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Liang X, He W, Huang C, Feng Z, Guan X, Liu Y, Sun Z, Li Z. Preoperative prediction of invasive behavior of pancreatic solid pseudopapillary neoplasm by MRI-based multiparametric radiomics models. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 47:3782-3791. [PMID: 35976419 DOI: 10.1007/s00261-022-03639-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE A log-combined model was developed to predict the invasive behavior of pancreatic solid pseudopapillary neoplasm (pSPN) based on clinical and radiomic features extracted from multiparametric magnetic resonance imaging (MRI). MATERIALS AND METHODS A total of 111 patients with pathologically confirmed pSPN who underwent preoperative plain and contrast-enhanced MRI were included, and divided into an invasive group (n = 34) and non-invasive group (n = 77). Clinical features and laboratory data related to pSPN invasive behavior were analyzed. Regions of interest were delineated based on T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and contrast-enhanced T1WI (CE-T1WI) to extract radiomic features. Correlation analysis was performed for these features, followed by L1_based feature selection (C = 0.15). A logistic regression algorithm was used to construct models based on each of the four sequences and a log-combined model was used to integrate the sequences. A receiver operating characteristic (ROC) curve was plotted to evaluate the model performance, and the Brier score was used to assess the overall accuracy of the model predictions. RESULTS The area under the ROC curve was 0.68, 0.73, 0.71, and 0.49 for Log-T1WI, Log-T2WI, Log-DWI, and Log-CE models, respectively, and 0.81 for the log-combined model. The accuracy, precision, sensitivity, and specificity of the log-combined model were 0.77, 0.88, 0.75, and 0.78, respectively. The best performance was obtained with the log-combined model with a Brier score of 0.18. Tumor location was identified as a significant clinical feature in comparison between the two groups (p < 0.05), and invasive pSPN was more frequent in the tail of the pancreas. CONCLUSION The log-combined model based on multiparametric MRI and clinical features can be used as a non-invasive diagnostic tool for preoperative prediction of pSPN invasive behavior and to facilitate the development of individualized treatment strategies and monitoring management plans.
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Affiliation(s)
- Xiuqun Liang
- Department of Radiology, The People's Hospital of Guangxi Zhuang Autonomous Region & Research Center of Radiology, Guangxi Academy of Medical Sciences, Nanning, 530021, Guangxi, China
| | - Wenguang He
- Department of Radiology, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310007, Zhejiang, China
| | - Chencui Huang
- Department of Research Collaboration, R&D center, Beijing Deepwise & League of PHD Technology Co, Ltd, Beijing, 100080, China
| | - Zhan Feng
- Department of Radiology, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310007, Zhejiang, China
| | - Xiaohui Guan
- Department of Radiology, The People's Hospital of Guangxi Zhuang Autonomous Region & Research Center of Radiology, Guangxi Academy of Medical Sciences, Nanning, 530021, Guangxi, China
| | - Ying Liu
- Department of Radiology, The People's Hospital of Guangxi Zhuang Autonomous Region & Research Center of Radiology, Guangxi Academy of Medical Sciences, Nanning, 530021, Guangxi, China
| | - Zeyong Sun
- Department of Radionuclide, The People's Hospital of Guangxi Zhuang Autonomous Region & Research Center of Radionuclide, Guangxi Academy of Medical Sciences, Nanning, 530021, Guangxi, China
| | - Zhi Li
- Department of Radiology, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310007, Zhejiang, China.
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2
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Muacevic A, Adler JR. Solid Pseudopapillary Epithelial Neoplasm of the Pancreas in the Paediatric Population: A Report of Two Cases. Cureus 2022; 14:e29805. [PMID: 36337824 PMCID: PMC9620738 DOI: 10.7759/cureus.29805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 11/05/2022] Open
Abstract
A rare pathology, the solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas accounts for approximately 1% of pancreatic neoplasms. Initially called ‘Frantz’s tumour’, it has now been renamed to SPEN by the World Health Organization (WHO). This tumour has a predilection for females and a good prognosis with surgical excision being the treatment of choice. Palpable abdominal masses in children are of significant clinical importance. Identifying cystic lesions in the pancreas from CT or MRI scans always warrant further investigations. Primary pancreatic neoplasms account for 0.1% of pancreatic tumours in the paediatric population; an extremely rare circumstance constituting a diagnostic and therapeutic challenge to surgeons. This article comprises two paediatric cases of SPEN in 14- and 11-year-old females, respectively, and a literature review on current management.
