Distinctive Histopathologic Findings of Pancreatic Hamartomas Suggesting Their “Hamartomatous” Nature

Yamaguchi, Hiroshi; Aishima, Shinichi; Oda, Yoshinao; Mizukami, Hajime; Tajiri, Takuma; Yamada, Sohsuke; Tasaki, Takashi; Yamakita, Keisuke; Imai, Koji; Kawakami, Fumi; Hara, Shigeo; Hanada, Keiji; Iiboshi, Tomohiro; Fukuda, Toshikatsu; Imai, Hiroshi; Inoue, Hiroyuki; Nagakawa, Tatsuya; Muraoka, Shunji; Furukawa, Toru; Shimizu, Michio

doi:10.1097/pas.0b013e318283ce4c

Cited by 37 publications

(44 citation statements)

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“…However, by contrast, pancreatic GIST were numerous, as 32 cases have been reported (20)(21)(22). There were no diagnoses of leiomyosarcoma, Ewing sarcoma, liposarcoma, cavernous hemangioma, hamartoma or angiomyolipoma in the present study, in agreement with previous studies (3,8,9,(13)(14)(15)(16). Therefore, the true prevalence of the primary mesenchymal tumor types in the pancreas requires additional comprehensive studies to be elucidated.…”

Section: Discussionsupporting

confidence: 82%

“…According to these previously reported studies, the most common benign tumor was schwannoma, and the most frequently reported primary sarcoma was leiomyosarcoma (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). The two comprehensive studies of primary mesenchymal tumors of the pancreas performed by Kim et al (3) and the present study identified certain different results.…”

Section: Discussionmentioning

confidence: 53%

“…According to the aforementioned studies, totaling >200 cases, the most common benign tumors were schwannomas (51 cases) (3-6), followed by inflammatory myofibroblastic tumors (34 cases) (3,7), solid and cystic hamartomas (28 cases) (3,8,9), fibromatosis (16 cases) (3,10,11), solitary fibrous tumors (15 cases) (3,12), cavernous hemangiomas (12 cases) (3,13) and 3 cases of angiomyolipoma (3,14,15). The most commonly reported primary sarcomas of the pancreas were leiomyosarcoma (41 cases) (3,16), followed by Ewing sarcomas/PNET (16 cases) (3), undifferentiated/unclassified sarcomas (15 cases) (3,17), and atypical lipomatous tumor/well-differentiated liposarcoma (2 cases) (3).…”

Section: Discussionmentioning

confidence: 99%

“…Although numerous primary mesenchymal tumors of the pancreas have been reported, the majority of cases were reported as case reports (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). To the best of our knowledge, there has been only one comprehensive study of these tumors in a single institution (3).…”

Section: Introductionmentioning

confidence: 99%

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Primary mesenchymal tumors of the pancreas in a single center over 15 years

Zhang

Wang

et al. 2016

Oncology Letters

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Abstract. In total, 95% of primary tumors in the pancreas are epithelial tumors; primary mesenchymal tumors at this site are extremely rare. At present, only one comprehensive study about these rare tumors has been performed. Another retrospective analysis of these rare tumors is performed in the present study, which, to the best of our knowledge, is the first to be performed in China. In the present study, 10 patients that underwent resection for primary mesenchymal tumors of the pancreas were identified in a 15-year period at the Chinese Academy of Medical Sciences and Peking Union Medical College, which accounted for 0.51% of the total surgically resected primary tumors of the pancreas at this hospital. Among the 10 patients, 7 patients (70%) were diagnosed with benign/borderline tumors, and the remaining 3 patients (30%) were diagnosed with malignant tumors. It was a unique finding of the present study that the preoperative diagnosis was frequently a misdiagnosis, in terms of the specific pathological diagnosis. Therefore, although primary mesenchymal tumors of the pancreas are extremely rare, they should be considered in order to make the correct preoperative diagnosis. Contrarily to a previous study, in the present study, the most common benign tumor was not desmoid tumor, but solitary fibrous tumors; the most frequent primary sarcoma was not undifferentiated/unclassified sarcoma either. In conclusion, the present study aids the understanding of these rare tumors; however, primary mesenchymal tumors of the pancreas require additional exploration in the future. IntroductionThe predominant primary tumor that occurs in the pancreas is ductal adenocarcinoma (1). Stroma is scant in the normal pancreas, and therefore primary mesenchymal tumors of the pancreas are extremely rare (2).Although numerous primary mesenchymal tumors of the pancreas have been reported, the majority of cases were reported as case reports (3-22). To the best of our knowledge, there has been only one comprehensive study of these tumors in a single institution (3). A lack of comprehensive studies from other large institutes to provide a comprehensive understanding of this type of tumor remains. In the present study, a thorough retrospective analysis of primary mesenchymal tumors of the pancreas in Peking Union Medical College Hospital (Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China) was performed and the relevant studies published in the English literature were reviewed.According to the published studies, at present there have been 221 cases of primary mesenchymal tumors of the pancreas reported in the English literature (3). Among these, the most commonly reported primary benign/borderline mesenchymal tumors of the pancreas were schwannomas, followed by inflammatory myofibroblastic tumors, solid and cystic hamartomas, and solitary fibrous tumors. In addition, the most frequently reported primary malignant mesenchymal tumors of the pancreas were leiomyosarcomas, followed by Ewing sarcomas/primitive neur...

