-
European Review For Medical and... Jun 2017Intraductal Papillary Mucinous Neoplasms (IPMNs) are the most common cystic tumors of the pancreas and are considered premalignant lesions. IPMNs are characterized by... (Review)
Review
Intraductal Papillary Mucinous Neoplasms (IPMNs) are the most common cystic tumors of the pancreas and are considered premalignant lesions. IPMNs are characterized by the papillary growth of the ductal epithelium with rich mucin production, which is responsible for cystic segmental or diffuse dilatation of the main pancreatic duct (MPD) and/or its branches. According to the different involvement of pancreatic duct system, IPMNs are divided into main duct type (MD-IPMN), branch duct type (BD-IPMN), and mixed type (MT-IPMN). IPMNs may be incidentally discovered in asymptomatic patients, particularly in those with BD-IPMNs, when imaging studies are performed for unrelated indications. The increase in their frequency may reflect the combined effects of new diagnostic techniques, the improvement of radiologic exams and progress in the recognition of the pathology. MD-IPMNs present a higher risk of malignant progression than BD-IPMNs; as a consequence, all the guidelines strictly suggest the need of surgery for MD- and MT- IPMNs with MPD > 10 mm, while the management of BD-IPMNs is still controversial and depends on several cysts and patients features. The choice between non-operative and surgical management depends on the distinction between benign and invasive IPMN forms, assessment of malignancy risk, patient's wellness and its preferences. This manuscript revises the different guidelines for the management of IPMNs that have been published in different world countries: the international (Sendai 2006 and Fukuoka 2012), the 2013 European, the 2014 Italian, and finally the 2015 American guidelines. In summary, this review will integrate the recent insights in the combination of diagnostic techniques, such as Magnetic Resonance Imaging (MRI) and endoscopic ultrasound (EUS), pathology classification, and management of IPMNs.
Topics: Adenocarcinoma, Mucinous; Adenocarcinoma, Papillary; Endosonography; Humans; Magnetic Resonance Imaging; Pancreatic Ducts; Pancreatic Neoplasms; Practice Guidelines as Topic
PubMed: 28682431
DOI: No ID Found -
Frontiers in Endocrinology 2023The 2015 American Thyroid Association guidelines proposed recurrence risk stratification of differentiated thyroid carcinoma, including papillary thyroid carcinoma... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The 2015 American Thyroid Association guidelines proposed recurrence risk stratification of differentiated thyroid carcinoma, including papillary thyroid carcinoma (PTC), but this stratification excluded non-initial treatment patients with worse outcomes. This study aimed to explore the potential risk factors for recurrence in PTC and develop a predictive model for both initial and non-initial treatment of patients with PTC.
METHODS
A total of 955 patients were included in this study. Differences between the recurrence (-) and recurrence (+) groups were compared. The 955 patients were randomized into two groups: the training group (671 cases) and the validation group (284 cases). All variables were selected using the LASSO regression analysis. A nomogram was developed based on the results of the univariate and multivariate logistic regression analyses. The nomogram performance was evaluated using discrimination and calibration.
RESULTS
Patients aged ≥55 years, extranodal extension (ENE), metastatic LN ratio (LNR) >0.5, and non-initial treatment were identified as potential risk factors for recurrence through LASSO regression and univariate and multivariate analyses. The receiver operating characteristic curve (ROC curve) showed high efficiency, with an area under the ROC curve (AUC) of 0.819 (95% confidence interval [CI], 0.729-0.909) and 0.818 (95% CI, 0.670-0.909) in the training and validation groups, respectively. The calibration curve indicated that the nomogram had a good consistency.
CONCLUSION
In patients with PTC, age ≥55 years, ENE, LNR >0.5, and non-initial treatment are potential risk factors for recurrence. The predictive model of recurrence was confirmed to be a practical and convenient tool for clinicians to accurately predict PTC recurrence.
Topics: Humans; Thyroid Cancer, Papillary; Retrospective Studies; Lymph Nodes; Thyroid Neoplasms; Risk Factors
PubMed: 37810888
DOI: 10.3389/fendo.2023.1268282 -
Journal of Clinical Laboratory Analysis Jan 2023According to the new 2022 World Health Organization classification of endocrine tumors, thyroid malignancy, formerly known as the cribriform-morular variant of papillary...
BACKGROUND
According to the new 2022 World Health Organization classification of endocrine tumors, thyroid malignancy, formerly known as the cribriform-morular variant of papillary thyroid carcinoma, is now categorized as differentiated thyroid malignancy; it is, at present, called cribriform-morular thyroid carcinoma and classified as a tumor of unknown histogenesis.