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3
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Tanoue K, Mataki Y, Kurahara H, Idichi T, Kawasaki Y, Yamasaki Y, Kita Y, Hozaka Y, Oi H, Nakajo A, Arigami T, Maemura K, Ohtsuka T. Multidisciplinary treatment of advanced or recurrent solid pseudopapillary neoplasm of the pancreas: three case reports. Surg Case Rep 2022; 8:7. [PMID: 35001187 PMCID: PMC8743312 DOI: 10.1186/s40792-022-01358-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 01/03/2022] [Indexed: 11/29/2022] Open
Abstract
Background Solid pseudopapillary neoplasm (SPN) is a rare pancreatic tumor that predominantly affects young females. Prognosis is excellent; however, 10–15% of patients show metastasis at the time of surgery or develop tumor recurrence after pancreatectomy. Case presentation We reviewed the clinical course of three patients with advanced or recurrent SPN and subsequently underwent multidisciplinary treatment at our institution between 2002 and 2019. The primary tumor was resected in all three patients, and metastases were also resected if indicated. Intensive combined therapy, including re-resection, chemotherapy, ablation, arterial chemoembolization, and radiation therapy, allowed all patients to survive for a long time. The literature review showed that resection seems to be more effective than other treatments for metastatic SPN. Conclusions Multidisciplinary treatment, including resection, may improve the prognosis of patients with SPN with recurrence or metastasis.
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Affiliation(s)
- Kiyonori Tanoue
- Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Yuko Mataki
- Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Hiroshi Kurahara
- Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
| | - Tetsuya Idichi
- Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Yota Kawasaki
- Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Yoichi Yamasaki
- Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Yoshiaki Kita
- Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Yuto Hozaka
- Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Hideyuki Oi
- Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Akihiro Nakajo
- Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Takaaki Arigami
- Department of Onco-Biological Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kosei Maemura
- Department of Digestive Surgery, Kagoshima City Hospital, Kagoshima, Japan
| | - Takao Ohtsuka
- Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
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4
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Johzuka J, Ona T, Nomura M. One Hour In Vivo-like Phenotypic Screening System for Anti-cancer Drugs Using a High Precision Surface Plasmon Resonance Device. ANAL SCI 2018; 34:1189-1194. [PMID: 30305596 DOI: 10.2116/analsci.18p013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In anti-cancer drug (candidate) screening, there is the need for evaluation at physiological concentrations similar to in vivo. This is often performed by three-dimensionally (3D) cultured cells; however, it requires a long culture period of 2 - 4 weeks with tedious experimental procedures. Here, we report on a high precision surface plasmon resonance (HP-SPR)-3D system. We developed the system with average fluctuation of 50 ndeg s-1 using two-dimensionally cultured cells attached onto a sensor chip by applying collagen on the top to change their activity into in vivo-like conditions without cell division. It allowed in vivo-like phenotypic screening for anti-cancer drugs within 1 h of drug addition. The data were collected as the stable linear signal change parts for at least 5 min after 25 min following drug addition. The results provided compatibility to clinically related chemosensitivity test for anti-cancer (P <0.001) using two cell lines of pancreatic cancer and three anti-cancer drugs to represent differences in individual gene expression and drug mode of action.
