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World Journal of Gastrointestinal... Mar 2015Rapid advances in radiologic technology and increased cross-sectional imaging have led to a sharp rise in incidental discoveries of pancreatic cystic lesions. These... (Review)
Review
Rapid advances in radiologic technology and increased cross-sectional imaging have led to a sharp rise in incidental discoveries of pancreatic cystic lesions. These cystic lesions include non-neoplastic cysts with no risk of malignancy, neoplastic non-mucinous serous cystadenomas with little or no risk of malignancy, as well as neoplastic mucinous cysts and solid pseudopapillary neoplasms both with varying risk of malignancy. Accurate diagnosis is imperative as management is guided by symptoms and risk of malignancy. Endoscopic ultrasound (EUS) allows high resolution evaluation of cyst morphology and precise guidance for fine needle aspiration (FNA) of cyst fluid for cytological, chemical and molecular analysis. Initially, clinical evaluation and radiologic imaging, preferably with magnetic resonance imaging of the pancreas and magnetic resonance cholangiopancreatography, are performed. In asymptomatic patients where diagnosis is unclear and malignant risk is indeterminate, EUS-FNA should be used to confirm the presence or absence of high-risk features, differentiate mucinous from non-mucinous lesions, and diagnose malignancy. After analyzing the cyst fluid for viscosity, cyst fluid carcinoembryonic antigen, amylase, and cyst wall cytology should be obtained. DNA analysis may add useful information in diagnosing mucinous cysts when the previous studies are indeterminate. New molecular biomarkers are being investigated to improve diagnostic capabilities and management decisions in these challenging cystic lesions. Current guidelines recommend surgical pancreatic resection as the standard of care for symptomatic cysts and those with high-risk features associated with malignancy. EUS-guided cyst ablation is a promising minimally invasive, relatively low-risk alternative to both surgery and surveillance.
PubMed: 25789091
DOI: 10.4253/wjge.v7.i3.213 -
Polski Przeglad Chirurgiczny Feb 2017The aim of this study was to assess short-term outcomes of surgical treatment of pancreatic cystic tumors (PCTs).
UNLABELLED
The aim of this study was to assess short-term outcomes of surgical treatment of pancreatic cystic tumors (PCTs).
MATERIAL AND METHODS
We retrospectively reviewed medical records of 46 patients (31 women and 15 men) who had undergone surgery for pancreatic cystic tumors in our department.
RESULTS
Pancreatic cystic tumors were located within the pancreatic head (21), body (11), tail (13), and whole pancreas (1). The following surgical procedures were performed: pancreatoduodenectomy (20), central pancreatectomy (9), distal pancreatectomy (3), distal pancreatectomy with splenectomy (3), distal extended pancreatectomy with splenectomy (2), total pancreatectomy (1), duodenum preserving pancreatic head resection (1), local tumor resection (4), and other procedures (2). Histopathological tumor types were as follows: serous cystadenoma (14), intraductal papillary mucinous adenoma (5), intraductal papillary mucinous carcinoma (5), solid pseudopapillary tumor (5), mucinous cystadenoma (5), mucinous cystadenoma with border malignancy (1), mucinous cystadenocarcinoma (2), adenocarcinoma (4), and other tumors (5). Early postoperative complications were observed in 14 (30.43%) patients. Reoperations were performed in 9 (19.56%) patients. The perioperative mortality rate was 6.52%.
CONCLUSIONS
Serous cystadenoma was the most common pancreatic cystic tumor in the analyzed group. PCTs were most frequently located within the pancreatic head. Pancreatic resection was possible in most patients, and pancreatoduodenectomy was the most common pancreatic resection type.
Topics: Cystadenoma, Mucinous; Cystadenoma, Serous; Female; Humans; Male; Pancreas; Pancreatectomy; Pancreatic Cyst; Pancreaticoduodenectomy; Poland; Retrospective Studies; Treatment Outcome
PubMed: 28522787
DOI: 10.5604/01.3001.0009.6008 -
Annals of Medicine and Surgery (2012) Oct 2022Serous cystadenomas account for approximately 25% of benign ovarian tumors in patients of childbearing age. Their growth is insidious, and the diagnosis can be difficult...
