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Romanian Journal of Morphology and... 2018Pancreatic mucinous cystadenoma (MCA) occurs almost exclusively in perimenopausal women and represents between 10% and 45% of cystic neoplasm of the pancreas, being...
AIM
Pancreatic mucinous cystadenoma (MCA) occurs almost exclusively in perimenopausal women and represents between 10% and 45% of cystic neoplasm of the pancreas, being considered a premalignant lesion.
MATERIALS AND METHODS
From 1983 to 2017, 31 patients underwent surgery for MCA of the pancreas in our Center. The median age was 47 years (range 17-81 years). All data were obtained retrospectively.
RESULTS
The female∕male gender ratio was 14.5∕1. Most of the patients (90.3%) were symptomatic. The most common clinical manifestation was non-specific abdominal pain (58.06%), followed by fatigue and vomiting. The median cyst size was 7 cm, with a range between 2 cm and 15 cm. There were 35 procedures in 31 patients (in four patients the resection was preceded by a drainage procedure). From the 28 resections, most of them (89.28%) were performed by an open approach; a minimal invasive approach was used in three patients (robotic - two; laparoscopic - one). Most of the resections (82.14%) were distal pancreatectomies. In all cases, the final diagnosis was based on histological examination that revealed columnar epithelium and ovarian-type stroma. Postoperative complications occurred in 10 (34.48%) patients. Postoperative mortality was 3.44% (one patient) by septic shock secondary to acute postoperative pancreatitis.
CONCLUSIONS
MCAs represent a rare pancreatic pathology with challenging diagnostic and therapeutic implications. Multi-detector computed tomography (MDCT) scan, endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI)∕magnetic resonance cholangiopancreatography (MRCP) are useful in the differential diagnosis with other pancreatic fluid collections and treatment. Oncological surgical resections are recommended. Histopathological examination establishes the final diagnosis. The most common postoperative complication is pancreatic fistula.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Cystadenoma, Mucinous; Female; Humans; Intraoperative Care; Male; Middle Aged; Pancreatic Neoplasms; Postoperative Complications; Tomography, X-Ray Computed; Treatment Outcome; Young Adult
PubMed: 30845296
DOI: No ID Found -
Case Reports in Gastroenterology 2017We report a case of appendiceal mucinous cystadenoma that was successfully diagnosed preoperatively and treated by laparoscopic resection. We could find volcano sign on...
We report a case of appendiceal mucinous cystadenoma that was successfully diagnosed preoperatively and treated by laparoscopic resection. We could find volcano sign on colonoscopy and cystic lesion without any nodules at the appendix on computed tomography (CT). Without any malignant factors in preoperative examinations, we performed laparoscopic appendectomy including the cecal wall. We could avoid performing excessive operation for cystadenoma with accurate preoperative diagnosis and intraoperative finding and pathological diagnosis during surgery. Appendiceal mucocele is a rare disease that is divided into 3 pathological types: hyperplasia, cystadenoma, and cystadenocarcinoma. The surgical approaches for it remain controversial and oversurgery is sometimes done for benign tumor, because preoperative diagnosis is difficult and rupturing an appendiceal tumor results in dissemination. Based on our study, volcano sign on colonoscopy and CT findings were important for the preoperative diagnosis of appendiceal mucocele. Furthermore, we think that laparoscopic resection will become a surgical option for the treatment of appendiceal mucocele.
PubMed: 29033775
DOI: 10.1159/000480374 -
Urology Case Reports Nov 2021Urachal villous adenoma is a rare entity. We aimed to share a case of a giant villous adenoma that was treated surgically. Surgery was uneventful and flow up was normal.
Urachal villous adenoma is a rare entity. We aimed to share a case of a giant villous adenoma that was treated surgically. Surgery was uneventful and flow up was normal.
PubMed: 34354928
DOI: 10.1016/j.eucr.2021.101782 -
Revista de La Facultad de Ciencias... Jun 2023The term pseudoascitis is used in patients who give the false impression of ascites, with abdominal distension but without peritoneal free fluid. The case of a...
