MyMedR

Fulltext Solid pseudopapillary tumor of the pancreas in a young Malay woman

Ngui NKT

Med J Malaysia, 2004 Oct;59(4):555-7.

Solid pseudopapillary tumors of the pancreas are very rare, low-grade malignant potentially curable neoplasms. Despite having non-specific symptomatology, they have typical features such as being more common in young women, and classically presenting as large abdominal masses. Accurate diagnosis is important because long-term survival hinges on complete resection of the tumor.

Matched MeSH terms: Pancreatic Neoplasms/diagnosis*

Education and imaging: Gastrointestinal: An unusual cause of gastric outlet obstruction

Hasmoni MH, Hilmi I, Goh KL

J Gastroenterol Hepatol, 2013 Mar;28(3):585.

PMID: 23565549

Matched MeSH terms: Pancreatic Neoplasms/diagnosis*

Pancreatic cancer in Universiti Sains Malaysia Hospital: a retrospective review of years 2001-2008

Norsa' adah B, Nur-Zafira A, Knight A

Asian Pac J Cancer Prev, 2012;13(6):2857-60.

PMID: 22938473

Pancreatic cancer is usually detected late and has a high mortality rate. Since little is known about this cancer in Malaysia, a review of all cases admitted to Universiti Sains Malaysia Hospital was conducted to identify the epidemiological distribution and assess survival. A list of pancreatic cancer patients in 2001-2008 was obtained from the Hospital Record Department. Only cases confirmed by radio-imaging or histo-pathology examination were included. We excluded those with incomplete medical records. Kaplan-Meier and Cox proportional hazard approaches were used for data analysis. Only 56 cases were included with a mean (SD) age of 49.6 (16.0) years, with 60.7% males and 82.1% of Malay ethnicity. Previous history included cholelithiasis in 23.2%, diabetes mellitus in 16.1%, previous laparotomy in 10.7%, chronic pancreatitis in 7.1%, alcohol drinking in 5.4% and positive family history in 3.6%. The common presenting history included 67.9% loss of appetite, 66.1% loss of weight, 58.9% jaundice and 46.4% abdominal pain. Tumour staging was: 21.5% stage l, 17.8% stage ll, 3.6% stage lll and 57.1% stage lV. The median (95% CI) survival time was 3.4 (0.5, 6.3) months and significant prognostic factors were duration of symptoms (HR 0.97; 95% CI: 0.95, 0.99; p value 0.013), ascites (HR 2.64; 95% CI: 1.28, 5.44; p value 0.008) and Whipple surgery (HR 4.20; 95% CI: 2.27, 7.76; p value <0.001). The history of presenting complaints was short and the majority presented at late stages of the disease, thus the median survival time was very poor.

Matched MeSH terms: Pancreatic Neoplasms/diagnosis

Fulltext Pancreatic metastases from ovarian carcinoma--diagnosis by endoscopic ultrasound-guided fine needle aspiration

Hadzri MH, Rosemi S

Med J Malaysia, 2012 Apr;67(2):210-1.

PMID: 22822646

Pancreatic metastases are very uncommon and originate most commonly from lung, colon, breast and kidney cancer. Ovarian adenocarcinoma has been reported as a primary site of pancreatic metastasis, but its diagnosis has rarely being reported by endoscopic ultrasound guided fine needle aspiration (EUS-FNA). We report a case of multiple metastases to the pancreas from ovarian carcinoma occurring four years after original resection of the primary tumour. Our patient presented with severe epigastric pain which was initially treated as acute pancreatitis. Further imaging modalities showed multiple large pseudocystic lesions in the pancreatic head and body. Subsequent EUS-FNA confirmed that the lesions were metastatic disease from an advanced ovarian carcinoma. She underwent palliative chemotherapy and the pancreatic lesion showed receding size.

Matched MeSH terms: Pancreatic Neoplasms/diagnosis

Early detection of pancreatic cancer: a possibility in some cases but not a reality in most

Goh KL, Yoon BK

J Dig Dis, 2012 Aug;13(8):389-92.