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Affiliation(s)
- Junko Johzuka
- O'Atari, Inc.,Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University, Global Innovation Center, Kyushu University
| | - Toshihiro Ona
- O'Atari, Inc.,Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University, Global Innovation Center, Kyushu University
| | - Masatoshi Nomura
- Department of Endocrine and Metabolic Diseases/Diabetes Mellitus, Kyushu University Hospital
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5
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AKIMOTO Y, KATO H, HARADA R, UCHIDA D, SEKI H, TOMODA T, MATSUMOTO K, YAMAMOTO N, HORIGUCHI S, TSUTSUMI K, MURO SI, UEKI T, ODA S, FUSHIMI S, YAGI T, OKADA H. Gender differences in clinicopathological features of 20 cases with solid pseudopapillary neoplasms of the pancreas. ACTA ACUST UNITED AC 2016. [DOI: 10.2958/suizo.31.135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yutaka AKIMOTO
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Hironari KATO
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Ryo HARADA
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Daisuke UCHIDA
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Hiroyuki SEKI
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Takeshi TOMODA
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Kazuyuki MATSUMOTO
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Naoki YAMAMOTO
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Shigeru HORIGUCHI
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Koichiro TSUTSUMI
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | | | - Toru UEKI
- Department of Internal Medicine, Fukuyama City Hospital
| | - Shinsuke ODA
- Department of Pathology, Okayama University Hospital
| | | | - Takahito YAGI
- Department of Hepato-Biliary-Pancreatic Surgery, Okayama University Hospital
| | - Hiroyuki OKADA
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
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6
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Maehira H, Shimizu T, Sonoda H, Mekata E, Yamaguchi T, Miyake T, Ishida M, Tani T. A rare case of primary choriocarcinoma in the sigmoid colon. World J Gastroenterol 2013; 19:6683-6688. [PMID: 24151399 PMCID: PMC3801386 DOI: 10.3748/wjg.v19.i39.6683] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 07/08/2013] [Accepted: 08/13/2013] [Indexed: 02/06/2023] Open
Abstract
Primary colorectal choriocarcinoma is an extremely rare neoplasm and is usually associated with a poor prognosis. Only 13 cases of colorectal choriocarcinoma have previously been reported. There is no standard chemotherapeutic regimen for this tumor type. A 68-year-old man presented with melena and was diagnosed with sigmoid colonic adenocarcinoma with multiple liver metastases. He underwent a laparoscopic sigmoidectomy. Pathology revealed choriocarcinoma with a focal component of moderately differentiated adenocarcinoma of colon origin. Based on the collagen gel droplet-embedded culture drug sensitivity test (CD-DST) results, mFOLFOX6 and bevacizumab were administered, which suppressed aggressive tumor growth for 4 mo. The patient died 9 mo after the initial diagnosis. Our study results suggest that the standard chemotherapy regimen for colorectal cancer might have suppressive effects against primary colorectal choriocarcinoma. Moreover, CD-DST may provide, at least in part, therapeutic insight for the selection of appropriate antitumor agents for such patients.
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MESH Headings
- Adenocarcinoma/complications
- Adenocarcinoma/pathology
- Adenocarcinoma/secondary
- Adenocarcinoma/therapy
- Aged
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bevacizumab
- Biopsy
- Chemotherapy, Adjuvant
- Choriocarcinoma, Non-gestational/complications
- Choriocarcinoma, Non-gestational/pathology
- Choriocarcinoma, Non-gestational/secondary
- Choriocarcinoma, Non-gestational/therapy
- Colectomy
- Colonoscopy
- Disease Progression
- Drug Screening Assays, Antitumor
- Fatal Outcome
- Humans
- Liver Neoplasms/secondary
- Male
- Melena/etiology
- Neoplasms, Complex and Mixed/complications
- Neoplasms, Complex and Mixed/pathology
- Neoplasms, Complex and Mixed/secondary
- Neoplasms, Complex and Mixed/therapy
- Sigmoid Neoplasms/complications
- Sigmoid Neoplasms/pathology
- Sigmoid Neoplasms/therapy
- Time Factors
- Tomography, X-Ray Computed
- Treatment Outcome
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7
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Differences in chemosensitivity between primary and metastatic tumors in colorectal cancer. PLoS One 2013; 8:e73215. [PMID: 24015297 PMCID: PMC3756023 DOI: 10.1371/journal.pone.0073215] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 07/17/2013] [Indexed: 12/27/2022] Open
Abstract
Purpose We retrospectively evaluated the in vitro chemosensitivity of primary site and metastatic site tumors in colorectal cancer. Methods Various resected tumor samples (33 from lymph nodes, 42 from liver, six from lung, and 68 primary tumors) were assessed via a collagen gel droplet-embedded culture drug sensitivity test to determine chemosensitivity to a single agent or a combination of agents. Results Sensitivity to combination chemotherapy was significantly higher than that of monotherapy in the primary site group, lymph node group, and liver group. There was significant difference between chemosensitivity of primary site and that of liver metastasis in each agent (5-FU, p<0.001; SN38, p = 0.045; 5-FU/SN38, p<0.001; OHP, p = 0.037; 5-FU/OHP, p = 0.045). Conclusions Tumors showed greater in vitro chemosensitivity to combination therapy when compared with monotherapy. Further, tumors that had metastasized to the liver were more resistant to chemotherapy when compared with matched primary tumors.