The term pseudoascitis is used in patients who give the false impression of ascites, with abdominal distension but without peritoneal free fluid. The case of a 66-year-old woman, hypertensive and hypothyroid with occasional alcohol consumption, who consults due to progressive abdominal distension of 6 months of evolution and diffuse percussion dullness is presented, in whom a paracentesis is performed with the wrong endorsement of examination ultrasound that reports abundant intrabdominal free fluid (Fig. 1), later finding in the CT scan of the abdomen and pelvis an expansive process of cystic appearance of 295mm x 208mm x 250mm. Left anexectomy is programmed (Fig. 2) with pathological report of mucinous ovarian cystadenoma. The case report refers to the availability of the giant ovarian cyst within the differential diagnosis of ascites. If no symptoms or obvious signs of liver, kidney, heart or malignant disease are found and / or ultrasound does not reveal typical signs of intra-abdominal free fluid (fluid in the bottom of the Morrison or Douglas sac, presence of floating free intestinal handles), a CT scan and / or an RMI should be requested before performing paracentesis, which could have potentially serious consequences.
Topics: Female; Humans; Aged; Ascites; Cystadenoma, Mucinous; Ovarian Neoplasms; Ovarian Cysts; Kidney
PubMed: 37402307
DOI: 10.31053/1853.0605.v80.n2.27848 -
Mucinous cystadenoma of the ovary in a 15-year-old girl: A case report and review of the literature.International Journal of Surgery Case... Nov 2022• Mucinous tumors of the ovary are epithelial tumors. They are classified into benign, borderline and malignant tumors. • Vaginal pelvic ultrasound is the imaging...
• Mucinous tumors of the ovary are epithelial tumors. They are classified into benign, borderline and malignant tumors. • Vaginal pelvic ultrasound is the imaging test of first choice. • Conservative treatment, detorsion of the adnexa without adnexectomy, is recommended in non-menopausal women. • The knowledge of clinical and histological characters will allow a better diagnostic andtherapeutic approach.
PubMed: 36270211
DOI: 10.1016/j.ijscr.2022.107757 -
Cureus Apr 2022Abdominal cystic tumors are highly prevalent. Due to the availability of superior imaging techniques, they are now diagnosed more commonly and considerably earlier....
Abdominal cystic tumors are highly prevalent. Due to the availability of superior imaging techniques, they are now diagnosed more commonly and considerably earlier. Although giant masses are seen sporadically, particularly in the rural scenarios. A 74-year-old multipara with distension of abdomen and breathlessness misdiagnosed as ascites initially was later on confirmed as giant borderline mucinous cystadenoma. We wish to highlight this case to bring forth the plight of rural women who are deprived of standard health care. The case of ovarian tumor presented seems to be the largest documented ovarian tumor in central India to the best of our knowledge.
PubMed: 35541292
DOI: 10.7759/cureus.23968 -
Przeglad Menopauzalny = Menopause Review Mar 2020Most ovarian and/or adnexal torsions occur in reproductive age and are less common in postmenopausal age. A 49-year-old menopausal woman presented to the Emergency...
Most ovarian and/or adnexal torsions occur in reproductive age and are less common in postmenopausal age. A 49-year-old menopausal woman presented to the Emergency Department with abdominal pain. She had a palpable pelvi-abdominal mass and abdominal tenderness on examination. Departmental ultrasound and magnetic resonance imaging (MRI) showed a large multilocular right adnexal cyst (15 × 12 cm) containing fluid with variable signal intensities on both T1 and T2 sequences (stained glass appearance) - most probably mucinous cystadenoma. The studied woman signed an informed consent form and agreed to exploratory laparotomy and adnexectomy. After the pre-operative investigations, which were done according to the hospital protocol, including CA-125 (26 IU/ml) and anaesthesia consultation, she was scheduled for laparotomy. At laparotomy an ovarian cyst originating from the right ovary was found with evidence of torsion of the infundibulopelvic and utero-ovarian ligaments (adnexal torsion). The right adnexa including the right ovary containing the ovarian cyst and the right fallopian tube was excised (adnexectomy). The histological examination of the excised adnexa confirmed the diagnosis of mucinous cystadenoma of the ovary. This report represents a rare case of an adnexal torsion in postmenopausal woman, to highlight that adnexal torsion can occur at any age and that the presence of ovarian mass or cyst predispose to adnexal torsion at any age.