PMID: 22788923 DOI: 10.1111/j.1751-2980.2012.00609.x

Pancreatic cancer is notoriously difficult to diagnose until a late stage when curative options are no longer available. Owing to its relatively low incidence and the lack of sensitivity of current diagnostic tool, screening of pancreatic cancer in the general population is not recommended. However, in high-risk individuals, especially those with well-described genetic syndromes and a strong family history of pancreatic cancer, screening can be carried out. Detection of a lesion of the diameter

Matched MeSH terms: Pancreatic Neoplasms/diagnosis*

Fulltext Duodenal intussusception of Brunner's gland adenoma mimicking a pancreatic tumour

Limi L, Liew NC, Badrul RH, Faisal MJ, Daniel YP

Med J Malaysia, 2010 Dec;65(4):311-2.

PMID: 21901954

Brunner's gland adenoma is a rare benign tumour of the duodenum. It is usually asymptomatic but may occasionally present with gastrointestinal haemorrhage and obstruction. We report a 40-year old lady, presenting with upper gastrointestinal bleeding and was found to have prolapsed and intussuscepted Brunner's gland adenoma of the duodenum, which mimicked the appearance of a tumour in the head of pancreas.

Matched MeSH terms: Pancreatic Neoplasms/diagnosis

Fulltext Benign insulinoma--a diagnostic challenge: a case report

Fock KM, Nambiar R

Med J Malaysia, 1984 Jun;39(2):170-2.

PMID: 6096683

A 22-year-old Malay man with recurrent hypoglycaemic fainting spells was found to have hyperinsulinism. Although the CT scan of the abdomen and arteriogram failed to demonstrate any tumour in the pancreas, three tumours were found in the body of the pancreas at laporatomy, An appraisal of the techinques currently available for diagnosis and localisation of insulinoma is presented.

Matched MeSH terms: Pancreatic Neoplasms/diagnosis*

Solid pseudopapillary neoplasm of the pancreas with liver metastasis initially misinterpreted as benign haemorrhagic cyst

Jung MJ, Kim HK, Choi SY, Kim SG, Jin SY

Malays J Pathol, 2017 Dec;39(3):327-330.

PMID: 29279599

Solid pseudopapillary neoplasm (SPN) of the pancreas is considered a low-malignant neoplasm with a good prognosis. However, 5% to 15% of patients with SPNs develop metastatic disease, most commonly in the liver. Metastatic hepatic malignancies that show pseudocystic features are rare. Here we describe the case of a middle-aged female with a cystic liver metastasis from SPN. To the best of our knowledge, SPN with a single cystic liver metastasis has not been described, although these tumours frequently undergo haemorrhagic-cystic degeneration. Thus, in these patients the marked cystic change could be misinterpreted as a benign lesion.

Matched MeSH terms: Pancreatic Neoplasms/diagnosis*

Pancreatic hemangioma mimicking a malignant pancreatic cyst

Lee J, Raman K, Sachithanandan S

Gastrointest Endosc, 2011 Jan;73(1):174-6.

PMID: 20932519 DOI: 10.1016/j.gie.2010.07.038

Matched MeSH terms: Pancreatic Neoplasms/diagnosis*

Fulltext Pancreatoblastoma: a rare tumour accidentally found

Naik VR, Jaafar H, Leow VM, Bhavaraju VM

Singapore Med J, 2006 Mar;47(3):232-4.

PMID: 16518559

A 15-year-old girl, who was previously well, complained of a mass in the abdomen after a minor motor vehicle accident. Physical and radiological investigations revealed a mass in the body of pancreas containing proteinaceous material and multiple nodules in both lobes of liver. Serological investigations for malignancy were normal. Histopathological examination of the resected specimen showed pancreatoblastoma. Pancreatoblastoma is an unusual malignant tumour seen in infants and children although rare cases have also been reported in adults. They are clinicopathologically distinct from adult pancreatic ductal carcinoma. The histogenesis, clinical features and treatment options are discussed along with presentation of the case.

Matched MeSH terms: Pancreatic Neoplasms/diagnosis*

Fulltext Solid-pseudopapillary carcinoma: a case study and literature review

Mat Zin AA, Shakir KA, Aminuddin AR, Mahedzan MR, Irnawati WA, Andee DZ, et al.

BMJ Case Rep, 2012;2012.

