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Sae Murakami,
Tetsuo Ajiki,
Kimihiko Ueno,
Hidehiro Sawa,
Shinobu Tsuchida,
Izuru Otsubo,
Yuko Yoshida,
Kenta Shinozaki,
Taro Okazaki, Ippei Matsumoto,
Takumi Fukumoto,
Yonson Ku
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ABSTRACT: A 25-year-old woman was referred to our hospital with persistent upper abdominal pain. Preoperative imaging studies revealed a hilar bile duct stricture with portal venous encasement, and the patient underwent curative resection involving extended left hepatectomy and segmental portal vein resection. The pathological findings demonstrated a well-differentiated tubular adenocarcinoma of the bile duct with regional lymph node metastasis (stage IIIB according to the UICC TNM classification), as well as the overexpression of p53 proteins and the K-ras gene mutation in tumor cells. The patient has shown no evidence of recurrence in the 10 months since the operation. Although there are several reports of relatively young adults with cholangiocarcinoma, the majority of such patients demonstrate either an anomalous arrangement of the pancreaticobiliary duct system or primary sclerosing cholangitis. The absence of any morphological abnormalities in this patient's biliary system implicates de novo carcinogenesis as the most likely cause of the cholangiocarcinoma.
Surgery Today 04/2013; · 1.22 Impact Factor
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ABSTRACT: BACKGROUND & AIMS: There are no accurate and reliable tools for diagnosis of early-stage pancreatic ductal adenocarcinoma (PDA) or small metastatic lesions. It is also a challenge to differentiate PDA from focal mass-forming pancreatitis (FMP). There is controversy over the efficacy of 18-fluorodeoxyglucose positron-emission tomography (FDG-PET) in diagnosis of PDA. We investigated whether FDG-PET provides information that, combined with data from other imaging techniques, can aide in decision making for patients with suspected PDA. METHODS: We performed a retrospective analysis of data collected from 232 consecutive patients with suspected PDA at Kobe University Hospital from January 2006 through June 2012. All patients underwent a diagnostic imaging protocol that included multi-detector row computed tomography (MDCT), super-paramagnetic iron oxide-enhanced magnetic resonance imaging (SPIO-MRI), and FDG-PET. Based on endoscopic ultrasonography, fine-needle aspiration biopsy, or endoscopic retrograde cholangiopancreatography analyses, 218 patients had PDA (89 underwent resection and 129 did not) and 14 had FMP (8 had focal mass-forming chronic pancreatitis [FMCP] and 6 had focal mass-forming autoimmune pancreatitis [(FMAIP]). RESULTS: FDG-PET detected 50% of stage 0 and I, 91.9% of stage II, 100% of stage III, and 96.8% of stage IV tumors. Detection was significantly affected by tumor size (P =.024) and T stage (P =.023) in resected tumors. MDCT and SPIO-MRI detected significantly more liver metastases than FDG-PET. Few para-aortic lymph node or peritoneal metastases were detected by FDG-PET. FDG-PET correctly identified 11 of the 14 patients with FMP (5/8 with FMCP and 6/6 with FMAIP). CONCLUSIONS: FDG-PET is not effective in detecting early-stage PDA and small metastases, or in differentiating PDA from FMP. Combining FDG-PET with current diagnostic techniques for PDA did not provide any decisive information, so it should not be included in this analysis.
Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 01/2013; · 5.64 Impact Factor
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Takao Iemoto,
Hideyuki Shiomi,
Atsuhiro Masuda,
Tsuyoshi Sanuki,
Hiromu Kutsumi,
Takanobu Hayakumo,
Makoto Shinzeki, Ippei Matsumoto,
Yonson Ku,
Maki Kanzawa,
Shigeo Hara,
Takeshi Azuma
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ABSTRACT: We describe a 69-year-old man with a history of multiple gastroduodenal ulcers, presenting with the onset of obstructive jaundice. Abdominal CT, MRI and EUS demonstrated a sheet-like mass in the pancreaticoduodenal groove. EUS-FNA did not reveal malignancy. Conservative treatment did not improve his clinical condition and repeated acute pancreatitis occurred during his treatment. Thus, pancreaticoduodenectomy was performed. Histopathological findings showed a duodenal ulcer penetrating the pancreas and infiltration of inflammatory cells and fibrosis in the pancreaticoduodenal groove. The spread of inflammation associated with the duodenal ulcer may have been one of the causes of groove pancreatitis.
Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 01/2013; 110(1):88-94.
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Isamu Yamada,
Tetsuo Ajiki,
Kimihiko Ueno,
Hidehiro Sawa,
Izuru Otsubo,
Yuko Yoshida,
Makoto Shinzeki,
Hirochika Toyama, Ippei Matsumoto,
Takumi Fukumoto,
Atsunori Nakao,
Joji Kotani,
Yonson Ku
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ABSTRACT: (18)F-Labeled fluorodeoxyglucose positron-emission tomography (FDG-PET), a rapidly evolving functional imaging modality, has recently been shown to be useful in the diagnosis and staging of various malignant tumors due to focal uptake of FDG-labeled glucose in malignant cell populations. However, the role of FDG-PET in the diagnosis and staging of biliary tract cancer is still controversial and has not yet been fully evaluated. The aim of this study was to determine the clinical importance of FDG-PET in the preoperative evaluation of biliary tract cancer and retrospectively clarify the characteristics of false-negative and false-positive cases. We retrospectively analyzed data for 73 consecutive patients diagnosed with cancer of the biliary tract and were admitted to the Department of Hepato-Biliary-Pancreatic Surgery at Kobe University Hospital for treatment, from January 2007 to August 2009. Since the sensitivity, specificity and positive predictive value (PPV) of FDG-PET in the diagnosis of bile duct carcinoma are usually relatively high, FDG-PET is considered to be a useful tool in diagnosing biliary tract cancer. FDG-PET also seems to be useful in clinical decision-making, regarding treatment strategy, including surgery. Our results showed that FDG-PET is highly sensitive in delineating the primary focus of biliary cancer and is a useful tool in preoperative examination. A disadvantage of FDG-PET is its inability to indicate small metastases and false-positive findings of inflamed gallbladder and bile duct lesions.
Anticancer research 11/2012; 32(11):5105-10. · 1.73 Impact Factor
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Izuru Ohtsubo,
Tetsuo Ajiki,
Taro Okazaki,
Kenta Shinozaki,
Yuko Yoshida,
Sae Murakami,
Makoto Shinzeki,
Masahiro Kido, Ippei Matsumoto,
Takumi Fukumoto,
Yonson Ku
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ABSTRACT: Case 1: A 69-year-old man was admitted to a nearby clinic due to upper abdominal pain. Computed tomography revealed stenosis of the hilar bile duct and dilation of the intrahepatic bile duct in both lobes of the liver. A percutaneous transhepatic biliary drainage tube was inserted in the right anterior segment branch, and an endoscopic naso-biliary drainage tube was inserted in the left hepatic duct. He was referred to our hospital because of suspected hilar bile duct cancer. Radiographic examination showed severe stenosis of the hepatic hilar duct and tapering of the entire intrahepatic bile duct. The extent of invasion could not be evaluated and we concluded that the tumor was unresectable. Although systemic chemotherapy with gemcitabine was performed, the patient died at 37 months after the start of chemotherapy. Case 2: A 70- year-old woman was admitted to a nearby hospital due to epigastric pain and fever. Endoscopic retrograde cholangiopancreatography revealed stenosis of the hilar bile duct and a wide range of multiple stenosis in the intrahepatic bile duct. Bile cytology showed adenocarcinoma. Therefore, we decided the tumor was unresectable. Systemic chemotherapy with gemcitabine was started. She is in good health 57 months after the start of chemotherapy.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2122-4.
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Kenta Shinozaki,
Tetsuo Ajiki,
Taro Okazaki,
Yuko Yoshida,
Sae Murakami,
Izuru Ohtsubo,
Sachiyo Shirakawa,
Masaki Tanaka,
Hidehiro Sawa,
Tadahiro Goto,
Sadaki Asari,
Kimihiko Ueno,
Hirochika Toyama,
Makoto Shinzeki,
Masahiro Kido, Ippei Matsumoto,
Takumi Fukumoto,
Takanobu Hayakumo,
Yonson Ku
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ABSTRACT: Local recurrences often develop after the resection of bile duct cancer. Imaging modalities do not have sufficient sensitivity or specificity to enable the definite diagnosis of recurrent bile duct cancer, and it may be difficult to decide when to start chemotherapeutic treatment. It is difficult to obtain specimens by conventional endoscopy after Roux-Y biliary reconstruction. The double-balloon endoscope(DBE) has 2 balloons: one at the tip of the endoscope and the other at the over- tube. The 2 balloons are inflated alternately and the endoscope can move through the small intestine in a caterpillar-like manner. DBE simplifies the approach to Roux-Y choledochojejunostomy and to obtaining a pathological specimen. Moreover, endoscopic biliary drainage and cholangiography can be performed with the DBE. Recently, the DBE has enabled systemic chemotherapy to be started after obtaining pathological evidence of malignancy, as well as biliary drainage instead of percutaneous transhepatic biliary drainage in cases with recurrent bile duct cancers. Here, we present 3 cases of recurrent bile duct cancer diagnosed and treated by a DBE.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):1877-9.
