-
American Journal of Physiology.... Jul 2016Mucin-type O-glycans, primarily core 1- and core 3-derived O-glycans, are the major mucus barrier components throughout the gastrointestinal tract. Previous reports...
Mucin-type O-glycans, primarily core 1- and core 3-derived O-glycans, are the major mucus barrier components throughout the gastrointestinal tract. Previous reports identified the biological role of O-glycans in the stomach and colon. However, the biological function of O-glycans in the small intestine remains unknown. Using mice lacking intestinal core 1- and core 3-derived O-glycans [intestinal epithelial cell C1galt1(-/-);C3GnT(-/-) or double knockout (DKO)], we found that loss of O-glycans predisposes DKO mice to spontaneous duodenal tumorigenesis by ∼1 yr of age. Tumor incidence did not increase with age; however, tumors advanced in aggressiveness by 20 mo. O-glycan deficiency was associated with reduced luminal mucus in DKO mice before tumor development. Altered intestinal epithelial homeostasis with enhanced baseline crypt proliferation characterizes these phenotypes as assayed by Ki67 staining. In addition, fluorescence in situ hybridization analysis reveals a significantly lower bacterial burden in the duodenum compared with the large intestine. This phenotype is not reduced with antibiotic treatment, implying O-glycosylation defects, rather than bacterial-induced inflammation, which causes spontaneous duodenal tumorigenesis. Moreover, inflammatory responses in DKO duodenal mucosa are mild as assayed with histology, quantitative PCR for inflammation-associated cytokines, and immunostaining for immune cells. Importantly, inducible deletion of intestinal O-glycans in adult mice leads to analogous spontaneous duodenal tumors, although with higher incidence and heightened severity compared with mice with O-glycans constitutive deletion. In conclusion, these studies reveal O-glycans within the small intestine are critical determinants of duodenal cancer risk. Future studies will provide insights into the pathogenesis in the general population and those at risk for this rare but deadly cancer.
Topics: Adenocarcinoma; Animals; Cell Line; Cell Proliferation; Cell Transformation, Neoplastic; Duodenal Neoplasms; Duodenitis; Duodenum; Galactosyltransferases; Genetic Predisposition to Disease; Glycosylation; Mice, 129 Strain; Mice, Inbred C57BL; Mice, Knockout; Mucus; N-Acetylglucosaminyltransferases; Phenotype
PubMed: 27229122
DOI: 10.1152/ajpgi.00060.2016 -
Modern Pathology : An Official Journal... Nov 2001Periampullary tumors in patients affected by Neurofibromatosis Type 1 (NF-1) are usually carcinoids or stromal tumors and, rarely, adenocarcinomas. We report a case of... (Review)
Review
Periampullary tumors in patients affected by Neurofibromatosis Type 1 (NF-1) are usually carcinoids or stromal tumors and, rarely, adenocarcinomas. We report a case of an adenocarcinoma of the ampulla of Vater in a 54-year-old woman with NF-1 admitted to the hospital with jaundice and undergoing pancreato-duodenectomy. Histologically, the resected specimen showed an adenocarcinoma of the ampulla as being a part of a complex atypical epithelial proliferation extended from the papilla to the mucosa of the duodenum and distal choledochus, islet-cell adenomatosis of the pancreas and multiple gastric, duodenal, jejunal stromal tumors. The ampullary and periampullary adenocarcinomas in NF-1 patients have peculiar features, suggesting a widespread predisposition to cancer development in periampullary tissues and requiring widely demolitive surgery. Moreover, they occur at a younger age than those occurring in non-NF-1 patients, may be associated with additional periampullary epithelial tumors, are often operable and may present long survival.
Topics: Adenocarcinoma; Ampulla of Vater; Common Bile Duct Neoplasms; Female; Humans; Middle Aged; Neurofibromatosis 1
PubMed: 11706080
DOI: 10.1038/modpathol.3880454 -
The Medical Clinics of North America Mar 1975In the majority of instances, periampullary tumors include adenocarcinomas of the pancreatic head, duodenum, ampulla of Vater, and lower bile duct. Diagnosis is based...
In the majority of instances, periampullary tumors include adenocarcinomas of the pancreatic head, duodenum, ampulla of Vater, and lower bile duct. Diagnosis is based mainly on a history of jaundice or is made by endoscopic duodenoscopy with retrograde pancreatography or by cholangiography or both. The best treatment for these tumors is pancreatoduodenectomy or palliative bypass if the tumor has spread beyond the region encompassed by resection. In experienced hands, resection can be accomplished with a mortality rate of less than 10 per cent and is followed by a 5-year survival rate of 30 to 40 per cent in carcinomas of the ampulla, duodenum, or lower bile duct and of about 10 to 15 per cent in carcinomas of the pancreatic head. Palliative surgical, chemotherapeutic, and radiotherapeutic procedures as yet do not prolong life appreciably.