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8
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Clinical potential of the anticancer drug sensitivity test for patients with synchronous stage IV colorectal cancer. Cancer Chemother Pharmacol 2013; 72:217-22. [PMID: 23728705 DOI: 10.1007/s00280-013-2189-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 05/07/2013] [Indexed: 01/14/2023]
Abstract
PURPOSE We retrospectively evaluated the clinical efficacy and feasibility of a collagen gel droplet-embedded culture drug sensitivity test (CD-DST) to guide therapy for patients with stage IV colorectal cancer (CRC). METHODS We investigated 38 patients with stage IV CRC. All patients were younger than 85 years and had untreated evaluable metastatic lesions. The primary tumors were surgically resected, and the tissue samples were investigated by CD-DST. Patients treated with in vitro sensitive drugs were defined as Group A (n = 14), while those treated with in vitro non-sensitive drugs were defined as Group B (n = 24). We evaluated response rate (RR), progression-free survival (PFS), and overall survival (OS). RESULTS RR was 85.71 % in Group A and 41.67 % in Group B (p = 0.0079). The median PFS was 696.5 days in Group A and 297.5 days in Group B (p = 0.0326). The median OS was 1,023.4 days in Group A and 518.5 days in Group B (p = 0.0061). CONCLUSIONS The CD-DST can define chemoresistant and chemosensitive tumors. The use of CD-DST might be one of the tools to supplement informed consent prior to initiation of therapy.
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9
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Mekata E, Sonoda H, Shimizu T, Tatsuta T, Yamaguchi T, Endo Y, Tani T. Clinical predictive value of in vitro anticancer drug sensitivity test for the therapeutic effect of adjuvant chemotherapy in patients with stage II-III colorectal cancer. Mol Clin Oncol 2013; 1:763-767. [PMID: 24649243 PMCID: PMC3915662 DOI: 10.3892/mco.2013.102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 04/09/2013] [Indexed: 11/06/2022] Open
Abstract
Clinically useful predictors of the efficacy of adjuvant chemotherapy following curative colorectal surgery remain to be determined. In the present study, we investigated the clinical utility of the collagen gel droplet-embedded culture drug sensitivity test (CD-DST) as a predictor of the therapeutic response to 5-fluorouracil (5-FU)-based adjuvant chemo-therapy in patients with stage II-III colorectal cancer. CD-DST was conducted using tumor samples surgically obtained from 189 patients. The therapeutic effect of 5-FU-based regimens between high (high-group) and low (low-group) sensitivity groups and a group that did not receive chemotherapy [CTx(-) group] was compared. CD-DST was successfully performed in 151 out of the 189 patients (79.9%), 87 of whom received 5-FU-based adjuvant chemotherapy after surgery. Twenty-seven of these 87 patients (31.0%) were classified as the high-group and the remaining 60 (69.0%) as the low-group. The 5-year recurrence-free survival (RFS) in the high-group was significantly higher compared to that in the low- and the CTx(-) groups. No differences in the 5-year RFS were observed between the low- and CTx(-) groups. In conclusion, CD-DST appears to be useful for predicting the therapeutic response to 5-FU-based adjuvant chemotherapy in patients with stage II-III colorectal cancer.
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Affiliation(s)
- Eiji Mekata
- Department of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Hiromichi Sonoda
- Department of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Tomoharu Shimizu
- Department of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Takeshi Tatsuta
- Department of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Tomohiro Yamaguchi
- Department of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Yoshihiro Endo
- Department of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Tohru Tani
- Department of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
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10
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Management of a malignant case of solid pseudopapillary tumor of pancreas: a case report and literature review. Pancreas 2012; 41:1336-40. [PMID: 22699200 DOI: 10.1097/mpa.0b013e31824d52c7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Solid pseudopapillary tumor of the pancreas is a rare neoplasm with low malignant potential, which affects predominantly young females. Only approximately 10% to 15% cases of solid pseudopapillary tumors (SPTs) are malignant. We present the case of a 57-year-old woman who developed malignant SPT of the pancreas. Meanwhile, a literature review was carried out. Some clinicopathological features and strategies of management of malignant SPT are presented. In general, surgical removal of the tumor even in case of metastases or recurrence offers an excellent prognosis. Chemotherapy and radiotherapy should be taken into consideration in patients with unresectable tumor.