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Takeshi Urade,
Motofumi Tanaka,
Takumi Fukumoto,
Masahiro Kido,
Shinobu Tsuchida,
Masanori Takahashi,
Atsushi Takebe,
Kaori Kuramitsu,
Masahide Awazu,
Masashi Chuma,
Kenji Fukushima,
Shinichi So,
Kentaro Tai,
Masato Fujimoto,
Hirochika Toyama,
Makoto Shinzeki, Ippei Matsumoto,
Tetsuo Ajiki,
Yonson Ku
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ABSTRACT: We report a case of bilobar multiple hepatocellular carcinoma (HCC) successfully treated by preoperative percutaneous isolated hepatic perfusion(PIHP) and subsequent hepatectomy. A 77-year-old man with elevated serum PIVKA-II level and hepatomas was referred to our hospital. Abdominal dynamic computed tomographpy and gadoxetate disodium-enhanced magnetic resonance imaging demonstrated advanced HCCs: 11 tumors with a maximum tumor size of 4.8 cm diameter in the right lobe, and 1 tumor of 3.6 cm diameter in the left lobe. Curative resection was impossible due to insufficient liver function and due to the locations of the tumors. Therefore, we performed preoperative PIHP in order to control the multiple HCCs in the right lobe. This resulted in normalization of serum PIVKA-II level and complete necrosis of all tumors in the right lobe, as observed on dynamic computed tomographpy after 4 weeks of PIHP. Then, at 7 weeks after PIHP, we performed extended left lobectomy for residual tumor in the left lobe. Finally, complete remission was thought to have been achieved. The patient is alive 6 months after PIHP, without recurrence.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):1825-7.
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Masaki Tanaka, Ippei Matsumoto,
Makoto Shinzeki,
Hirochika Toyama,
Sadaki Asari,
Tadahiro Goto,
Sachiyo Shirakawa,
Hironori Yamashita,
Hidehiro Sawa,
Kimihiko Ueno,
Masanori Takahashi,
Shinobu Tsuchida,
Masahiro Kido,
Tetsuo Ajiki,
Takumi Fukumoto,
Yonson Ku
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ABSTRACT: A 69-year-old woman who had locally advanced pancreatic cancer underwent proton beam radiotherapy(67.5 GyE/25 Fr) concurrent with gemcitabine chemotherapy (GEM 800 mg/m2 day 1, 8) at Hyogo Ion Beam Medical Center, followed by GEM chemotherapy (1,000 mg/m2 day 1, 8, 15/28 day)at Kobe University Hospital. She visited our hospital because she was suffering from dyspnea 212 days after first administration of GEM. A chest computed tomography revealed that infiltrations were spreading in the bilateral lung fields. A bronchoscopy showed diffuse alveolar hemorrhage. We diagnosed GEM related interstitial lung disease with diffuse alveolar hemorrhage. We introduced steroid pulse therapy (methylprednisolone 1 g/day) for 3 days followed by oral prednisolone (40 mg/day), which was tapered gradually. She recovered and was discharged on the 24th day after admission.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2158-60.