Topics: Adenocarcinoma; Ampulla of Vater; Antineoplastic Agents; Bile Duct Neoplasms; Common Bile Duct; Diagnostic Techniques, Surgical; Duodenal Neoplasms; Endoscopy; Humans; Palliative Care; Pancreatic Neoplasms; Radiography
PubMed: 46944
DOI: 10.1016/s0025-7125(16)32033-8 -
Cancer Science Nov 2007The dietary components responsible for the development of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) remain unclear. Wistar rats were divided into four...
High animal-fat intake changes the bile-acid composition of bile juice and enhances the development of Barrett's esophagus and esophageal adenocarcinoma in a rat duodenal-contents reflux model.
The dietary components responsible for the development of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) remain unclear. Wistar rats were divided into four groups based on their diet: a low soybean-oil diet, a low cow-fat diet, a high soybean-oil diet, and a high cow-fat diet. First, we evaluated the bile acid composition of the bile juice in each group without operation, using high-performance liquid chromatography. Because only high cow-fat intake induced changes in the composition of bile acids in bile juice, we then selected animals fed with a low soybean-oil diet and those with a high cow-fat diet to carry out esophago-jejunostomy for reflux of the duodenal contents, and compared sequential morphological changes between these groups up to 30 weeks after surgery. At 30 weeks after surgery, the reflux animals in the high cow-fat group showed a significantly higher incidence of BE and Barrett's dysplasia than those in the low soybean-oil group, and the incidence of EAC in the high cow-fat group was also slightly higher than that in the low soybean-oil group. High dietary animal fat changed the bile-acid composition and increased the concentration of taurine conjugates in the bile juice. These increased bile acids promoted the development of BE and Barrett's dysplasia leading to EAC.
Topics: Adenocarcinoma; Animals; Barrett Esophagus; Bile; Bile Acids and Salts; Bile Reflux; Dietary Fats; Disease Models, Animal; Duodenogastric Reflux; Duodenum; Esophageal Neoplasms; Gastrointestinal Contents; Hydrogen-Ion Concentration; Rats
PubMed: 17868414
DOI: 10.1111/j.1349-7006.2007.00605.x -
Advances in Therapy Jun 2021Brunner's gland hamartoma is a benign tumor of the duodenum, but has malignant potential with a very low risk of progression into adenocarcinoma. It is uncommon with a... (Review)
Review
Brunner's gland hamartoma is a benign tumor of the duodenum, but has malignant potential with a very low risk of progression into adenocarcinoma. It is uncommon with a frequency of less than 1.0% among the primary tumors of the small intestine. In addition, its clinical manifestations are nonspecific, etiology remains unclear, and treatment strategy needs to be further refined. This literature review mainly discusses the epidemiology, clinical features, possible etiology and pathogenesis, diagnostic methods, malignant potential, treatment, and prognosis of Brunner's gland hamartoma.
Topics: Adenocarcinoma; Brunner Glands; Duodenum; Hamartoma; Humans
PubMed: 33914269
DOI: 10.1007/s12325-021-01750-6 -
Journal of Surgical Oncology Apr 1987Three patients with carcinoma of the first and the third part of the duodenum are reported. A review of the literature shows the diagnosis of this rare lesion of the...
Three patients with carcinoma of the first and the third part of the duodenum are reported. A review of the literature shows the diagnosis of this rare lesion of the duodenum is usually late. In order for surgical resection to be successful, suspicion of such a lesion and an aggressive workup is needed.
Topics: Adenocarcinoma; Aged; Aged, 80 and over; Duodenal Neoplasms; Duodenum; Humans; Male; Middle Aged; Neoplasm Metastasis; Pylorus
PubMed: 3560962
DOI: 10.1002/jso.2930340410 -
American Journal of Surgery Feb 2005Pancreatic resections including pancreaticoduodenectomy and distal pancreatectomy are the standard of care for patients with malignant tumors of the pancreas. Patients... (Review)
Review
BACKGROUND
Pancreatic resections including pancreaticoduodenectomy and distal pancreatectomy are the standard of care for patients with malignant tumors of the pancreas. Patients with benign disease or unusual tumors may benefit from other nonstandard resections.
METHODS
A review of the literature and the author's experiences were undertaken.
RESULTS
Parenchymal-sparing surgeries including pancreatic enucleation, central pancreatectomy, splenic-preserving distal pancreatectomy, and duodenal-preserving pancreatic head resection are described. The utility of each procedure is reviewed. Outcome results from published series are included.
