Acute pancreatitis in intraductal papillary mucinous neoplasms correlates with pancreatic volume and epithelial subtypes

Tanaka, Takeshi; Masuda, Atsuhiro; Sofue, Keitaro; Toyama, Hirochika; Shiomi, Hideyuki; Sakai, Arata; Kobayashi, Takashi; Tanaka, Shunta; Nakano, Ryota; Yamada, Yasutaka; Ashina, Shigeto; Tsujimae, Masahiro; Yamakawa, K.; Abe, Shohei; Gonda, Masanori; Masuda, Shōgo; Inomata, Noriko; Uemura, Hiroji; Kohashi, Shinya; Nagao, Kae; Kanzawa, Maki; Itoh, Tomoo; Fukumoto, Takumi; Kodama, Yuzo

doi:10.1016/j.pan.2020.11.005

Cited by 9 publications

(8 citation statements)

References 13 publications

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“…In a series of 182 pancreatic intraductal papillary neoplasms, including 3 IOPNs, Tanaka et al found no correlation between oncocytic features and acute pancreatitis. On the other hand, intestinal and pancreato-biliary type IPMNs showed 22.4% and 35.7% incidence rates, respectively (5).…”

Section: Discussionmentioning

confidence: 98%

Intraductal oncocytic papillary neoplasm (IOPN): two case reports and review of the literature

Innocenti¹,

Rotondo²,

Donati³

et al. 2023

Transl Cancer Res

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Background: Intraductal oncocytic papillary neoplasms (IOPNs) place at the oncocytic extreme of the intraductal pancreatic neoplasm spectrum and display typical morphological features. Their identification in 1996 by Adsay et al. has been followed by a growing number of cases, paving the way for a deeper understanding of this underestimated entity. Contrarily to intraductal papillary mucinous neoplasms (IPMNs), most IOPNs run an indolent course and surgery is usually curative. Pancreatic IOPNs tend to develop from the main pancreatic duct (MPD) and their diagnosis is either incidental or subsequent to mass-related symptoms. Up to 30% of cases show concomitant areas of minimal stromal invasion and loco-regional or systemic spread are confined to a minority of cases. Biological hallmarks of IOPNs are being identified, including recurrent kinase gene rearrangements. Morphological and biological traits of IOPNs seem to overlap with those of other malignancies. A deeper understanding of these entities is needed in order to shed light upon the nature of pancreato-biliary oncocytic neoplasms. This case report describes two patients with a diagnosis of IOPN-one of them accounting for the largest IOPN ever described-and provides a brief review of recent discoveries on the subject.Case Description: We describe two cases of IOPN occurring in adult male patients, respectively in their 60s and 70s. Both patients had unremarkable clinical history. In case 1 the diagnosis was coincidental to a right renal colic; case 2 complained a right lumbar pain radiating to the homolateral groin. In both cases imaging analyses revealed a voluminous pancreatic mass, posing the indication to laparoscopic pancreatectomy. Gross and histological features were consistent with the diagnosis of IOPN. Surgical margin were free from disease and the patient did not undergo further treatment. After a 10-and 7-month follow-up respectively, patients did not experience relapse.Conclusions: Recent immunohistochemical (IHC) and molecular data reveal unique characteristics of IOPNs, highlighting the substantial differences from IPMNs. Further research is needed in order to identify novel prognostic and predictive markers applicable to oncocytic neoplasms of the pancreato-biliary tract.

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Section: Discussionmentioning

confidence: 98%

Intraductal oncocytic papillary neoplasm (IOPN): two case reports and review of the literature

Innocenti¹,

Rotondo²,

Donati³

et al. 2023

Transl Cancer Res

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“…There are many other less frequent causes of AP, especially, pancreatic tumors (typically PDAC and IPMN, but occasionally PNET and other tumors). Previous studies have shown that 1.3%–13.8% of PDAC 29–31 and 7%–67% of IPMN 10,11,32 may present with AP. The underlying mechanism whereby a tumor may cause AP remains unclear.…”

Section: Discussionmentioning

confidence: 98%

“…Previous studies have shown that 1.3%-13.8% of PDAC [29][30][31] and 7%-67% of IPMN 10,11,32 may present with AP. The underlying mechanism whereby a tumor may cause AP remains unclear.…”

Section: Comparison Of Baseline Characteristics Between the Ap And Co...mentioning

confidence: 98%

Preoperative acute pancreatitis and hyperenzymemia are associated with poor prognosis in patients with nonfunctional pancreatic neuroendocrine tumors

Song

Tan

Yuan

et al. 2023

Journal of Surgical Oncology

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Background We aimed to investigate the prevalence of acute pancreatitis (AP) and hyperenzymemia as well as their clinical impact on postoperative survival outcomes in patients with pancreatic neuroendocrine tumors (PNETs). Methods A retrospective cohort study of 218 patients who underwent radical surgical resection for nonfunctional PNETs (NF‐PNETs) was conducted. Multivariate survival analysis was performed by the Cox proportional hazard model, with results expressed as hazard ratio (HR) and 95% confidence interval (CI). Results Of the 151 patients who met the inclusion criteria, the incidences of preoperative AP and hyperenzymemia were 7.9% (12/152) and 23.2% (35/151), respectively. The mean recurrence‐free survival (RFS, 95% CI) for patients in control, AP, and hyperenzymemia groups was 136 (127–144), 88 (74–103), and 90 (61–122) months, with a 5‐year RFS rate of 86.5%, 58.3%, and 68.9%, respectively. In the multivariable‐adjusted Cox hazard model that included tumor grade and lymph node status, the adjusted HR of AP and hyperenzymemia for recurrence was 2.58 (95% CI: 1.47–7.86, p = 0.008) and 2.43 (95% CI: 1.08–7.06, p = 0.040). Conclusion Preoperative AP and hyperenzymemia are associated with poor RFS following radical surgical resection in NF‐PNETs patients.

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“…Acute pancreatitis is a worrisome feature of IPMN, which has been reported to be a risk factor for high-grade dysplasia in surgical specimens [ 9 , 10 ]. A study on history of acute pancreatitis in 182 resected IPMNs revealed that size, location, macroscopic type, and main pancreatic duct diameter were not predictors of acute pancreatitis [ 11 ]. Thus, we cannot guarantee that the IPMN played no role in the pathogenesis of acute pancreatitis in this case.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Acute Pancreatitis after Biliary and Pancreatic Stent Removal with a Forward-Viewing Endoscope

Okamoto

Fukuda

2021

Case Rep Gastroenterol

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Plastic biliary stents are commonly used for biliary drainage, while plastic pancreatic stents may be used prophylactically against acute pancreatitis in patients at high risk for post-endoscopic retrograde cholangiopancreatography pancreatitis. Removal of these prostheses is generally safe and can easily be performed in the ambulatory setting. Herein, we report a case of acute pancreatitis induced by removal of plastic biliary and pancreatic stents with a forward-viewing endoscope.

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Acute pancreatitis in intraductal papillary mucinous neoplasms correlates with pancreatic volume and epithelial subtypes

Cited by 9 publications

References 13 publications

Intraductal oncocytic papillary neoplasm (IOPN): two case reports and review of the literature

Intraductal oncocytic papillary neoplasm (IOPN): two case reports and review of the literature

Preoperative acute pancreatitis and hyperenzymemia are associated with poor prognosis in patients with nonfunctional pancreatic neuroendocrine tumors

Acute Pancreatitis after Biliary and Pancreatic Stent Removal with a Forward-Viewing Endoscope

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