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Hirochika Toyama, Ippei Matsumoto,
Makoto Shinzeki,
Sachiyo Shirakawa,
Masaki Tanaka,
Hironori Yamashita,
Tetsuo Ajiki,
Kimihiko Ueno,
Hidehiro Sawa,
Izuru Otsubo,
Sae Murakami,
Masahiro Kido,
Takumi Fukumoto,
Yonson Ku
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ABSTRACT: We report a case of postoperative liver metastasis arising from pancreatic carcinoma treated with a novel procedure that we developed-percutaneous isolated hepatic perfusion (PIHP). A 69-year-old man diagnosed with pancreatic body cancer(pT3, pN0, pStage III) was treated using distal pancreatectomy and adjuvant therapy with gemcitabine(GEM). Six months later, a metastasis to the medial segment of the liver was found using computer tomography(CT). The patient was treated by chemotherapy with S-1, but the liver metastasis grew, and we therefore employed PIHP as the third-line therapy, using 80 mg doxorubicin (DXR) and 62 mg mitomycin C (MMC). Six weeks after PIHP, the tumor marker carbohydrate antigen 19-9( CA19-9) had decreased from 44,469 to 4,268 U/mL, and the carcinoembryonic antigen(CEA) level decreased from 28.8 to 5.4 U/mL. Although the size of the carcinoma remained the same on CT, some cells had liquefied as a result of necrosis. However, the patient died about 1 year after PIHP due to the growth of liver metastasis, peritoneal metastasis, and local recurrence, reflected by a progressively increasing level of tumor marker. In this case, PIHP seemed to be ineffective due to local recurrence and peritoneal metastasis as well as early enlargement of liver metastasis. However, the reduction in tumor marker levels and the observed tumor necrosis, suggest that PIHP is a potentially effective and promising treatment for liver metastasis arising from pancreatic carcinoma.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):1886-8.
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Digestive Endoscopy 11/2012; 24(6):484. · 1.19 Impact Factor
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ABSTRACT: INTRODUCTION: Pancreatogenic diabetes after pancreatectomy is of growing importance due to the increasing life expectancy of pancreatectomized patients. Although reduction of pancreatic volume is thought to affect glucose metabolism, a consistent relationship has yet to be determined. This study aimed to investigate functional consequences of distal pancreatectomy (DP) in preoperatively non-diabetic patients. METHODS: This study included 61 non-diabetic patients who underwent DP. Clinical data were obtained, and the percent resected volume (PRV) of each pancreas was determined via multi-detector row computed tomography volumetry. RESULTS: During the follow-up period (median 26 months), 22 patients (36 %) developed new-onset diabetes within a median onset time of 8 months (range 0.5-42 months) postoperatively. The remaining 39 patients also showed impaired glucose metabolism. Multivariate analysis identified preoperative hemoglobin A1c ≥ 5.7 % (odds ratio 15.6, p = 0.001) and PRV > 44 % (odds ratio 11.3, p = 0.004) as independent risk factors for new-onset diabetes. CONCLUSIONS: Key determinants of postoperative glycemic control include preoperative functional reserve of the endocrine pancreas and the volume reduction of pancreatic parenchyma. Our findings enable reliable preoperative evaluation of the risk of postoperative diabetes and appropriate postoperative surveillance, which is helpful for early intervention in high risk patients.
Journal of Gastrointestinal Surgery 09/2012; · 2.83 Impact Factor
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ABSTRACT: Routine performance of intraoperative cholangiography (IOC) during cholecystectomy is controversial. The aim of this study was to evaluate the role of IOC during cholecystectomy in addition to preoperative magnetic resonance cholangiopancreatography (MRCP) in our institution over a 12-year period.
A total of 425 consecutive patients who underwent IOC during cholecystectomy were included in this study. MRCP was performed preoperatively for bile duct evaluation in all patients. When common bile duct (CBD) stones were detected, they were removed endoscopically before the operation. We estimated the results of IOC in terms of the success rate, the detection rate of anatomic abnormality of the biliary system, and the incidence of residual CBD stones.
MRCP preoperatively identified 6 (1.4 %) patients with abnormal biliary systems and 56 with CBD stones, which were endoscopically removed. The success rate of IOC was 93.8 % (399/425). Abnormalities of the biliary system were detected in 12 patients (12/399, 3.0 %) and CBD stones in 8 (8/399, 2.0 %). Of the eight patients with stones, seven had been examined by endoscopy preoperatively and found to have CBD stones. The detection rate of bile duct stones in patients with preoperative endoscopic removal of CBD stones (7/56, 12.5 %) was significantly higher than those with CBD stones first detected during IOC (1/365, 0.3 %) (p < 0.01). Moreover, no residual CBD stones were detected in patients who were operated on within fewer than 12 days from endoscopic treatment to the operation.