CONCLUSIONS
Nonstandard pancreatic resections should be considered in select patients with unusual lesions. Such procedures are safe and effective and may be associated with a reduced incidence of exocrine insufficiency.
Topics: Adenocarcinoma; Duodenum; Humans; Pancreatectomy; Pancreatic Neoplasms; Pancreaticoduodenectomy; Spleen
PubMed: 15720996
DOI: 10.1016/j.amjsurg.2004.11.005 -
BMC Surgery May 2017Pancreatic heterotopia (PH) is defined as ectopic pancreatic tissue outside the normal pancreas and its vasculature and duct system. Most frequently, PH is detected...
BACKGROUND
Pancreatic heterotopia (PH) is defined as ectopic pancreatic tissue outside the normal pancreas and its vasculature and duct system. Most frequently, PH is detected incidentally by histopathological examination. The aim of the present study was to analyze a large single-center series of duodenal PH with respect to the clinical presentation.
METHODS
A prospective pancreatic database was retrospectively analyzed for cases of PH of the duodenum. All pancreatic and duodenal resections performed between January 2000 and October 2015 were included and screened for histopathologically proven duodenal PH. PH was classified according to Heinrich's classification (Type I acini, ducts, and islet cells; Type II acini and ducts; Type III only ducts).
RESULTS
A total of 1274 pancreatic and duodenal resections were performed within the study period, and 67 cases of PH (5.3%) were identified. The respective patients were predominantly male (72%) and either underwent pancreatoduodenectomy (n = 60); a limited pancreas resection with partial duodenal resection (n = 4); distal pancreatectomy with partial duodenal resection (n = 1); total pancreatectomy (n = 1); or enucleation (n = 1). Whereas 65 patients (83.5%) were asymptomatic, 11 patients (18.4%) presented with symptoms related to PH (most frequently with abdominal pain [72%] and duodenal obstruction [55%]). Of those, seven patients (63.6%) had chronic pancreatitis in the heterotopic pancreas. The risk of malignant transformation into adenocarcinoma was 2.9%.
CONCLUSIONS
PH is found in approximately 5% of pancreatic or duodenal resections and is generally asymptomatic. Chronic pancreatitis is not uncommon in heterotopic pancreatic tissue, and even there is a risk of malignant transformation. PH should be considered for the differential diagnosis of duodenal lesions and surgery should be considered, especially in symptomatic cases.
Topics: Adenocarcinoma; Adult; Aged; Duodenum; Female; Humans; Male; Middle Aged; Pancreas; Pancreatectomy; Pancreatic Neoplasms; Pancreaticoduodenectomy; Pancreatitis, Chronic; Prospective Studies; Retrospective Studies; Young Adult
PubMed: 28482873
DOI: 10.1186/s12893-017-0250-x -
Der Chirurg; Zeitschrift Fur Alle... Jul 1981Duodenal tumors are rare. The symptoms are mostly uncharacteristic upper abdominal pain or chronic anemia on account of occult blood loss. Tumors of mesenchymal or...
Duodenal tumors are rare. The symptoms are mostly uncharacteristic upper abdominal pain or chronic anemia on account of occult blood loss. Tumors of mesenchymal or neurogenic origin may lead to dangerous bleeding from ulceration of the mucosa. Malignant tumors of the duodenum are often histologically adenocarcinomas and should be treated by partial or total pancreatectomy. If located below the papilla or at the duodenojejunal flexure, sometimes partial duodenal resection with end-to-end anastomosis may be performed. Benign tumors should be removed by local excision. In cases of duodenal malignancy, early detection and radical resection should help to increase the survival rate of the patients.
Topics: Adenocarcinoma; Adenoma; Carcinoid Tumor; Duodenal Neoplasms; Duodenum; Female; Gastrointestinal Hemorrhage; Humans; Leiomyoma; Lipoma; Male; Middle Aged; Pancreatectomy; Prognosis
PubMed: 6973446
DOI: No ID Found -
Revista Espanola de Enfermedades... Nov 2021We present the case of an 81-year-old male with a history of surgically resected colorectal and bladder cancer, who was admitted to our hospital with a urinary...
We present the case of an 81-year-old male with a history of surgically resected colorectal and bladder cancer, who was admitted to our hospital with a urinary infection. A routine renal ultrasound showed a pelvic cyst and a CT scan confirmed a non-complicated cyst, but a lesion was observed in the left lung. He underwent a PET-CT in which an unexpected enhancement of the small bowel attracted our attention.
Topics: Adenocarcinoma; Aged, 80 and over; Duodenal Neoplasms; Duodenum; Humans; Male; Positron Emission Tomography Computed Tomography; Ultrasonography
PubMed: 34320812
DOI: 10.17235/reed.2021.8200/2021