Small serotonin-positive pancreatic endocrine tumors caused obstruction of the main pancreatic duct

We report 2 cases of pancreatic endocrine tumors that caused obstruction of the main pancreatic duct(MPD).A 49-year-old asymptomatic man was referred to our institution because dilation of the MPD was revealed by abdominal ultrasonography(US).No tumor was detected by endoscopic ultrasonography,computed tomography(CT),and magnetic resonance imaging(MRI).The diameter of the MPD was > 20 mm at the body,and no dilation was noted at the head.Although malignancy was not confirmed through cytology or imaging,pancreatic cancer was strongly suspected.Pancreaticoduo-denectomy was performed.Pathological and immunohistochemical examination revealed a 5 mm × 3 mm serotonin-positive endocrine tumor.Fibrosis was present around the MPD and seemed to cause stricture.A 32-year-old asymptomatic man had elevated serum amylase,and US demonstrated dilation of the MPD.No tumor was detected by CT and MRI.Pancreatic cancer was suspected due to stricture and dilation of the MPD.Pancreatectomy of middle part of pancreas was performed.Pathological and immunohistochemical examination revealed a serotonin-positive endocrine tumor sized 5 mm × 4 mm.We report 2 cases of serotonin-positive pancreatic endocrine tumors that caused stricture of the MPD in spite of the small size of the tumor.

Prognostic Impact of Cell Division Cycle Associated 2 Expression on Pancreatic Ductal Adenocarcinoma

Objective To examine the expression of cell division cycle associated 2(CDCA 2) in pancreatic ductal adenocarcinoma(PDAC) and investigate its role in prognosis of PDAC patients.Methods This retrospective study included 155 PDAC patients who underwent surgical treatment and complete post-operative follow-up.Clinicopathologic data were collected through clinical database.Tissue microarray was constructed and immunohistochemistry was performed to detect CDCA2 expression in the PDAC tumor tissues and adjacent non-tumor tissues.Clinicopathological characteristics between high and low CDCA2 expression were compared.Correlation of CDCA2 expressions with patients' survival was analyzed using Kaplan-Meier method and Cox regression analysis.Results Expression of CDCA2 in PDAC cells was significantly higher than that in adjacent non-tumor tissues(U=4056.5,P<0.001).Univariate analysis showed that CDCA2 expression [hazard ratio(HR)=1.574,95% confidence interval(CI)=1.014-2.443,P=0.043] and node metastasis(HR=1.704,95%CI=1.183-2.454,P=0.004) were significantly associated with prognosis.Cox regression analysis showed CDCA2 expression was not an independent prognostic risk factor(HR=1.418,95%CI=0.897-2.242,P=0.135) for PDCA patients.Stratification survival analysis demonstrated CDCA2 expression as an independent prognostic risk factor in male patients(HR=2.554,95%CI=1.446-4.511,P=0.003) or in non-perineural invasion patients(HR=2.290,95%CI=1.146-4.577,P=0.012).Conclusions CDCA2 is highly expressed in PDAC tumor tissue.Although CDCA2 is not an independent prognostic risk factor for PDAC patients,it might be used to help predict prognosis of male or non-perineural invasion patients of PDAC.