IOC is indicated even after preoperative sphincterotomy for CBD stones. In our study, it resulted in a 12.5 % incidence of persistent stones after sphincterotomy. IOC plays an additional role in detecting CBD stones and in revealing abnormalities of the biliary tree in patients whose biliary tree was preoperatively evaluated by MRCP.
World Journal of Surgery 08/2012; 36(11):2661-5. · 2.36 Impact Factor
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Sadaki Asari, Ippei Matsumoto,
Hirochika Toyama,
Makoto Shinzeki,
Tadahiro Goto,
Sachiyo Shirakawa,
Isamu Yamada,
Tetsuo Ajiki,
Takumi Fukumoto,
Tomoo Ito,
Yonson Ku
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ABSTRACT: Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a distinct entity characterized by papillary proliferations of mucin-producing epithelial cells with excessive mucin production and cystic dilatation of the pancreatic ducts. The clinical presentation often involves recurrent episodes of pancreatitis associated with the temporal obstruction of the main pancreatic duct caused by the hypersecretion of mucin. We herein describe a case in which the patient repeatedly experienced the occurrence of idiopathic acute pancreatitis in the head of the pancreas over a 9-year period, and who was ultimately was cured by distal pancreatectomy for IPMNs in the pancreatic tail. This case illustrates the potential pitfalls in the diagnosis of IPMNs owing to a discrepancy between the site of pancreatitis and that of the IPMN. The possible mechanisms linking acute pancreatitis with the formation of IPMNs are also reviewed.
Surgery Today 02/2012; 42(4):398-402. · 1.22 Impact Factor
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Kenji Fukushima,
Masahiro Kido,
Takumi Fukumoto,
Yuichi Hori,
Nobuya Kusunoki,
Shinobu Tsuchida,
Masanori Takahashi,
Motofumi Tanaka,
Kaori Kuramitsu,
Daisuke Tsugawa,
Hidetoshi Gon,
Masashi Chuma,
Takeshi Urade, Ippei Matsumoto,
Tetsuo Ajiki,
Yonson Ku,
Maki Kanzawa,
Tomoo Ito
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ABSTRACT: In December 2008, a 43-year-old male who had been pointed out a nodular shadow in the right upper field on a chest radiography was admitted to hospital. A 35 mm mass infiltrating to superior vena cava in the right upper lobe of the lung, and 32 mm mass in the liver at S7 were detected by CT. Pathological diagnosis of the liver tumor was adenocarcinoma. Under the diagnosis of lung carcinoma and liver metastasis, systemic chemotherapy was started from January 2009. Radiofrequency ablation (RFA) therapy was added for liver S7 mass in February, and radiation therapy was performed for lung mass in December. The lung lesion has markedly reduced, but the liver lesion recurred in October 2009, which continued to grow up to 80 mm until August 2010. He presented to our hospital with the diagnosis of liver metastasis of controlled primary lung cancer. In October, we performed right hepatectomy with diaphragma and right lung resection. The pathological diagnosis was intrahepatic cholangiocarcinoma. Multiple recurrences in remnant liver, lung and peritoneal metastasis were detected in January 2011. For intrahepatic cholangiocarcinoma, hepatectomy is the only established treatment, and RFA treatment remains controversial. Clinical diagnosis of multiple cancers should be decided with caution.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2030-2.
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Takeshi Urade,
Masahiro Kido,
Takumi Fukumoto,
Yuichi Hori,
Nobuya Kusunoki,
Shinobu Tsuchida,
Masanori Takahashi,
Motofumi Tanaka,
Kaori Kuramitsu,
Daisuke Tsugawa,
Hidetoshi Gon,
Masashi Chuma,
Kenji Fukushima, Ippei Matsumoto,
Tetsuo Ajiki,
Kazuki Terashima,
Yusuke Demizu,
Masao Murakami,
Yonson Ku
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ABSTRACT: We report a case of multiple advanced hepatocellular carcinomas (HCC) with bilobar distribution treated by combination therapy of hepatectomy and particle therapy (carbon ion therapy). A 73-year-old man who had been pointed out hepatic tumors on abdominal CT was referred to our hospital in February 2010. Advanced HCCs; 8 cm Vp3 and 6 cm in the left lobe, 4 cm in the posterior segment, and 1 .5 cm in the S8 area, were detected by abdominal dynamic CT and EOB-MRI etc. Curative resection was not applied due to insufficiency of liver function and unfavorable anatomical tumor locations. Accordingly we have developed a novel combination therapy of hepatectomy and particle therapy. First we performed left lobectomy in March 2010, followed by administration of particle therapy to the posterior segment for local control in May. Then, transcatheter arterial chemoembolization was administered 4 times for residual tumors. The patient survives for 15 months after the initial therapy with good local control.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2065-7.