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11
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Ansari D, Elebro J, Tingstedt B, Ygland E, Fabricius M, Andersson B, Andersson R. Single-institution experience with solid pseudopapillary neoplasm of the pancreas. Scand J Gastroenterol 2011; 46:1492-7. [PMID: 22050136 DOI: 10.3109/00365521.2011.627448] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare clinical entity. The objective of this study was to review a single institution's experience with this uncommon tumor, as well as review the literature. MATERIAL AND METHODS Consecutive patients, who underwent surgery for a pathologically confirmed SPN between 1991 and 2010, were retrospectively reviewed. A PubMed search (January 1980-June 2011) was conducted to identify risk factors for death among SPN patients. RESULTS The institutional review identified 16 patients with SPN. Thirteen patients were female and three patients were male (median age 34 years). All patients underwent radical resection. Two patients had metastatic disease at the time of operation as evident by the presence of lymph node metastasis and gallbladder metastasis. One developed liver metastasis 4 months postoperatively and subsequently died. The other patient received adjuvant chemotherapy (gemcitabine and capecitabine), and 23 months after the initial operation, no tumor recurrence was detected and the patient is still alive. All other patients remain disease-free. Analysis of 29 fatalities reported in the English literature (including the present case) revealed several atypical features including male gender, old age, tumor size >5 cm, diffuse growth pattern, cellular or nuclear atypia, high mitotic rate, extensive necrosis, extrapancreatic invasion, metastasis and incomplete resection. CONCLUSIONS SPN is not always indolent. Male patients and those with old age, atypical histopathology (large tumors, diffuse growth, cellular/nuclear atypia, mitotic activity, necrosis, invasion/metastasis) and incomplete resection may have a higher risk of recurrence and death, deserving particular attention.
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Affiliation(s)
- Daniel Ansari
- Department of Surgery, Clinical Sciences Lund, Lund University, Sweden
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12
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Imamura N, Chijiiwa K, Ohuchida J, Hiyoshi M, Takahashi N, Yorita K, Kataoka H. Synchronous solid pseudopapillary neoplasm and intraductal papillary mucinous neoplasm of the pancreas: report of a case. Surg Today 2011; 41:865-71. [PMID: 21626339 DOI: 10.1007/s00595-010-4361-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2010] [Accepted: 04/20/2010] [Indexed: 02/06/2023]
Abstract
Solid pseudopapillary neoplasm (SPN) of the pancreas, most commonly found in young female subjects, is a rare neoplasm with low potential for malignancy. We report an unusual case of a 66-year-old male patient who had a simultaneous malignant SPN and an intraductal papillary mucinous adenoma (IPMA) of the pancreas. The patient was admitted to our department for the evaluation of the main solid tumor with calcification and small multilocular cystic lesions apart from the main tumor in the pancreatic head. We performed pylorus-preserving pancreaticoduodenectomy to treat the calcified tumor and multilocular cystic lesions. The diagnosis of malignant SPN was confirmed on the basis of histological invasion to the adjacent structures. The separate cystic lesions were diagnosed as a branch-type IPMA. The synchronous occurrence of IPMA and SPN in the present case did not demonstrate that there were tumors maintained through the common abnormal Wnt signaling pathway by immunohistochemical study. To our knowledge, this is the first known case of synchronous SPN and IPMA of the pancreas.
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Affiliation(s)
- Naoya Imamura
- Department of Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
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13
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Soloni P, Cecchetto G, Dall'igna P, Carli M, Toffolutti T, Bisogno G. Management of unresectable solid papillary cystic tumor of the pancreas. A case report and literature review. J Pediatr Surg 2010; 45:e1-6. [PMID: 20438906 DOI: 10.1016/j.jpedsurg.2010.02.045] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Revised: 02/09/2010] [Accepted: 02/11/2010] [Indexed: 01/15/2023]
Abstract
Pancreatic solid papillary cystic tumor is a rare neoplasm with an excellent prognosis if surgical excision is complete. We report on a case and review 47 more cases extracted from the published literature to assess the treatment options when solid papillary cystic tumor is considered unresectable. Chemotherapy and radiotherapy were beneficial in a limited number of patients, but therapeutic decisions must be made bearing in mind that patients may be long-term survivors without any treatment because of the tumor's slow growth.
