Pub Date : 2021-01-01DOI: 10.36648/1590-8577.21.22.93-98
Ergun Sefa, T. Emre, Batur Sebnem Pekmezci Yasemin, Velidedeoglu Mehmet, S. Osman, Pekmezci Salih
Introduction Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare clinical entity with low malignant potential and good clinical prognosis. It was first defined by Frantz Virginia in 1959 and was renamed solid pseudopapillary tumor by the World Health Organization (WHO) in 2010. SPN is more common in young women with an average age of 28-32 years and a female: male ratio of 3-10:1 in different publications. Material & Method The data were retrospectively analyzed for 26 patients whose pathology was compatible with SPN and operated on between 2003 and 2019 in the General Surgery Clinic at XXX. Results Of the patients, 25 (96.2%) were female and 1 (3.8%) was male; the mean age at diagnosis was 37.1 (range: 18-69, eight patients <30 years); mean body mass index was 28.8 kg/m2. The most common reason for referral was abdominal pain (n=13, 50%); three patients (11%) had nausea and vomiting, and one patient (3.8%) had jaundice with mass at the head of the pancreas. Ten patients (38%) were asymptomatic and were diagnosed incidentally during examinations performed for other reasons. The most frequent tumor localization was the head and neck part of the pancreas (n=10, 38%); eight patients (31%) had body, and eight patients (31%) had tail localization. Ten patients (38%) had Whipple procedure (pancreaticoduodenectomy), 15 patients (53%) had distal pancreatectomy, and one patient had intra-abdominal mass excision and segmental small bowel resection operation in addition to distal pancreatectomy. Six (37%) of the 16 patients who underwent distal pancreatectomy had splenectomy too. One of the patients had laparoscopic distal pancreatectomy and splenectomy. The mean tumor diameter was 7.2 cm (range: 2-23 cm). Conclusion SPN is a rare tumor, and even though it is diagnosed late and in large sizes, it has prolonged survival when appropriate surgical resection is applied. The ability to perform surgery even in cases with relapse or meta stasis during the SPN follow-up reveals the importance of accurate diagnosis.
{"title":"Solid Pseudopapillary Neoplasm of the Pancreas: A Good Prognostic Tumor of the Bad Lucky Organ","authors":"Ergun Sefa, T. Emre, Batur Sebnem Pekmezci Yasemin, Velidedeoglu Mehmet, S. Osman, Pekmezci Salih","doi":"10.36648/1590-8577.21.22.93-98","DOIUrl":"https://doi.org/10.36648/1590-8577.21.22.93-98","url":null,"abstract":"Introduction Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare clinical entity with low malignant potential and good clinical prognosis. It was first defined by Frantz Virginia in 1959 and was renamed solid pseudopapillary tumor by the World Health Organization (WHO) in 2010. SPN is more common in young women with an average age of 28-32 years and a female: male ratio of 3-10:1 in different publications. Material & Method The data were retrospectively analyzed for 26 patients whose pathology was compatible with SPN and operated on between 2003 and 2019 in the General Surgery Clinic at XXX. Results Of the patients, 25 (96.2%) were female and 1 (3.8%) was male; the mean age at diagnosis was 37.1 (range: 18-69, eight patients <30 years); mean body mass index was 28.8 kg/m2. The most common reason for referral was abdominal pain (n=13, 50%); three patients (11%) had nausea and vomiting, and one patient (3.8%) had jaundice with mass at the head of the pancreas. Ten patients (38%) were asymptomatic and were diagnosed incidentally during examinations performed for other reasons. The most frequent tumor localization was the head and neck part of the pancreas (n=10, 38%); eight patients (31%) had body, and eight patients (31%) had tail localization. Ten patients (38%) had Whipple procedure (pancreaticoduodenectomy), 15 patients (53%) had distal pancreatectomy, and one patient had intra-abdominal mass excision and segmental small bowel resection operation in addition to distal pancreatectomy. Six (37%) of the 16 patients who underwent distal pancreatectomy had splenectomy too. One of the patients had laparoscopic distal pancreatectomy and splenectomy. The mean tumor diameter was 7.2 cm (range: 2-23 cm). Conclusion SPN is a rare tumor, and even though it is diagnosed late and in large sizes, it has prolonged survival when appropriate surgical resection is applied. The ability to perform surgery even in cases with relapse or meta stasis during the SPN follow-up reveals the importance of accurate diagnosis.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69688939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1590-8577.21.22.77-82