PMID: 22927280 DOI: 10.1136/bcr-2012-006495

Solid-pseudopapillary tumour (SPT) is a rare exocrine tumour of the pancreas and is considered to have low malignant potential. Few morphological criteria are used to predict malignant behaviour such as equivocal perineural invasion, angioinvasion and invasion to surrounding tissue, and should be designated as solid-pseudopapillary carcinoma (SPC). We report a case of SPC. Clinical and radiological findings are typical for SPT with no metastatic disease. There is no tumour recurrence after 4&emsp14;months postresection. Clinical history and radiological findings were retrieved from the patient's record sheet and Viarad system. H&E staining and few immunoproxidase staining were reviewed by several pathologists. The histological findings are typical for SPT, with additional perineural invasion. There is no angioinvasion or capsular invasion identified. This is our first experience in diagnosing and managing SPC. We look forward to seeing the patient's disease status during her next routine follow-up. We expect good disease-free survival and very low risk of tumour recurrence, in view of only one risk factor (perineural invasion) and uninvolved surgical margins by the tumour.

Matched MeSH terms: Pancreatic Neoplasms/diagnosis*

Fulltext Human pentastomiasis caused by Armillifer moniliformis in Malaysian Borneo

Latif B, Omar E, Heo CC, Othman N, Tappe D

Am J Trop Med Hyg, 2011 Nov;85(5):878-81.

PMID: 22049042 DOI: 10.4269/ajtmh.2011.11-0404

We report a case of visceral pentastomiasis caused by Armillifer moniliformis in a 70-year-old aboriginal farmer from rural Malaysian Borneo. The patient complained of upper abdominal pain, jaundice, and loss of weight. Radiological investigations and subsequent histopathological examination revealed an adenocarcinoma of the pancreas with an adjacent liver nodule containing a nymph of A. moniliformis. This report constitutes the first documented human pentastomid infection in the whole of Malaysia after nearly 40 years, and it is the third description from Malaysian Borneo. Cases of human and animal pentastomiasis in Malaysia are discussed.

Matched MeSH terms: Pancreatic Neoplasms/diagnosis

Fulltext CTC phenotyping for a preoperative assessment of tumor metastasis and overall survival of pancreatic ductal adenocarcinoma patients

Sun Y, Wu G, Cheng KS, Chen A, Neoh KH, Chen S, et al.

EBioMedicine, 2019 Aug;46:133-149.

PMID: 31375425 DOI: 10.1016/j.ebiom.2019.07.044

BACKGROUND: The evaluation for surgical resectability of pancreatic ductal adenocarcinoma (PDAC) patients is not only imaging-based but highly subjective. An objective method is urgently needed. We report on the clinical value of a phenotypic circulating tumor cell (CTC)-based blood test for a preoperative prognostic assessment of tumor metastasis and overall survival (OS) of PDAC patients.

METHODS: Venous blood samples from 46 pathologically confirmed PDAC patients were collected prospectively before surgery and immunoassayed using a specially designed TU-chip™. Captured CTCs were differentiated into epithelial (E), mesenchymal and hybrid (H) phenotypes. A further 45 non-neoplastic healthy donors provided blood for cell line validation study and CTC false positive quantification.

FINDINGS: A validated multivariable model consisting of disjunctively combined CTC phenotypes: "H-CTC≥15.0 CTCs/2ml OR E-CTC≥11.0 CTCs/2ml" generated an optimal prediction of metastasis with a sensitivity of 1.000 (95% CI 0.889-1.000) and specificity of 0.886 (95% CI 0.765-0.972). The adjusted Kaplan-Meier median OS constructed using Cox proportional-hazard models and stratified for E-CTC 

Matched MeSH terms: Pancreatic Neoplasms/diagnosis*

Fulltext Malignant pancreatic carcinoid tumour

Zarina AL, Hamidah A, Zulkifli SZ, Zulfiqar MA, Jamal R

Singapore Med J, 2007 Dec;48(12):e320-2.

PMID: 18043827

Pancreatic carcinoid tumours are rare, particularly within the paediatric population. The clinical presentation is largely dependent on the functionality of the tumour. Although the tumour is generally slow-growing, surgical resection is still the mainstay of curative treatment. Morbidity is, however, significantly contributed by secretion of excess hormones; in view of this, biotherapy is an important treatment strategy. Octreotide, a somatostatin analogue, has been shown to be successful in both symptomatic control and stability of tumour progression. We report a 12-year-old girl, who presented with hypertensive crisis, and showed good response to a combination of chemotherapy and octreotide.

