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Advances in Clinical and Experimental... Feb 2020Neuroendocrine tumors (NET) of the gastrointestinal tract and pancreas are extremely rare in the pediatric population and limited data is available. In most cases, NET... (Review)
Review
Neuroendocrine tumors (NET) of the gastrointestinal tract and pancreas are extremely rare in the pediatric population and limited data is available. In most cases, NET of the gastrointestinal tract in children are located in the appendix. Pancreatic NET are a small but partially distinct group of the gastrointestinal neuroendocrine neoplasms. The most common in this group are insulinomas; however, in some research, the gastrinoma type neoplasms are perceived to be most common in children. This study reviews the typical clinical presentation, appropriate diagnostics, staging, and treatment of these uncommon neoplasms. It is important to know the epidemiology and symptomatology in this age group despite the fact that the majority of physicians treating the youngest patients will never have to deal with it. This will facilitate an early diagnosis in case of symptoms that may suggest neuroendocrine cancer. It appears necessary to create harmonized recommendations regarding the diagnosis, treatment and post-treatment follow-up for pediatric patients.
Topics: Child; Gastrointestinal Neoplasms; Humans; Neoplasm Staging; Neuroendocrine Tumors; Pancreatic Neoplasms; Pediatricians
PubMed: 32091671
DOI: 10.17219/acem/111806 -
World Journal of Gastroenterology Jan 2009Cystic neoplasms of the pancreas are increasingly recognized due to the expanding use and improved sensitivity of cross-sectional abdominal imaging. Major advances in... (Review)
Review
Cystic neoplasms of the pancreas are increasingly recognized due to the expanding use and improved sensitivity of cross-sectional abdominal imaging. Major advances in the last decade have led to an improved understanding of the various types of cystic lesions and their biologic behavior. Despite significant improvements in imaging technology and the advent of endoscopic-ultrasound (EUS)-guided fine-needle aspiration, the diagnosis and management of pancreatic cystic lesions remains a significant clinical challenge. The first diagnostic step is to differentiate between pancreatic pseudocyst and cystic neoplasm. If a pseudocyst has been effectively excluded, the cornerstone issue is then to determine the malignant potential of the pancreatic cystic neoplasm. In the majority of cases, the correct diagnosis and successful management is based not on a single test but on incorporating data from various sources including patient history, radiologic studies, endoscopic evaluation, and cyst fluid analysis. This review will focus on describing the various types of cystic neoplasms of the pancreas, their malignant potential, and will provide the clinician with a comprehensive diagnostic approach.
Topics: Algorithms; Cholangiopancreatography, Endoscopic Retrograde; Diagnosis, Differential; Endosonography; Female; Humans; Magnetic Resonance Imaging; Male; Pancreatic Cyst; Pancreatic Neoplasms; Tomography, X-Ray Computed
PubMed: 19115467
DOI: 10.3748/wjg.15.48 -
Pathology Oncology Research : POR Apr 2020The solid-pseudopapillary neoplasm of the pancreas is a rare but enigmatic entity occurring mainly in young women. Since the first description by V. Frantz in 1959 the... (Review)
Review
The solid-pseudopapillary neoplasm of the pancreas is a rare but enigmatic entity occurring mainly in young women. Since the first description by V. Frantz in 1959 the terminology of this tumor has continuously changed but it has remained simply descriptive, because the exact histogenesis is still obscure. Although in majority of cases the survival is excellent, nevertheless, the expected prognosis is not exactly predictable. In this review the authors aim to summarize its clinico-pathological features, the expected biological behavior, the molecular alterations, the immune phenotype and discuss the putative histogenesis. From diagnostic point of view, the salient histological characteristic findings are analyzed that would help to differentiate it from other, look-alike pancreatic tumors, and suggestions are made about the desirable content of the histological report.