CASE REPORT
In this case report, we report on a 15-year-old patient who underwent external radiotherapy to the neck for Hodgkin's disease and developed cribriform-morular thyroid carcinoma 5 years after radiotherapy.
CONCLUSIONS
We believe that cribriform-morular thyroid carcinoma with diffuse nuclear beta-catenin expression has exciting and unresolved uncertainties that may affect disease prognosis and follow-up for cytopathologists and endocrinologists.
Topics: Humans; Adolescent; Thyroid Neoplasms; Thyroid Cancer, Papillary; Neck
PubMed: 36535913
DOI: 10.1002/jcla.24819 -
The Journal of Veterinary Medical... Mar 2022Dogs with ovarian papillary adenocarcinoma occasionally present with ascites and/or pleural effusion. These aspirated fluids often contain a large number of cells, and...
Dogs with ovarian papillary adenocarcinoma occasionally present with ascites and/or pleural effusion. These aspirated fluids often contain a large number of cells, and distinction between neoplastic cells and activated mesothelial cells can be difficult. In this study, 7 cases of canine ovarian papillary adenocarcinoma, including 3 with ascites and pleural effusion, were immunohistochemically examined. Ovarian tumor cells were positive for cytokeratin CAM5.2 (CAM5.2), Wilms' tumor 1 (WT-1) and progesterone receptor (PR) in all 7 cases. A metastatic lesion of the mediastinum in one case was also positive for CAM5.2, WT-1 and PR. Immunohistochemistry on cell blocks obtained from ascites and/or pleural effusion of 2 cases revealed the presence of PR-positive epithelial cells. Whereas, activated mesothelial cells in ascites or pleural effusion collected from dogs without neoplastic lesions were negative for PR. In addition, surface epithelium and subsurface epithelial structures (SES) of normal canine ovaries, that are considered to be the cell of origin for ovarian papillary adenocarcinoma, were also positive for CAM5.2, WT-1 and PR. These results indicate that, together with CAM5.2, WT-1 and PR is a useful diagnostic marker for canine ovarian papillary adenocarcinoma. Expression of PR may be associated with progesterone-dependent nature of canine ovarian papillary adenocarcinoma.
Topics: Adenocarcinoma, Papillary; Animals; Biomarkers, Tumor; Diagnosis, Differential; Dog Diseases; Dogs; Immunohistochemistry; Kidney Neoplasms; Ovarian Neoplasms; Pleural Effusion, Malignant
PubMed: 35110458
DOI: 10.1292/jvms.21-0633 -
Medicine Dec 2018Endoscopic submucosal dissection (ESD) is a primary treatment for the early gastric cancer (EGC) who has a negligible risk of lymph node metastasis. Papillary... (Review)
Review
BACKGROUND
Endoscopic submucosal dissection (ESD) is a primary treatment for the early gastric cancer (EGC) who has a negligible risk of lymph node metastasis. Papillary adenocarcinoma (PAC) of stomach is a rare histologic variant of gastric cancer and categorized into EGC with differentiated-histology. However, aggressive features such as higher rate of lymphovascular invasion (LVI) or submucosal invasion have been reported, whereas comparable lymph node metastasis (LNM) rate to the lesions meeting the current ESD criteria also has been reported. This study aimed to evaluate the feasibility of ESD for EGC with PAC.
METHODS
We will search the core databases (MEDLINE (through PubMed), the Cochrane Library, and Embase) from their inception to December 2018 by 2 independent evaluators. The P.I.C.O. is as follows; Patients: who have EGC with PAC, Intervention: ESD or surgery, Comparison: none, Outcome: at least one among the rate of complete resection, curative resection, en bloc resection, recurrence, procedure-related adverse event, LVI or LNM that enabled an evaluation of the feasibility of ESD. All types of study design with full text will be sought and included. The risk of bias will be assessed using the ROBINS-I tool. Descriptive data synthesis is planned, and quantitative synthesis will be used if the included studies are sufficiently homogenous. Publication bias will be assessed with quantitative analyses if more than 10 articles are enrolled.
RESULTS
The results will provide evidence for efficacy and safety of ESD for EGC with PAC.
CONCLUSION
This study will provide evidence of ESD for EGC with PAC.