INTRODUCTION
Serous cystadenomas account for approximately 25% of benign ovarian tumors in patients of childbearing age. Their growth is insidious, and the diagnosis can be difficult as they are often asymptomatic, Patients with serous cystadenoma often experience symptoms only if the lesion is twisted or has a mass effect because of its size.This was the case in our patient, whose cough and low back pain prompted her To consult a doctor, which led to the definitive diagnosis and treatment.
MATERIALS AND METHODS
We report a case of a patient admitted for strangulated umbilical hernia with fortuitous discovery of a giant ovarian mass in the P35 visceral emergency department at the CHU ibn rochd hospital in Casablanca, Morocco.
RESULTS
the patient were operated in the emergency room, approached by laparotomy with the exploration we found umbilical hernia with a 6 cm long neck and necrotic bowel content a left latero-uterine mass of 40 cm of solid-cystic aspect and tube and right ovary without abnormalities and uterus of normal size the patient had an Segmental resection of 10 cm at 2.60 m from the ADJ and 1 m from the JIC with T-T grelo-grelic anastomosis and a left adnexectomy with a left latero-uterine mass of 45 cm and Epipoic and parietal peritoneum biopsy and Examination of the patient's spicemen showed serous cystadenoma weighing 10 kg and measuring 30 × 36*20 cm adjoining a tubular formation measuring 11 × 10*5 cm with bowel resection showed ischemic and hemorrhagic necrosis related to the occlusion with acellular ascites fluid.
DISCUSSION
Very Cystadenomas There are 2 types: Pleudomucinous cystadenomas or mucoid cysts, These are the most frequent neoplastic cysts of the ovary which are, in general, lumpy, multilocular, producing a gelatinous substance [8]. Their consistency is variable, some taut and firm, others semi-solid, spongy, thick, hollowed out "honeycomb" parts, which contain thick, stringy mucus. The coloration is variable: grayish white when the wall is thick, translucent in some places, with yellowish or white reflections, blue-black or reddish if there is spilled blood, grayish if there is cholesterol. on the other hand Serous cystadenomas or papillary cysts A little less frequent than mucoid cysts. Usually unilocular or paucicular, round or relatively flat, they contain protein-rich serous fluid. The coloration varies according to the content and thickness of the wall: light yellow or brown if the wall is thin, purplish red if there is blood, greyish white if the wall is thick. Consistency clearly fluctuates on the whole but can be hard in places, semi-solid, if there are abundant vegetations inside.
CONCLUSION
Very large tumors have become curiosities in industrialized countries where the health care system is well developed. On the other hand, they are not rare in developing countries. The delay in diagnosis is most often due to the patient herself who does not consult out of ignorance or refusal of her pathology. But it can happen, and this is serious.
PubMed: 36268316
DOI: 10.1016/j.amsu.2022.104698 -
Indian Journal of Otolaryngology and... Jun 2023Oncocytic papillary cystadenoma is a rare, benign tumor highly uncommon in the larynx. Although controversy exists regarding its true nature it is considered a...
Oncocytic papillary cystadenoma is a rare, benign tumor highly uncommon in the larynx. Although controversy exists regarding its true nature it is considered a phenomenon of metaplasia. We present the case of a 57-year-old patient with synchronous, bilateral oncocytic papillary cystadenoma of the ventricles and we discuss the current literature.
PubMed: 37274980
DOI: 10.1007/s12070-022-03431-4 -
BMC Urology Apr 2021Primary Seminal Vesicle (SV) tumours are a rare entity, with most SV masses representing invasion of the SV by malignancy originating in an adjacent organ, most often...
BACKGROUND
Primary Seminal Vesicle (SV) tumours are a rare entity, with most SV masses representing invasion of the SV by malignancy originating in an adjacent organ, most often the prostate. Previously reported primary SV epithelial tumours have included adenocarcinoma and cystadenoma, with limited prior reports of inracystic papillary structures.
CASE PRESENTATION
A 35-year-old male presented with azoospermia, intermittent macroscopic haematuria, and mild right iliac fossa and groin pain. A papillary appearing seminal vesicle mass was found on imaging and seminal vesicoscopy. The mass was robotically excised with diagnosis of benign cystic papillary adenoma made.