PubMed: 32699544
DOI: 10.5114/pm.2020.95295 -
Journal of Multidisciplinary Healthcare 2014Pancreatic cystic lesions are commonly encountered today with the routine use of cross-sectional imaging modalities such as computed tomography (CT) and magnetic... (Review)
Review
Pancreatic cystic lesions are commonly encountered today with the routine use of cross-sectional imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). The majority of patients discovered to have a pancreatic cyst are completely asymptomatic; yet the presence of such a finding instills fear in the minds of both patient and physician, as the concern for malignant transformation to pancreatic cancer is great despite the relatively low overall likelihood of cyst progression. Not all cysts in the pancreas represent pancreatic cystic neoplasms (PCNs), and not all PCNs have significant malignant potential. Mucinous PCNs are the most concerning, as these lesions have the greatest potential for cancerous transformation to adenocarcinoma. Within the group of mucinous PCNs, intraductal papillary mucinous neoplasms (IPMNs) involving the main pancreatic duct are the most worrisome, and surgical resection should be pursued if the patient has appropriate operative risks. IPMN lesions involving the branch ducts, and mucinous cystadenomas, have a lower likelihood for malignancy, and they may be closely followed for the development of any worrisome or high-risk features. Surveillance of known PCNs is performed with a combination of CT, MRI and endoscopic ultrasound (EUS). EUS-guided fine-needle aspiration (EUS-FNA) may be used to assess cyst fluid cytology, and also to detect cyst fluid amylase level, carcinoembryonic antigen level, and DNA molecular analysis in certain cases. The presence or absence of specific cyst morphological features, as well as the cyst fluid analysis, is what enables the physician to guide the patient towards continued surveillance, versus the pursuit of surgical resection.
PubMed: 24520195
DOI: 10.2147/JMDH.S43098 -
Revista Espanola de Enfermedades... Nov 2008
Topics: Adult; Aged; Appendectomy; Appendiceal Neoplasms; Appendicitis; Appendix; Cecal Diseases; Cystadenocarcinoma, Mucinous; Cystadenoma, Mucinous; Diagnostic Errors; Dilatation, Pathologic; Female; Humans; Hyperplasia; Incidental Findings; Male; Middle Aged; Mucocele; Terminology as Topic
PubMed: 19159184
DOI: 10.4321/s1130-01082008001100017 -
World Journal of Surgical Oncology Feb 2015The diagnosis of pancreatic cystic neoplasms has become more accurate recently. In some cases, however, doubt remains regarding the lesion's malignant potential. CA 19-9... (Review)
Review
BACKGROUND
The diagnosis of pancreatic cystic neoplasms has become more accurate recently. In some cases, however, doubt remains regarding the lesion's malignant potential. CA 19-9 has long been identified as a reliable biomarker in differentiating pancreatic benign and malignant lesions, especially in non-jaundiced patients.
CASE REPORT AND DISCUSSION
We report a case of a young female who presented with a mucinous lesion in the tail of the pancreas and a serum CA 19-9 over 1,000,000 U/mL. She was taken to surgery and had a distal pancreatectomy and splenectomy. Pathology reports showed only a mucinous cystadenoma. After 1 year of follow-up, her serum CA 19-9 was normal. Following that, the work-up in these lesions, the role of the biomarker in pancreatic adenocarcinoma and in the differentiation between benign and malignant lesions is discussed.
Topics: Adult; Biomarkers, Tumor; CA-19-9 Antigen; Cystadenoma, Mucinous; Female; Humans; Pancreatectomy; Pancreatic Neoplasms; Prognosis; Splenectomy
PubMed: 25888888
DOI: 10.1186/s12957-015-0476-y