Topics: Adenocarcinoma, Papillary; Endoscopic Mucosal Resection; Humans; Lymphatic Metastasis; Research Design; Stomach Neoplasms
PubMed: 30593208
DOI: 10.1097/MD.0000000000013905 -
BMC Cancer Nov 2022This study aimed to analyze the ability of computed tomography (CT) texture analysis to discriminate papillary gastric adenocarcinoma (PGC) and to explore the diagnostic...
BACKGROUND
This study aimed to analyze the ability of computed tomography (CT) texture analysis to discriminate papillary gastric adenocarcinoma (PGC) and to explore the diagnostic efficacy of multivariate models integrating clinical information and CT texture parameters for discriminating PGCs.
METHODS
This retrospective study included 20 patients with PGC and 80 patients with tubular adenocarcinoma (TAC). The clinical data and CT texture parameters based on the arterial phase (AP) and venous phase (VP) of all patients were collected and analyzed. Two CT signatures based on the AP and VP were built with the optimum features selected by the least absolute shrinkage and selection operator method. The performance of CT signatures was tested by regression analysis. Multivariate models based on regression analysis and the support vector machine (SVM) algorithm were established. The diagnostic performance of the established nomogram based on regression analysis was evaluated by receiver operating characteristic curve analysis.
RESULTS
Thirty-two and fifteen CT texture parameters extracted from AP and VP CT images, respectively, differed significantly between PGCs and TACs (all p < 0.05). The diagnostic performance of CT signatures based on the AP and VP achieved AUCs of 0.873 and 0.859 in distinguishing PGCs. Multivariate models that integrated two CT signatures and age based on regression analysis and the SVM algorithm showed favorable performance in preoperatively predicting PGCs (AUC = 0.922 and 0.914, respectively).
CONCLUSION
CT texture analysis based multivariate models could preoperatively predict PGCs with satisfactory diagnostic efficacy.
Topics: Humans; Retrospective Studies; Adenocarcinoma; Stomach Neoplasms; Tomography, X-Ray Computed; ROC Curve; Adenocarcinoma, Papillary
PubMed: 36357844
DOI: 10.1186/s12885-022-10261-8 -
Tumour Biology : the Journal of the... Mar 2017We aimed to demonstrate the differences in the expression of glucose metabolism-related proteins according to the thyroid cancer subtypes and investigate the...
We aimed to demonstrate the differences in the expression of glucose metabolism-related proteins according to the thyroid cancer subtypes and investigate the implications of these differences. A total of 566 thyroid cancer patients, including 342 cases of papillary thyroid carcinoma, 112 cases of follicular carcinoma, 70 cases of medullary carcinoma, 23 cases of poorly differentiated carcinoma, 19 cases of anaplastic carcinoma, and 152 cases of follicular adenoma, were enrolled in the study. Immunohistochemical staining for glucose transporter 1, hexokinase II, carbonic anhydrase IX, and monocarbonylate transporter 4 was performed, and the relationship between immunoreactivity and clinicopathologic parameters was analyzed. Glucose transporter 1 and tumoral monocarbonylate transporter 4 expression levels were shown to be the highest in anaplastic carcinoma, and medullary carcinoma showed the highest carbonic anhydrase IX and lowest hexokinase II levels compared with other subtypes. Stromal expression of monocarbonylate transporter 4 was observed in papillary thyroid carcinoma and anaplastic carcinoma samples. Conventional papillary thyroid carcinoma tumors expressed higher levels of glucose transporter 1, and tumoral and stromal monocarbonylate transporter 4, than the follicular variant, which showed a higher expression of carbonic anhydrase IX. Papillary thyroid carcinoma samples with BRAF V600E mutation were shown to have higher glucose transporter 1, hexokinase II, carbonic anhydrase IX, and tumoral monocarbonylate transporter 4 expression levels. Univariate analysis showed that papillary thyroid carcinoma cases with glucose transporter 1 positivity had shorter overall survival, patients with medullary carcinoma and hexokinase II positivity were shown to have a shorter disease-free survival and overall survival, and tumoral monocarbonylate transporter 4 positivity was associated with shorter overall survival compared with papillary thyroid carcinoma patients with negativity for each marker. Disease-free survival and overall survival of patients with poorly differentiated carcinoma were shown to be significantly decreased when glucose transporter 1 and tumoral monocarbonylate transporter 4 are expressed. We demonstrated that the expression levels of glycolysis-related proteins differ between thyroid cancer subtypes and are correlated with poorer prognosis, depending on the subtype.