Beatriz Yukari Yokoyama, E. Chehter
Context The acquired immunodeficiency syndrome (AIDS) has become one of the biggest pandemics since 1981. According to the Joint United Nations Program on HIV/AIDS (UNAIDS), in 2018, 38 million people worldwide were living with HIV. In parallel to this scenario, the prevalence and mortality of diabetes have increased in recent decades. Thus, it would be pertinent to know if the risk factors for the development of diabetes mellitus to which people with HIV/AIDS are exposed are the same as those of the non-infected population. According to autopsy studies conducted at the Sao Paulo Death Verification Service, University of Sao Paulo, HIV-infected patients in the pre-HAART era (Highly Active Antiretroviral Therapy) presented histological changes in the exocrine pancreas, although in the endocrine pancreas these were not significant. In the post-HAART era, the exocrine pancreas continued to present histological changes, but in this population, they also occurred in the endocrine pancreas and were particularly important in the islets of Langerhans. Objective We seek to address the relationship between the use of HAART for the treatment of HIV/AIDS and the possible impacts on the pancreas. Methods Horizontal review by the Prisma method, bibliographic search in PubMed and Google Scholar. Results Was observed an association between the development of diabetes mellitus and the use of HAART, mainly with the oldest protease inhibitors from 1997-2004. Conclusion Although diabetes mellitus is a multifactorial pathology, antiretrovirals have played an important role in increasing the prevalence of diabetes mellitus in the population undergoing HIV/AIDS treatment.
{"title":"Diabetes and HIV: What Do We Know?","authors":"Beatriz Yukari Yokoyama, E. Chehter","doi":"10.36648/1590-8577.21.22.77-82","DOIUrl":"https://doi.org/10.36648/1590-8577.21.22.77-82","url":null,"abstract":"Context The acquired immunodeficiency syndrome (AIDS) has become one of the biggest pandemics since 1981. According to the Joint United Nations Program on HIV/AIDS (UNAIDS), in 2018, 38 million people worldwide were living with HIV. In parallel to this scenario, the prevalence and mortality of diabetes have increased in recent decades. Thus, it would be pertinent to know if the risk factors for the development of diabetes mellitus to which people with HIV/AIDS are exposed are the same as those of the non-infected population. According to autopsy studies conducted at the Sao Paulo Death Verification Service, University of Sao Paulo, HIV-infected patients in the pre-HAART era (Highly Active Antiretroviral Therapy) presented histological changes in the exocrine pancreas, although in the endocrine pancreas these were not significant. In the post-HAART era, the exocrine pancreas continued to present histological changes, but in this population, they also occurred in the endocrine pancreas and were particularly important in the islets of Langerhans. Objective We seek to address the relationship between the use of HAART for the treatment of HIV/AIDS and the possible impacts on the pancreas. Methods Horizontal review by the Prisma method, bibliographic search in PubMed and Google Scholar. Results Was observed an association between the development of diabetes mellitus and the use of HAART, mainly with the oldest protease inhibitors from 1997-2004. Conclusion Although diabetes mellitus is a multifactorial pathology, antiretrovirals have played an important role in increasing the prevalence of diabetes mellitus in the population undergoing HIV/AIDS treatment.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69689214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1590-8577.21.S5.01-03
Kevin Y. Wang, Fatima Fayaaz, Jeffrey Chi, P. Lee, M. Saif
Pancreatic adenocarcinoma is associated with high rates of mortality due to a high rate of recurrence even in early stage resected disease. Metastatic disease of the pancreas usually presents initially with spread to the surgical bed, liver, and lungs, and further metastatic disease to the bone is rare. Here, we present a case of pancreatic cancer recurrence with isolated osteoblastic and osteolytic bone metastasis without visceral organ spread in a patient with early stage resected pancreatic head adenocarcinoma. We review the literature for such cases and propose possible mechanisms and treatments.