Topics: Humans; Neoplasms, Cystic, Mucinous, and Serous; Pancreatic Neoplasms
PubMed: 31209654
DOI: 10.1007/s12253-019-00671-8 -
Chinese Clinical Oncology Jun 2017Patients with borderline resectable pancreatic adenocarcinoma have primary tumors within the pancreas that involve the mesenteric vasculature to a limited degree. Their... (Review)
Review
Patients with borderline resectable pancreatic adenocarcinoma have primary tumors within the pancreas that involve the mesenteric vasculature to a limited degree. Their tumors are nonetheless at high-risk for a microscopically positive surgical resection margin and/or early treatment failure when pancreatectomy is performed de novo. The optimal treatment strategy for these patients has not been established; however, relatively favorable outcomes can be achieved with systemic chemotherapy and radiation therapy (RT) prior to intended resection. In this article, we discuss the modalities used to stage localized pancreatic cancer, the concept of borderline resectable pancreatic cancer (BRPC), the rationale for the use of preoperative therapy, and review recent publications, placing special emphasis on the necessity of appropriate patient selection and coordinating multimodality management to maximize outcomes.
Topics: Adenocarcinoma; Chemotherapy, Adjuvant; Combined Modality Therapy; Humans; Margins of Excision; Neoadjuvant Therapy; Neoplasm Staging; Pancreatectomy; Pancreatic Neoplasms; Patient Selection; Retrospective Studies; Treatment Outcome
PubMed: 28705004
DOI: 10.21037/cco.2017.06.17 -
Journal of Nuclear Medicine Technology Jun 2015Pancreatic malignancy carries a poor prognosis and is the fourth leading cause of cancer-related deaths in the United States. Although conventional imaging with CT and... (Review)
Review
Pancreatic malignancy carries a poor prognosis and is the fourth leading cause of cancer-related deaths in the United States. Although conventional imaging with CT and MR remains the main imaging modality, recent times have seen an increase in the applications of PET/CT in the evaluation of pancreatic malignancy. Newer data are becoming available, highlighting the advantages, limitations, and pitfalls in PET/CT imaging of the pancreas. This article highlights the applications of PET/CT in various stages of management of pancreatic malignancy and compares these with conventional imaging with CT and MR.
Topics: Humans; Neoplasm Staging; Pancreatic Neoplasms; Positron-Emission Tomography; Preoperative Period; Radiotherapy Planning, Computer-Assisted; Tomography, X-Ray Computed
PubMed: 25857417
DOI: 10.2967/jnmt.114.145458 -
Medicine Mar 2016The hedgehog signaling pathway was first discovered in the 1980s. It is a stem cell-related pathway that plays a crucial role in embryonic development, tissue... (Review)
Review
The hedgehog signaling pathway was first discovered in the 1980s. It is a stem cell-related pathway that plays a crucial role in embryonic development, tissue regeneration, and organogenesis. Aberrant activation of hedgehog signaling leads to pathological consequences, including a variety of human tumors such as pancreatic cancer. Multiple lines of evidence indicate that blockade of this pathway with several small-molecule inhibitors can inhibit the development of pancreatic neoplasm. In addition, activated hedgehog signaling has been reported to be involved in fibrogenesis in many tissues, including the pancreas. Therefore, new therapeutic targets based on hedgehog signaling have attracted a great deal of attention to alleviate pancreatic diseases. In this review, we briefly discuss the recent advances in hedgehog signaling in pancreatic fibrogenesis and carcinogenesis and highlight new insights on their potential relationship with respect to the development of novel targeted therapies.
Topics: Fibrosis; Hedgehog Proteins; Humans; Pancreas; Pancreatic Neoplasms; Signal Transduction
PubMed: 26962810
DOI: 10.1097/MD.0000000000002996 -
World Journal of Gastroenterology Aug 2016Pancreatic cancer is a disease that carries a poor prognosis. Accurate tissue diagnosis is required. Tumours contain a high content of stromal tissue and therefore... (Review)
Review
Pancreatic cancer is a disease that carries a poor prognosis. Accurate tissue diagnosis is required. Tumours contain a high content of stromal tissue and therefore biopsies may be inconclusive. Circulating tumour cells (CTCs) have been investigated as a potential "liquid biopsy" in several malignancies and have proven to be of prognostic value in breast, prostate and colorectal cancers. They have been detected in patients with localised and metastatic pancreatic cancer with sensitivities ranging from 38%-100% using a variety of platforms. Circulating tumour DNA (ctDNA) has also been detected in pancreas cancer with a sensitivity ranging from 26%-100% in studies across different platforms and using different genetic markers. However, there is no clear consensus on which platform is the most effective for detection, nor which genetic markers are the most useful to use. Potential roles of liquid biopsies include diagnosis, screening, guiding therapies and prognosis. The presence of CTCs or ctDNA has been shown to be of prognostic value both at diagnosis and after treatment in patients with pancreatic cancer. However, more prospective studies are required before this promising technology is ready for adoption into routine clinical practice.