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Surgery 10/2011; · 3.10 Impact Factor
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ABSTRACT: Autoimmune pancreatitis (AIP) is a rare disease that closely mimics pancreatic cancer (PC) in its presentation. It is very important for clinicians to distinguish one from the other because their treatment and prognosis are vastly different. Typical radiological imaging findings, in particular observation of diffusely or segmentally narrowed main pancreatic duct (MPD) with an irregular wall by endoscopic retrograde cholangiopancreatography (ERCP), are essential for making the diagnosis of AIP. On the other hand, MPD obstruction is one of the most frequent features on ERCP.
We report a rare case of a patient with focal mass-forming AIP strongly suspected of being PC because of MPD obstruction on ERCP.
It was difficult to distinguish PC from AIP with current diagnostic modalities. We will continue to make an effort to distinguish between the two disorders to prevent unnecessary surgery.
Journal of Gastrointestinal Surgery 05/2011; 15(12):2296-8. · 2.83 Impact Factor
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Jun Inoue,
Atsuhiro Masuda,
Masaya Saito,
Mitsuko Onoyama,
Hideyuki Shiomi,
Hirochika Toyama,
Ryo Shinzeki, Ippei Matsumoto,
Yoshitake Hayashi,
Tetsuya Makino,
Hidetoshi Tada,
Hiromu Kutsumi,
Yonson Ku,
Takeshi Azuma
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ABSTRACT: Since the revision of Clinical Diagnostic Criteria for Autoimmune Pancreatitis (AIP) 2006, many cases of localized AIP have been reported. Localized AIP is often difficult to preoperatively differentiate from pancreatic carcinoma. We present two cases of localized AIP that developing relapse after surgical treatment. Swollen hilar lymph nodes of lung was detected on CT in both two cases. Recently, AIP is thought to be the pancreatic manifestation of an IgG4 related systemic disease, which has been associated with many extrapancreatic lesions. Response to steroid treatment and the detection of extrapancreatic lesions may contribute to provide adequate diagnosis thereby avoiding unnecessary surgery.
Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 04/2011; 108(4):640-9.
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ABSTRACT: A 57-year-old woman with a history of diabetes mellitus underwent simultaneous pancreas-kidney transplantation. The pancreaticoduodenal graft was implanted in the right iliac fossa. The donor's portal vein was anastomosed to the recipient's inferior vena cava (IVC). Seven days after the surgery, a thrombus was detected in the graft veins. Percutaneous thrombolysis was immediately performed; however, venous congestion was still present. We therefore attempted selective embolectomy using a Fogarty Thru-Lumen Catheter. Thrombi were directed from the graft veins toward the IVC and captured in the IVC filter with complete elimination of the thrombus without any major complications. We present our technique for the successful treatment of pancreas graft thrombosis within a short time period by percutaneous selective embolectomy using a Fogarty Thru-Lumen Catheter.
CardioVascular and Interventional Radiology 12/2010; 34(3):650-3. · 2.09 Impact Factor
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ABSTRACT: Pancreatic neoplasms during pregnancy are rare. We describe two cases of mucinous cystic neoplasm (MCN) associated with pregnancy. A 34-year-old woman in the 26th week of pregnancy was given a diagnosis of MCN measuring 19 cm in diameter. We decided to resect it post partum in consideration of the risk of abortion. She had a healthy infant in the 40th week of pregnancy and three months later, distal pancreatectomy was performed. Pathological analysis revealed a mucinous cystadenoma of the pancreas. The second case was a 36-year-old woman. She was given a diagnosis of MCN, measuring 16 cm in diameter, post partum and distal pancreatectomy was performed. Pathologically, the tumor was an invasive mucinous cystadenocarcinoma of the pancreas. In this report, we did an extensive literature review and discussed the management of MCN during pregnancy with special reference to the timing of the operation and the relationship between tumor growth and sex hormones.
Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 11/2010; 107(11):1828-34.