{"title":"Early Resected Pancreatic Head Adenocarcinoma with Development of Sole Osteoblastic/Osteolytic Metastatic Disease: A Case Report and Review of the Literature","authors":"Kevin Y. Wang, Fatima Fayaaz, Jeffrey Chi, P. Lee, M. Saif","doi":"10.36648/1590-8577.21.S5.01-03","DOIUrl":"https://doi.org/10.36648/1590-8577.21.S5.01-03","url":null,"abstract":"Pancreatic adenocarcinoma is associated with high rates of mortality due to a high rate of recurrence even in early stage resected disease. Metastatic disease of the pancreas usually presents initially with spread to the surgical bed, liver, and lungs, and further metastatic disease to the bone is rare. Here, we present a case of pancreatic cancer recurrence with isolated osteoblastic and osteolytic bone metastasis without visceral organ spread in a patient with early stage resected pancreatic head adenocarcinoma. We review the literature for such cases and propose possible mechanisms and treatments.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69689572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1590-8577.21.S4.004
Narendra Singh
{"title":"A short report on Focal autoimmune Pancreatitis","authors":"Narendra Singh","doi":"10.36648/1590-8577.21.S4.004","DOIUrl":"https://doi.org/10.36648/1590-8577.21.S4.004","url":null,"abstract":"","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"11 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69689711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1590-8577.21.S4.003
U. Divya
{"title":"Undifferentiated carcinoma of pancreas in a young Persons","authors":"U. Divya","doi":"10.36648/1590-8577.21.S4.003","DOIUrl":"https://doi.org/10.36648/1590-8577.21.S4.003","url":null,"abstract":"","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69689172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1590-8577.21.S5.09-16
B. Chong, T. Gardner
Cystic fibrosis (CF) is the most common genetic disease among Caucasians; worldwide, it affects up to 80,000 children and adults. Its pathophysiology is due to a mutation of the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) channel, which alters the secretory epithelium of organs including lungs, intestines, sinuses and pancreas. The pancreas in particular can be affected and cystic fibrosis can result in acute pancreatitis, chronic pancreatitis, and pancreatic insufficiency, which can affect all ages with significant morbidity and mortality. Research has explored the interplay of cofactors that contribute to the pathophysiology of pancreatic-related disorders. This has provided clues to early screening and counseling for the cystic fibrosis population, as well as insights treating this disease. While there are currently no targeted therapies for CF-related pancreatic disorders, recent investigation of CFTR modulators and other mechanisms provides future promise.
{"title":"Cystic Fibrosis-Related Pancreatic Disorders","authors":"B. Chong, T. Gardner","doi":"10.36648/1590-8577.21.S5.09-16","DOIUrl":"https://doi.org/10.36648/1590-8577.21.S5.09-16","url":null,"abstract":"Cystic fibrosis (CF) is the most common genetic disease among Caucasians; worldwide, it affects up to 80,000 children and adults. Its pathophysiology is due to a mutation of the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) channel, which alters the secretory epithelium of organs including lungs, intestines, sinuses and pancreas. The pancreas in particular can be affected and cystic fibrosis can result in acute pancreatitis, chronic pancreatitis, and pancreatic insufficiency, which can affect all ages with significant morbidity and mortality. Research has explored the interplay of cofactors that contribute to the pathophysiology of pancreatic-related disorders. This has provided clues to early screening and counseling for the cystic fibrosis population, as well as insights treating this disease. While there are currently no targeted therapies for CF-related pancreatic disorders, recent investigation of CFTR modulators and other mechanisms provides future promise.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69689634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1590-8577.22.1.29-30
V. Hosdurg
Neuroendocrine tumors are a heterogenous group of tumors arising most commonly in the gastrointestinal tract and in the bronchus pulmonary tree. Other rare sites include parathyroid and adrenal glands. Peripancreatic lymph-node as a primary site for neuroendocrine tumor is extremely rare and no reports could be seen in literature. A thorough search of literature found a case report of a primary neuroendocrine tumor of the inguinal lymph-node. Reporting the case report of a 48year old man who presented with complains of epigastric pain and on evaluation found to have an exophytic tumor from the superior border of the body of pancreas. At surgery the tumor was found to be separate from the pancreas and was easily enucleated off the superior border of pancreas. Histopathology of the excised tumor showed features of an NET within a lymph-node. He was followed up closely and at 1year post operatively patient is asymptomatic and in good health.