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Primary mesenchymal tumors of the pancreas in a single center over 15 years

Zhang

Wang

et al. 2016

Oncology Letters

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“…Well-formed islets of Langerhans are not common. In fact, Pauser et al 118, 120 and Yamaguchi et al 121 defined the criteria for the diagnosis of pancreatic hamartoma as: (1) forming a well-demarcated mass, (2) being comprised of mature acini and ducts with distorted architecture, and (3) lacking discrete islets of Langerhans. Adjacent pancreatic parenchyma is usually unremarkable.…”

Section: Pancreatic Hamartomamentioning

confidence: 99%

Benign Tumors and Tumorlike Lesions of the Pancreas

Basturk

Aşkan

2016

Surgical Pathology Clinics

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Synopsis The pancreas is a complex organ that may give rise to large number of neoplasms and non-neoplastic lesions. This article will focus on benign neoplasms such as serous neoplasms as well as tumor-like (pseudotumoral) lesions that may be mistaken for neoplasm not only by clinicians and radiologists, but also by pathologists. The family of pancreatic pseudotumors, by a loosely defined conception of that term, includes a variety of lesions including heterotopia, hamartoma, and lipomatous pseudohypertrophy. Autoimmue pancreatitis (covered in chronic pancreatitis chapter) and paraduodenal (“groove”) pancreatitis may also lead to pseudotumor formation. Knowledge of these entities will help in making an accurate diagnosis.

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Pancreatic hamartoma: Possibility of a preoperative diagnosis via endoscopic ultrasound–guided fine‐needle aspiration biopsy

Shintaku

Gokita

Oshima

et al. 2023

Diagnostic Cytopathology

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Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) is useful for preoperatively diagnosing various pancreatic tumors. Although there is a risk of complications, such as pancreatitis, this procedure achieves the crucial need of reducing unnecessary invasive surgery for benign lesions. Herein, we reported a surgically resected case of pancreatic hamartoma in the pancreatic head whose retrospective analysis revealed that the specimens obtained via EUS-FNAB contained hamartoma fragments. Pancreatic hamartoma is an extremely rare benign disease that is exceptionally difficult to diagnose before surgical resection owing to its rarity and lack of established imaging findings. To the best of our knowledge, the preoperative diagnosis of pancreatic hamartoma via EUS-FNAB specimens has not been reported to date. Herein, postoperative EUS-FNAB evaluation revealed a collection of pancreatic hamartoma lesions, although the initial diagnosis was pancreatic tissue with focal atrophy and fibrosis. Diagnosis using EUS-FNAB can be challenging owing to the very small sample size. If mature acini and ducts with fibrous stroma without islets are observed in the EUS-FNAB specimen, pancreatic hamartoma should be considered as a differential diagnosis. Thus, careful follow-up or reexamination of EUS-FNAB should be considered instead of surgery if a benign lesion is suspected preoperatively.

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Distinctive Histopathologic Findings of Pancreatic Hamartomas Suggesting Their “Hamartomatous” Nature

Cited by 37 publications

References 4 publications

Primary mesenchymal tumors of the pancreas in a single center over 15 years

Primary mesenchymal tumors of the pancreas in a single center over 15 years

Benign Tumors and Tumorlike Lesions of the Pancreas

Pancreatic hamartoma: Possibility of a preoperative diagnosis via endoscopic ultrasound–guided fine‐needle aspiration biopsy

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