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Kori M, Tsunematsu M, Yao R, Hamura R, Yoda A, Endo H, Horiuchi T, Abe K, Hisa T, Onda S. Successful laparoscopic resection for giant mature cystic teratoma of the pancreas: a case report and surgical refinements. Surg Case Rep 2024; 10:115. [PMID: 38722483 PMCID: PMC11082099 DOI: 10.1186/s40792-024-01918-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/02/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Mature cystic teratomas or dermoid cysts of the pancreas complicate surgical approaches because of their anatomical position and ever-growing size. Herein, we report a case of a giant mature cystic teratoma of the pancreas that was successfully resected via complete laparoscopic distal pancreatectomy (LDP). CASE PRESENTATION A 39-year-old female patient was referred to our hospital for the evaluation of a pancreatic tumor. Three years of follow-up revealed that the tumor had increased in size to 18 cm, with hyperintense solid components on diffusion-weighted magnetic resonance imaging. Considering the possibility of malignancy, we decided to perform an LDP. The capsule appeared solid enough to withstand the retraction of the endoscopic forceps. Tumor size made it difficult to dissect the dorsal side of the tumor from the caudal to the cranial side. Early transection of the pancreas and additional ports facilitated dissection of the dorsal side of the tumor. We completed the LDP without intraoperative cyst rupture. On pathological examination, the tumor was diagnosed as a mature cystic teratoma originating from the pancreatic tail. The patient was discharged on postoperative day 13 with no complications. CONCLUSION LDP may be an option for surgical procedures in patients with large cystic lesions of the pancreatic body or tail. Intraoperative observation of the tumor and surgical refinement are necessary to complete the laparoscopic procedure without tumor rupture.
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Affiliation(s)
- Mayuko Kori
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Masashi Tsunematsu
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan.
| | - Ran Yao
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Ryoga Hamura
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Atsushi Yoda
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Hidetoshi Endo
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Takashi Horiuchi
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Kyohei Abe
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Takeshi Hisa
- Department of Gastroenterology, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
| | - Shinji Onda
- Department of Digestive Surgery, Saku Central Hospital Advanced Care Center, 3400-28, Nakagomi, Saku, Nagano, 385-0051, Japan
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Tasis N, Prountzopoulou AA, Skafida E, Arnaouti M, Tsirlis T, Plastiras A, Manatakis DK, Arnogiannaki N, Korkolis DP. Giant teratoma of the pancreas expanding to the mediastinum: Rare tumor and literature review. Rare Tumors 2022; 14:20363613221147470. [PMID: 36601383 PMCID: PMC9806373 DOI: 10.1177/20363613221147470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022] Open
Abstract
Pancreatic mature cystic teratomas are very rare with limited cases found in the literature. These lesions raise a diagnostic challenge and complicate the surgical approach not only because of their anatomic position but also because of their ever-growing size. An elusive diagnosis, usually leads to the operative theatre where surgical resection takes place. We present a rare case of a large pancreatic cystic teratoma extending into the mediastinum in a 29-year-old woman which was succesfully managed with en-bloc distal pancreatectomy and spleenectomy.
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Affiliation(s)
- Nikolaos Tasis
- Department of Surgical Oncology, St Savvas Cancer
Hospital, Athens, Greece,2nd Department of Surgery, Athens Naval and Veterans
Hospital, Athens, Greece,Nikolaos Tasis, Department of Surgical
Oncology, St Savvas Cancer Hospital, Dimitsanas 1, Athens 11522, Greece.
| | | | | | - Maria Arnaouti
- Department of Pathology, St Savvas Cancer
Hospital, Athens, Greece
| | - Theodoros Tsirlis
- Department of Surgical Oncology, St Savvas Cancer
Hospital, Athens, Greece
| | - Aris Plastiras
- Department of Surgical Oncology, St Savvas Cancer
Hospital, Athens, Greece
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Djokic M, Hadzialjevic B, Rankovic B, Dezman R, Tomazic A. Neuroendocrine Tumor Arising within Mature Cystic Teratoma of the Pancreas: Literature Review and Case Report. Curr Oncol 2022; 29:4717-4724. [PMID: 35877234 PMCID: PMC9322391 DOI: 10.3390/curroncol29070374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/29/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
Cystic teratomas are germ cell tumors most commonly found in the ovaries and testes. The pancreas, however, is very rare as a site of occurrence. Moreover, only two cases of cystic teratoma with concomitant neuroendocrine tumor have been reported to date. We report the case of a 33-year-old female who presented with abdominal pain. Computed tomography and magnetic resonance imaging of the upper abdomen revealed an 85 mm cystic tumor in the head of the pancreas. Cystic teratoma and mucinous cystadenoma were suggested as differential diagnoses. Cytopathologic analysis of endoscopic ultrasound-guided fine needle aspiration was consistent with mucinous cystadenoma. Therefore, the patient underwent surgical resection. Histologic analysis revealed a mature cystic teratoma of the pancreas with a concomitant neuroendocrine tumor. The patient is in great condition at 8 months follow-up. Cystic teratoma of the pancreas with a concomitant neuroendocrine tumor is an extremely rare condition. Surgical resection remains the mainstay of treatment as it provides a definitive diagnosis and no recurrences have been reported to date.