CONCLUSION
In this manuscript we describe a rare case of a benign cystic papillary adenoma of the seminal vesicle, a unique histological entity differentiated from cystadenoma of the Seminal Vesicle by its papillary component.
Topics: Adenoma; Adult; Genital Neoplasms, Male; Humans; Male; Seminal Vesicles
PubMed: 33858401
DOI: 10.1186/s12894-021-00830-7 -
World Journal of Gastroenterology Jan 2016Nearly 2.5% of cross-sectional imaging studies will report a finding of a cystic pancreatic lesion. Even though most of these are incidental findings, it remains very... (Review)
Review
Nearly 2.5% of cross-sectional imaging studies will report a finding of a cystic pancreatic lesion. Even though most of these are incidental findings, it remains very concerning for both patients and treating clinicians. Differentiating and predicting malignant transformation in pancreatic cystic lesions is clinically challenging. Current evaluation of suspicious cystic lesions includes a combination of radiologic imaging, endoscopic ultrasound (EUS) and cyst fluid analyses. Despite these attempts, precise diagnostic stratification among non-mucinous, mucinous, and malignant cystic lesions is often not possible until surgical resection. EUS-guided needle based confocal laser endomicroscopy (nCLE) for evaluation of pancreatic cysts is emerging as a powerful technique with remarkable potential. Though limited imaging data from 3 large clinical trials (INSPECT, DETECT and CONTACT) are currently the reference standard for nCLE imaging, nonetheless these have not been validated in large studies. The aim of this review article is to review the evolving role of EUS-guided nCLE in management of pancreatic cystic lesions in terms of its significance, adverse events, limitations, and implications.
Topics: Diagnosis, Differential; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Humans; Image Interpretation, Computer-Assisted; Microscopy, Confocal; Observer Variation; Pancreatic Cyst; Predictive Value of Tests; Prognosis; Reproducibility of Results
PubMed: 26819534
DOI: 10.3748/wjg.v22.i4.1701 -
World Journal of Gastroenterology Jul 2018Pancreatic cystic lesions (PCLs) are increasingly being identified because of the widespread use of high-resolution abdominal imaging. These cysts encompass a spectrum... (Review)
Review
Pancreatic cystic lesions (PCLs) are increasingly being identified because of the widespread use of high-resolution abdominal imaging. These cysts encompass a spectrum from malignant disease to benign lesions, and therefore, accurate diagnosis is crucial to determine the best management strategy, either surgical resection or surveillance. However, the current standard of diagnosis is not accurate enough due to limitations of imaging and tissue sampling techniques, which entail the risk of unnecessary burdensome surgery for benign lesions or missed opportunities of prophylactic surgery for potentially malignant PCLs. In the last decade, endoscopic innovations based on endoscopic ultrasonography (EUS) imaging have emerged, aiming to overcome the present limitations. These new EUS-based technologies are contrast harmonic EUS, needle-based confocal endomicroscopy, through-the-needle cystoscopy and through-the needle intracystic biopsy. Here, we present a comprehensive and critical review of these emerging endoscopic tools for the diagnosis of PCLs, with a special emphasis on feasibility, safety and diagnostic performance.