{"title":"Primary Neuroendocrine Tumor of Peripancreatic Lymph Node - A Rare Case Report","authors":"V. Hosdurg","doi":"10.36648/1590-8577.22.1.29-30","DOIUrl":"https://doi.org/10.36648/1590-8577.22.1.29-30","url":null,"abstract":"Neuroendocrine tumors are a heterogenous group of tumors arising most commonly in the gastrointestinal tract and in the bronchus pulmonary tree. Other rare sites include parathyroid and adrenal glands. Peripancreatic lymph-node as a primary site for neuroendocrine tumor is extremely rare and no reports could be seen in literature. A thorough search of literature found a case report of a primary neuroendocrine tumor of the inguinal lymph-node. Reporting the case report of a 48year old man who presented with complains of epigastric pain and on evaluation found to have an exophytic tumor from the superior border of the body of pancreas. At surgery the tumor was found to be separate from the pancreas and was easily enucleated off the superior border of pancreas. Histopathology of the excised tumor showed features of an NET within a lymph-node. He was followed up closely and at 1year post operatively patient is asymptomatic and in good health.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69689644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1590-8577.22.2.55-56
M. Siena, C. Gallo, I. Boškoski, G. Costamagna
{"title":"A Rock in the Belly: Medicine is not an Exact Science","authors":"M. Siena, C. Gallo, I. Boškoski, G. Costamagna","doi":"10.36648/1590-8577.22.2.55-56","DOIUrl":"https://doi.org/10.36648/1590-8577.22.2.55-56","url":null,"abstract":"","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69690201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1590-8577.22.2.57-62
A. Muthukumar
While numerous causes of pancreatitis have been documented, many of the causal associations have not been studied widely. Drug induced disorders include a wide variety of clinical symptoms varying from mild skin rash to severe life-threatening reactions. Pancreatitis is known to be associated with many drugs as well as immune mediated disorders. Drug induced pancreatitis is a type of acute event which shows classical evidence supporting an acute pancreatic inflammation and associated systemic features. Pancreatitis with normal blood work up is an interesting area still warranting proper pathophysiological mechanism involved. In this report we document a case who had two such drug induced events.
{"title":"Azathioprine Induced Normal Lipase Pancreatitis in a Case of Bullous Pemphigoid","authors":"A. Muthukumar","doi":"10.36648/1590-8577.22.2.57-62","DOIUrl":"https://doi.org/10.36648/1590-8577.22.2.57-62","url":null,"abstract":"While numerous causes of pancreatitis have been documented, many of the causal associations have not been studied widely. Drug induced disorders include a wide variety of clinical symptoms varying from mild skin rash to severe life-threatening reactions. Pancreatitis is known to be associated with many drugs as well as immune mediated disorders. Drug induced pancreatitis is a type of acute event which shows classical evidence supporting an acute pancreatic inflammation and associated systemic features. Pancreatitis with normal blood work up is an interesting area still warranting proper pathophysiological mechanism involved. In this report we document a case who had two such drug induced events.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"41 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69690209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1590-8577.21.22.123
Athiba Saha
{"title":"Why do we need to be focused on pancreatic cancer","authors":"Athiba Saha","doi":"10.36648/1590-8577.21.22.123","DOIUrl":"https://doi.org/10.36648/1590-8577.21.22.123","url":null,"abstract":"","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69688463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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