Topics: Biomarkers, Tumor; Biopsy; DNA, Neoplasm; Female; Humans; Male; Neoplastic Cells, Circulating; Pancreatic Neoplasms
PubMed: 27621566
DOI: 10.3748/wjg.v22.i32.7175 -
Journal of Surgical Oncology May 2021Metastatic pancreatic ductal adenocarcinoma (PDAC) is a major cause of cancer-related mortality in 2021. Cytotoxic therapies are the therapeutic mainstay for PDAC. The... (Review)
Review
Metastatic pancreatic ductal adenocarcinoma (PDAC) is a major cause of cancer-related mortality in 2021. Cytotoxic therapies are the therapeutic mainstay for PDAC. The recent approval of olaparib as maintenance therapy for germline BRCA1/2-mutated PDAC and pembrolizumab for mismatch repair deficient PDAC represent molecularly targeted approaches for this disease. Investigational therapeutic strategies include targeting the stroma, metabolism, tumor microenvironment, and the immune system, and selected approaches are reviewed herein.
Topics: Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Pancreatic Ductal; Clinical Trials as Topic; Humans; Immunotherapy; Neoplasm Metastasis; Pancreatic Neoplasms; Randomized Controlled Trials as Topic
PubMed: 33831245
DOI: 10.1002/jso.26359 -
Current Opinion in Genetics &... Feb 2019Despite recent advances in the treatment of cancer, pancreatic ductal adenocarcinoma (PDAC) still retains the worst survival rate of common malignancies. Late diagnosis... (Review)
Review
Despite recent advances in the treatment of cancer, pancreatic ductal adenocarcinoma (PDAC) still retains the worst survival rate of common malignancies. Late diagnosis and lack of curative therapeutic options are the most pressing clinical problems for this disease. Therefore, there is a need for patient models and biomarkers that can be applied in the clinic to identify the most effective therapy for a patient. Pancreatic ductal organoids are ex-vivo models of PDAC that can be established from very small biopsies, enabling the study of localized, advanced, and metastatic patients. Organoids models have been applied to pancreatic cancer research and offer a promising platform for precision medicine approaches.
Topics: Carcinoma, Pancreatic Ductal; Humans; Neoplasm Metastasis; Organoids; Pancreas; Pancreatic Neoplasms; Precision Medicine; Translational Research, Biomedical
PubMed: 30844513
DOI: 10.1016/j.gde.2019.02.003 -
Arquivos Brasileiros de Cirurgia... 2016The solid pseudopapillary neoplasm is a rare tumor of the pancreas. However, it´s etiology still maintain discussions.
BACKGROUND
The solid pseudopapillary neoplasm is a rare tumor of the pancreas. However, it´s etiology still maintain discussions.
AIM
To analyze it´s clinical data, diagnosis and treatment.
METHODS
A retrospective study of medical records of all patients treated from January 1997 until July 2015.
RESULTS
Were identified 17 cases. Most patients were women (94.11%) and the average age was 32.88 years. The main complaint was abdominal mass (47.05%). The most frequent location was in the body/tail of the pancreas (72.22%) and the most frequently performed surgery was distal pancreatectomy with splenectomy (64.70%). No patient had metastases at diagnosis. Conservative surgery for pancreatic parenchyma was performed in only three cases. The rate of complications in the postoperative period was 35.29% and the main complication was pancreatic fistula (29.41%). No patient underwent adjuvant treatment.
CONCLUSIONS
The treatment is surgical and the most common clinical presentation is abdominal mass. Distal pancreatectomy with splenectomy was the most frequently performed surgery for its treatment.
Topics: Adolescent; Adult; Female; Humans; Male; Pancreatic Neoplasms; Retrospective Studies; Young Adult
PubMed: 27438034
DOI: 10.1590/0102-6720201600020007