Topics: Biopsy; Endosonography; Humans; Microscopy, Confocal; Needles; Pancreas; Pancreatic Cyst; Reproducibility of Results
PubMed: 30018480
DOI: 10.3748/wjg.v24.i26.2853 -
Ear, Nose, & Throat Journal Jun 2024To provide a comprehensive review of nonsurgical approaches for the management of Warthin's tumors (WTs) and evaluate their safety and efficacy as alternatives to... (Review)
Review
To provide a comprehensive review of nonsurgical approaches for the management of Warthin's tumors (WTs) and evaluate their safety and efficacy as alternatives to surgical intervention. A systematic literature search was conducted in PubMed, Web of Science, Cochrane Library, and Embase databases using specific keywords related to WT and nonsurgical treatments. Studies published before 2012, non-English publications, and mixed methodology articles were excluded. The selection process involved title and abstract screening, followed by a thorough assessment of the remaining articles based on inclusion and exclusion criteria. Data regarding study characteristics, participants, interventions, and outcomes were collected. A total of 1582 records were analyzed, and 6 studies met the inclusion criteria. These studies evaluated different nonsurgical interventions for WT management, including microwave ablation, radiofrequency ablation, and ultrasound-guided ethanol sclerotherapy. The findings demonstrated that microwave ablation and radiofrequency ablation led to a significant reduction in tumor size and improved cosmetic appearance. Ultrasound-guided ethanol sclerotherapy also resulted in a notable decrease in tumor size without complications. The included studies supported the safety and efficacy of these nonsurgical options for the treatment of WTs. Nonsurgical approaches, such as microwave ablation, radiofrequency ablation, and ultrasound-guided ethanol sclerotherapy, have emerged as viable alternatives to surgical intervention for the management of WTs. These interventions offer promising outcomes in terms of tumor size reduction and cosmetic improvement. Further research with larger sample sizes and long-term follow-up is warranted to validate these findings and establish standardized protocols for nonsurgical management of WTs.
PubMed: 38864169
DOI: 10.1177/01455613241260969 -
Viszeralmedizin Feb 2015Cystic pancreatic lesions are more and more often found. Malignant risk ranges from nil to more than 60%. A precise diagnosis is required to adapt surveillance or... (Review)
Review
BACKGROUND
Cystic pancreatic lesions are more and more often found. Malignant risk ranges from nil to more than 60%. A precise diagnosis is required to adapt surveillance or therapeutic strategy.
METHODS
We tried to identify the most difficult differential diagnoses encountered in a tertiary center of pancreatology and to guide the reader as how to reach the correct strategy and diagnosis in these situations.
RESULTS
We identified eight clinically difficult situations: i) chronic pancreatitis versus intraductal papillary mucinous neoplasms, ii) serous versus mucinous cystic neoplasms, iii) serous cystic neoplasms versus branch-duct intraductal papillary mucinous neoplasms, iv) intraductal papillary mucinous neoplasms versus acinar cell cystadenoma, v) (pseudo-) solid serous cystic neoplasm versus neuroendocrine tumor, vi) pancreatic neuroendocrine tumors versus solid pseudopapillary tumors, vii) cystic forms of a solid tumor, and viii) rare pancreatic or peripancreatic cystic lesions. The work-up should rely on computed tomography scan, pancreatic magnetic resonance imaging, and, only if necessary, endoscopic ultrasound with or without fine needle aspiration.
CONCLUSION
An expert analysis of imaging data allows a precise diagnosis in most of the cases. Pancreatic resection should no longer be performed in case of diagnostic doubt.
PubMed: 26285674
DOI: 10.1159/000371786 -
Current Health Sciences Journal 2022Cystadenoma arising from the larynx is a rare benign minor salivary gland tumor that can show mucinous or papillary morphology. The epithelial lining of the salivary...
Cystadenoma arising from the larynx is a rare benign minor salivary gland tumor that can show mucinous or papillary morphology. The epithelial lining of the salivary gland tumor can present with oncocytic features, which is attributed to an increased number of mitochondria. We present a rare case of oncocytic papillary cystadenoma (OPC) of the larynx which has a combination of these features. The WHO defines OPC tumors as entities which closely resemble Warthin tumor, but lack its classic lymphoid component. The immunohistochemical profile and molecular genetic features are largely unknown. We present an 84-year-old female, former smoker, who presented with progressive dysphonia, dysphagia, and shortness of breath. Laryngoscopy revealed a large, smooth mass originating from the ventricle of the right vocal fold. Subsequent biopsy demonstrated cyst wall fragments lined by a bilayer of large columnar to cuboidal oncocytic cells that had granular eosinophilic cytoplasm, round to oval nuclei with finely dispersed chromatin, and small but distinct nucleoli. The surrounding stroma was slightly fibrotic with scant lymphoid elements. No nuclear pleomorphism, increased mitosis, or necrosis was identified. In the larynx, benign salivary gland tumors are rare and less frequent than malignant neoplasms. Awareness of rare benign entities like OPC help ensure proper management and aid in avoiding unnecessary therapy.
PubMed: 36815090
DOI: 10.12865/CHSJ.48.03.15