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Affiliation(s)
- Mihajlo Djokic
- Department of Abdominal Surgery, Ljubljana University Medical Center, Zaloska Cesta 7, 1000 Ljubljana, Slovenia; (M.D.); (B.H.)
- Department of Surgery, Faculty of Medicine, University of Ljubljana, Zaloska Cesta 7, 1000 Ljubljana, Slovenia
| | - Benjamin Hadzialjevic
- Department of Abdominal Surgery, Ljubljana University Medical Center, Zaloska Cesta 7, 1000 Ljubljana, Slovenia; (M.D.); (B.H.)
| | - Branislava Rankovic
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Korytkova Ulica 2, 1000 Ljubljana, Slovenia;
| | - Rok Dezman
- Department of Radiology, Ljubljana University Medical Center, Zaloska Cesta 7, 1000 Ljubljana, Slovenia;
| | - Ales Tomazic
- Department of Abdominal Surgery, Ljubljana University Medical Center, Zaloska Cesta 7, 1000 Ljubljana, Slovenia; (M.D.); (B.H.)
- Department of Surgery, Faculty of Medicine, University of Ljubljana, Zaloska Cesta 7, 1000 Ljubljana, Slovenia
- Correspondence:
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Diaconescu S, Gîlcă-Blanariu GE, Poamaneagra S, Marginean O, Paduraru G, Stefanescu G. Could the burden of pancreatic cancer originate in childhood? World J Gastroenterol 2021; 27:5322-5340. [PMID: 34539135 PMCID: PMC8409163 DOI: 10.3748/wjg.v27.i32.5322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/08/2021] [Accepted: 07/30/2021] [Indexed: 02/06/2023] Open
Abstract
The presence of pancreatic cancer during childhood is extremely rare, and physicians may be tempted to overlook this diagnosis based on age criteria. However, there are primary malignant pancreatic tumors encountered in pediatric patients, such as pancreatoblastoma, and tumors considered benign in general but may present a malignant potential, such as the solid pseudo-papillary tumor, insulinoma, gastrinoma, and vasoactive intestinal peptide secreting tumor. Their early diagnosis and management are of paramount importance since the survival rates tend to differ for various types of these conditions. Many pediatric cancers may present pancreatic metastases, such as renal cell carcinoma, which may evolve with pancreatic metastatic disease even after two or more decades. Several childhood diseases may create a predisposition for the development of pancreatic cancer during adulthood; hence, there is a need for extensive screening strategies and complex programs to facilitate the transition from pediatric to adult healthcare. Nevertheless, genetic studies highlight the fact the specific gene mutations and family aggregations may be correlated with a special predisposition towards pancreatic cancer. This review aims to report the main pancreatic cancers diagnosed during childhood, the most important childhood diseases predisposing to the development of pancreatic malignancies, and the gene mutations associates with pancreatic malignant tumors.
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Affiliation(s)
- Smaranda Diaconescu
- Department of Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
- Department of Pediatric Gastroenterology, St Mary Emergency Children's Hospital, Iasi 700309, Romania
| | - Georgiana Emmanuela Gîlcă-Blanariu
- Department of Gastroenterology and Hepatology, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi 700115, Romania
- Department of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, Iasi 700111, Romania
| | - Silvia Poamaneagra
- Department of Pediatric Gastroenterology, St Mary Emergency Children's Hospital, Iasi 700309, Romania
- Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures 540142, Romania
| | - Otilia Marginean
- Department of Pediatrics, Research Center of Disturbance of Growth and Development on Children-Belive, University of Medicine and Pharmacy “Victor Babes” Timisoara, Timisoara 300041, Romania
- First Clinic of Pediatrics, "Louis Turcanu" Emergency Childen's Hospital, Timisoara 300011, Romania
| | - Gabriela Paduraru
- Department of Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
- Department of Pediatric Gastroenterology, St Mary Emergency Children's Hospital, Iasi 700309, Romania
| | - Gabriela Stefanescu
- Department of Gastroenterology and Hepatology, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi 700115, Romania
- Department of Gastroenterology and Hepatology, “St. Spiridon” Emergency Hospital, Iasi 700111, Romania
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