Matched MeSH terms: Pancreatic Neoplasms/diagnosis*

Fulltext CA19-9 and apolipoprotein-A2 isoforms as detection markers for pancreatic cancer: a prospective evaluation

Honda K, Katzke VA, Hüsing A, Okaya S, Shoji H, Onidani K, et al.

Int J Cancer, 2019 Apr 15;144(8):1877-1887.

PMID: 30259989 DOI: 10.1002/ijc.31900

Recently, we identified unique processing patterns of apolipoprotein A2 (ApoA2) in patients with pancreatic cancer. Our study provides a first prospective evaluation of an ApoA2 isoform ("ApoA2-ATQ/AT"), alone and in combination with carbohydrate antigen 19-9 (CA19-9), as an early detection biomarker for pancreatic cancer. We performed ELISA measurements of CA19-9 and ApoA2-ATQ/AT in 156 patients with pancreatic cancer and 217 matched controls within the European EPIC cohort, using plasma samples collected up to 60 months prior to diagnosis. The detection discrimination statistics were calculated for risk scores by strata of lag-time. For CA19-9, in univariate marker analyses, C-statistics to distinguish future pancreatic cancer patients from cancer-free individuals were 0.80 for plasma taken ≤6 months before diagnosis, and 0.71 for >6-18 months; for ApoA2-ATQ/AT, C-statistics were 0.62, and 0.65, respectively. Joint models based on ApoA2-ATQ/AT plus CA19-9 significantly improved discrimination within >6-18 months (C = 0.74 vs. 0.71 for CA19-9 alone, p = 0.022) and ≤ 18 months (C = 0.75 vs. 0.74, p = 0.022). At 98% specificity, and for lag times of ≤6, >6-18 or ≤ 18 months, sensitivities were 57%, 36% and 43% for CA19-9 combined with ApoA2-ATQ/AT, respectively, vs. 50%, 29% and 36% for CA19-9 alone. Compared to CA19-9 alone, the combination of CA19-9 and ApoA2-ATQ/AT may improve detection of pancreatic cancer up to 18 months prior to diagnosis under usual care, and may provide a useful first measure for pancreatic cancer detection prior to imaging.

Matched MeSH terms: Pancreatic Neoplasms/diagnosis*

Fulltext Functional single nucleotide polymorphisms within the cyclin-dependent kinase inhibitor 2A/2B region affect pancreatic cancer risk

Campa D, Pastore M, Gentiluomo M, Talar-Wojnarowska R, Kupcinskas J, Malecka-Panas E, et al.

Oncotarget, 2016 08 30;7(35):57011-57020.

PMID: 27486979 DOI: 10.18632/oncotarget.10935

The CDKN2A (p16) gene plays a key role in pancreatic cancer etiology. It is one of the most commonly somatically mutated genes in pancreatic cancer, rare germline mutations have been found to be associated with increased risk of developing familiar pancreatic cancer and CDKN2A promoter hyper-methylation has been suggested to play a critical role both in pancreatic cancer onset and prognosis. In addition several unrelated SNPs in the 9p21.3 region, that includes the CDNK2A, CDNK2B and the CDNK2B-AS1 genes, are associated with the development of cancer in various organs. However, association between the common genetic variability in this region and pancreatic cancer risk is not clearly understood. We sought to fill this gap in a case-control study genotyping 13 single nucleotide polymorphisms (SNPs) in 2,857 pancreatic ductal adenocarcinoma (PDAC) patients and 6,111 controls in the context of the Pancreatic Disease Research (PANDoRA) consortium. We found that the A allele of the rs3217992 SNP was associated with an increased pancreatic cancer risk (ORhet=1.14, 95% CI 1.01-1.27, p=0.026, ORhom=1.30, 95% CI 1.12-1.51, p=0.00049). This pleiotropic variant is reported to be a mir-SNP that, by changing the binding site of one or more miRNAs, could influence the normal cell cycle progression and in turn increase PDAC risk. In conclusion, we observed a novel association in a pleiotropic region that has been found to be of key relevance in the susceptibility to various types of cancer and diabetes suggesting that the CDKN2A/B locus could represent a genetic link between diabetes and pancreatic cancer risk.

Matched MeSH terms: Pancreatic Neoplasms/diagnosis

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