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Affiliation(s)
- Pietro Soloni
- Division of Hematology/Oncology, Department of Pediatrics, University Hospital of Padova, 35128 Padova, Italy
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14
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Maniwa Y, Yoshimura M, Hashimoto S, Takata M, Nishio W. Chemosensitivity of lung cancer: Differences between the primary lesion and lymph node metastasis. Oncol Lett 2010; 1:345-349. [PMID: 22966306 DOI: 10.3892/ol_00000061] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Accepted: 12/23/2009] [Indexed: 01/10/2023] Open
Abstract
In this study, chemosensitivity tests were performed on both primary lesions (PLs) and lymph node metastases (LMs) from surgically resected non-small cell lung cancer (NSCLC). Differences between the results obtained were evaluated. Operative specimens were obtained from 13 patients with NSCLC [6 with squamous cell carcinoma (SQ) and 7 with adenocarcinoma (AD)] whose lymph nodes were confirmed to be positive for metastasis. Both the PL and LM from the same patient were examined immediately after resection. The collagen gel droplet-embedded culture drug sensitivity test (CD-DST) was used as the chemosensitivity test against six anticancer drugs [5-fluorouracil (5-FU), cisplatin, gemcitabine, docetaxel, vinorelbine and SN-38 (an active metabolite of irinotecan)]. When the growth rate, determined by the T/C ratio (T, signal for viable cells in the treated group and C, signal in the control) was less than 50%, the tumor cells were considered to be sensitive to the drug. Only in 4 cases (2 SQ and 2 AD) was the chemosensitivity of the primary lesion identical to that of LM. In the SQ cases, chemosensitivity of the primary lesions to 5-FU tended to be consistent with that of LMs. In contrast, the primary lesions in 4 of the 7 AD cases were negative for chemosensitivity to 5-FU; however, LMs were sensitive. In many cases, the chemosensitivity of the PLs to each anticancer drug differed from that of the LMs. In conclusion, both primary and metastatic tumors should be examined to ensure maximum clinical efficacy of in vitro drug-sensitivity testing for adjuvant chemotherapy after complete resection of n1 and n2 NSCLC.
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Affiliation(s)
- Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe
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Romics L, Oláh A, Belágyi T, Hajdú N, Gyűrűs P, Ruszinkó V. Solid pseudopapillary neoplasm of the pancreas—proposed algorithms for diagnosis and surgical treatment. Langenbecks Arch Surg 2010; 395:747-55. [DOI: 10.1007/s00423-010-0599-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Accepted: 01/20/2010] [Indexed: 02/06/2023]
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Expression pattern of claudins 5 and 7 distinguishes solid-pseudopapillary from pancreatoblastoma, acinar cell and endocrine tumors of the pancreas. Am J Surg Pathol 2009; 33:768-74. [PMID: 19194274 DOI: 10.1097/pas.0b013e3181957bc4] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Solid-pseudopapillary tumor (SPT) of the pancreas is characterized by a discohesive appearance of the neoplastic cells. This has been linked to the displacement of E-cadherin and beta-catenin from their normal membrane location, which prevents adherens junctions to form. The nuclear localization of beta-catenin is also a feature of SPT that helps in differential diagnosis. This latter includes pancreatic endocrine tumor (PET) as SPT may show neuroendocrine differentiation, and pancreatic acinar cell carcinoma (ACC) and pancreatoblastoma (PB) that may often show nuclear beta-catenin staining. However, the role of additional cell-cell adhesion systems remains to be elucidated in SPT, particularly that of claudins that are essential components of tight junctions showing modulated expression in diverse tumor types. We studied 20 SPT, 20 nonfunctioning PET, 7 ACC, 2 PB, and their matched normal pancreas for the immunohistochemical expression of claudin family members 1, 2, 3, 4, 5, and 7, beta-catenin and E-cadherin. All SPT showed intense membrane claudin 5 and cytoplasmic claudin 2 staining, lack of claudins 3 and 4, and positive cytoplasmic claudins 1 and 7 in few cases. Conversely, PET, ACC, and PB showed strong membrane expression of claudin 7 and lack of claudin 5, whereas claudins 1, 2, 3, and 4 showed variable expression among samples. All SPT showed nuclear beta-catenin and lack of E-cadherin membrane staining, whereas PET, ACC, and PB only showed nuclear beta-catenin in 1, 2, and 2 cases, respectively. SPT shows a peculiar claudin expression profile and the highly specific pattern of claudins 5 and 7 differentiates SPT from PET, ACC, and PB.
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F-18 fluorodeoxyglucose uptake in a solid pseudopapillary tumor of the pancreas mimicking malignancy. Clin Nucl Med 2008; 33:766-8. [PMID: 18936608 DOI: 10.1097/rlu.0b013e318187f0f0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Solid pseudopapillary tumors (SPTs), predominantly affecting young women, are rare pancreatic tumors. It is reported that imaging features of SPT are solid and cystic components, and there is intratumoral hemorrhage and calcification. However, findings of positron emission tomography (PET) using F-18 fluorodeoxyglucose (FDG) with pathologic correlation have not been fully evaluated. We present a case of SPT that mimicked malignancy on FDG-PET.
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