related to the odontogenic apparatus, although it was later renamed as a calcifying cystic odontogenic tumor by the WHO calcification in 2005 due to its histological complexity, morphological diversity and aggressive proliferation [2]. Here, we describe a case of a calcifying cystic odontogenic tumor in a 4- year-old boy. The lesion was surgically removed, and the histopathological examination revealed it to be a cystic tumor with ghost cells, a stellate reticulum and small amount of dentinoid tissue in the cystic wall.
文摘Background: Massive cystic degeneration of the uterine myoma might mimic an ovarian tumor, especially a malignant ovarian tumor, causing misdiagnosis. We present a case of a woman with marked cystic degeneration of a uterine leiomyoma mimicking an ovarian neoplasm. Case: A 65-year-old woman (gravida 6, para 6) visited us due to an abdominal tumor. Clinical examination and radiology exploration suggested the presence of an ovarian tumour. The patient underwent a total abdominal hysterectomy with bilateral adnexectomy. Histopathology confirmed a final diagnosis of a degenerated leiomyoma. The patient’s postoperative course was uneventful and she was discharged on her 5<sup>th</sup> post-operative day. Conclusions: When a patient has a huge abdomino-pelvic mass, mimicking an ovarian tumor, cystic degeneration of uterine myoma should be considered as a differential diagnosis.
文摘Cystic nephromas (CNs) are uncommon, benign renal neoplasms reported in infants/young children of both genders and in adult females, concerning the pediatric population few studies have been conducted. The diagnosis of cystic nephroma is based on clinical signs, imaging tests, and anatomo-pathological study. In children, CNs can appear as a palpable abdominal mass in most of cases, hematuria or recurrent urinary infections. They are characterized by multycystic architecture and the exclusive presence of mature nephrogenic elements. Treatment is surgical with a very good prognosis in most of cases. We are going to report a case of a 13-month-old girl child diagnosed with Cystic nephromas who presented to pediatric emergency with unexplained crying episodes in order to increase clinicians awareness about this rare tumor.
文摘Background: Cystic hygromas are primarily found in the cervicofacial, thoracic, and abdominal regions, with limited occurrences in other areas. Despite existing literature on this condition, comprehensive descriptions and MRI findings of cystic hygromas in the extremities are rare. Aim: This case report aims to present a unique instance of a cystic hygroma in the left thigh. The objective is to provide detailed insights into the characteristics of this atypical presentation. Case Presentation: The case involves a 2-year-10 month-old girl with a cystic hygroma in her left thigh. The report includes a comprehensive description of the lesion’s clinical features and diagnostic evaluation, emphasizing the MRI findings to enhance understanding of this rare occurrence. Conclusion: This case report highlights the rarity of cystic hygromas outside the cervicofacial, thoracic, and abdominal regions, explicitly focusing on the occurrence in the left thigh. By presenting detailed insights into the clinical features, MRI findings, histopathological findings, and the surgical approach employed, this report contributes to the existing knowledge on this condition in atypical locations and informs future treatment strategies.