Topics: Adenocarcinoma, Follicular; Adenoma; Carbonic Anhydrase IX; Carcinoma; Carcinoma, Medullary; Carcinoma, Papillary; Disease-Free Survival; Female; Gene Expression Regulation, Neoplastic; Glucose; Glucose Transporter Type 1; Glycolysis; Hexokinase; Humans; Male; Monocarboxylic Acid Transporters; Muscle Proteins; Thyroid Cancer, Papillary; Thyroid Neoplasms; Tissue Array Analysis
PubMed: 28347233
DOI: 10.1177/1010428317695922 -
Medicine Jun 2019Endoscopic submucosal dissection (ESD) has increasingly been used to treat early gastric cancer (EGC); however, its efficacy in treating papillary adenocarcinoma-type...
Endoscopic submucosal dissection (ESD) has increasingly been used to treat early gastric cancer (EGC); however, its efficacy in treating papillary adenocarcinoma-type EGC remains unknown.We sought to identify risk factors for lymph node (LN) metastasis in papillary adenocarcinoma-type EGC and evaluate the clinical outcome after ESD.This study retrospectively reviewed the medical records of patients who were diagnosed with EGC in our hospital from January 2009 to December 2016. In total, 85 patients had papillary adenocarcinoma-type EGC, of whom 52 and 33 underwent surgical treatment and ESD, respectively. This study analyzed the LN metastasis risk factors and clinical outcomes between these 2 groups and with those of an existing ESD indication group.LN metastasis occurred in 13 (25.0%) of 52 patients who underwent surgery. Multivariate analysis indicated that lymphovascular invasion was an independent risk factor (odds ratio: 20.624; 95% confidence interval: 19.628-21.497; P = .001). Of 33 patients who underwent ESD, 21 (63.6%) had an absolute indication and 12 (36.4%) had an expanded indication. All 3 (9.1%) patients with non-curative resection underwent additional surgery. The clinical outcomes were compared to those of 926 patients who underwent ESD of non-papillary adenocarcinoma-type EGC. There were no significant differences in curative resection rate (P = .327), procedure-related complication (P = .853), local recurrence (P = 1.000), or overall survival (P = 1.000).ESD of papillary adenocarcinoma-type EGC showed an acceptable outcome in comparison to an existing ESD indication group. However, these patients exhibit a relatively higher risk of LN metastasis.
Topics: Adenocarcinoma, Papillary; Aged; Endoscopic Mucosal Resection; Female; Gastrectomy; Humans; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Republic of Korea; Retrospective Studies; Risk Factors; Stomach Neoplasms
PubMed: 31232966
DOI: 10.1097/MD.0000000000016134 -
Cancer Cytopathology Jul 2019Certain carcinomas of the thyroid gland behave aggressively resulting in increased patient morbidity and poor patient prognosis. The diagnosis of these aggressive... (Review)
Review
Certain carcinomas of the thyroid gland behave aggressively resulting in increased patient morbidity and poor patient prognosis. The diagnosis of these aggressive thyroid cancer subtypes is sometimes challenging and subject to increased interobserver variability. This review deals with the cytological features of such tumors including aggressive variants of papillary thyroid carcinoma, poorly differentiated thyroid carcinoma, and anaplastic thyroid carcinoma. These malignancies fall into 2 groups based on their cytomorphology: those that exhibit distinct microscopic features (eg, nuclear findings typical of classical papillary thyroid carcinoma or marked anaplasia) and those that present with more subtle cytologic features (eg, nuclear pseudostratification, "soap bubble" nuclei, supranuclear or subnuclear cytoplasmic vacuoles, rosette-like structures, hobnail cells). We review the literature regarding these aggressive thyroid cancers and highlight important phenotypic characteristics that can be useful for their diagnosis based on fine needle aspiration.
Topics: Adenocarcinoma, Follicular; Biopsy, Fine-Needle; Diagnosis, Differential; Humans; Prognosis; Thyroid Cancer, Papillary; Thyroid Carcinoma, Anaplastic; Thyroid Gland; Thyroid Neoplasms
PubMed: 31150164
DOI: 10.1002/cncy.22136 -
Clinical Case Reports Sep 2021We present the case of a 64-year-old male with a 3-month history of a mass involving the distal portion of the fifth finger on the left hand which was histologically...
We present the case of a 64-year-old male with a 3-month history of a mass involving the distal portion of the fifth finger on the left hand which was histologically confirmed as digital papillary adenocarcinoma. Although the tumor is low grade, the chances of recurrence and metastasis are high.
PubMed: 34532052
DOI: 10.1002/ccr3.4814