Serous cystadenocarcinoma of the pancreas with liver metastases

Eriguchi, Naofumi; Aoyagi, Shigeaki; Nakayama, Toshimichi; Hara, Masao; Miyazaki, Takashi; Kutami, Rumiko; Jimi, Atsuo

doi:10.1007/s005340050075

Cited by 70 publications

(41 citation statements)

References 8 publications

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“…2,4 Furthermore, although serous cystic neoplasms are almost entirely benign, some malignant cases that involve the adjacent organs and/or metastasize to the liver have been reported. [5][6][7] Patients who have symptoms associated with serous cystic neoplasms usually require surgical treatment. 1,2 Mucinous cystic neoplasms develop almost exclusively in middle-aged and elderly women, and are associated with a significant risk of malignant change from adenoma to carcinoma.…”

mentioning

confidence: 99%

Association of epidermal growth factor receptor and mitogen-activated protein kinase with cystic neoplasms of the pancreas

Kuboki

Shiratori²,

Hatori³

et al. 2010

Modern Pathology

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The molecular pathobiology of pancreatic cystic neoplasms is poorly understood. The aim of this study was to know the involvement of epidermal growth factor receptor (EGFR) and its downstream targets in the serous cystic neoplasms and the mucinous cystic neoplasms of the pancreas. In a total of 72 pancreatic cystic neoplasms, including 39 serous cystic neoplasms and 33 mucinous cystic neoplasms, we examined the expression of native and phosphorylated EGFR, mitogen-activated protein kinase (MAPK), and AKT by immunohistochemistry and somatic mutations in EGFR, KRAS, BRAF, and PIK3CA, by direct sequencing. We also assessed the copy numbers of EGFR transcripts and the amplification of the EGFR gene in some of the samples. We found that EGFR, phosphorylated EGFR, MAPK, and phosphorylated MAPK were evidently expressed in 100, 54, 100, and 69% of the serous cystic neoplasms, and in 12%, none, 33, and 27% of the mucinous cystic neoplasms, respectively; the expression was significantly higher and more prevalent in the serous cystic neoplasms than in the mucinous cystic neoplasms. The expression of AKT and phosphorylated AKT was low in both the types of neoplasms. On average, EGFR transcripts in the serous cystic neoplasms and the mucinous cystic neoplasms increased 53.5-and 2.5-fold, respectively, as compared with that in normal tissues, with the increase in the former being significantly greater than that in the latter. Amplification of the EGFR gene was not detected in any of the examined serous cystic neoplasms. None of the tumors had mutations in any of the examined portions of the genes, except two mucinous cystic neoplasms with mutations in codon-12 of KRAS. These results indicate that EGFR and MAPK are actively involved in the pathobiology of serous cystic neoplasms and may therefore be potential diagnostic markers and therapeutic targets in patients with the above mentioned types of neoplasms.

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confidence: 99%

Association of epidermal growth factor receptor and mitogen-activated protein kinase with cystic neoplasms of the pancreas

Kuboki

Shiratori²,

Hatori³

et al. 2010

Modern Pathology

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“…A handful of malignant serous cystic neoplasms, serous cystadenocarcinomas, have been reported. 129,[153][154][155][156][157][158][159][160][161] Most of these were microscopically identical to serous cystadenomas, and no morphologic findings, other than behavior, have been found to distinguish these malignant variants from their benign counterparts. In fact, in some, the diagnosis of malignancy was established only after metastases to the liver were detected.…”

Section: Serous Cystadenocarcinomasmentioning

confidence: 99%

Cystic lesions of the pancreas

Adsay

2007

Modern Pathology

191

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Although cystic tumors of the pancreas are relatively rare, they constitute an increasingly important category. Advances in imaging and interventional techniques and the sharp drop in the mortality rate of pancreatic surgery have rendered pancreatic biopsies and resections commonplace specimens. Consequently, in the past two decades, the nature of many cystic tumors in this organ has been better characterized. The names of some existing entities were revised; for example, what was known as papillary-cystic tumor is now regarded as solidpseudopapillary tumor. New entities, in particular, intraductal papillary mucinous neoplasm and its variants, such as oncocytic and intestinal subtypes were recognized. The importance of clinical and pathologic correlation in the evaluation of these lesions was appreciated, in particular, with regards to the multifocality of these lesions, their association with invasive carcinomas, and thus their 'preinvasive' nature. Consensus criteria for the distinction of these from the ordinary precursors of adenocarcinoma, the pancreatic intraepithelial neoplasia, were established. The definition of mucinous cystic neoplasms was refined; ovarian-like stroma has now become almost a requirement for the diagnosis of mucinous cystic neoplasia, and defined as such, the propensity of these tumors to occur in perimenopausal women became even more striking. The validity and clinical value of classifying the pancreatic cysts of mucinous type as adenoma, borderline, CIS and invasive have been established. Related to this, the importance of thorough sampling in accurate classification of these mucinous lesions was recognized. Greater accessibility of the pancreas afforded by improved invasive as well as noninvasive modalities has also increased the detection of otherwise clinically silent cystic tumors, which has led to the recognition of more innocuous entities such as acinar cell cystadenoma and squamoid cyst of pancreatic ducts. As the significance of the cystic lesions emerged, cystic forms of otherwise typically solid tumors were also better characterized. Thus, significant developments have taken place in the classification and our understanding of pancreatic cystic tumors in the past few years, and experience with these lesions is likely to grow exponentially in the coming years. Modern Pathology (2007) 20, S71-S93.

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“…In the interior they form a honeycomb appearance, or a sponge-like structure with numerous small closely packed cysts arranged around a central stellate calcified scar (Buck and Hayes, 1990). There are very few cases of microcystic adenocarcinomas reported (Abe et al, 1998;Eriguchi et al, 1998;Wu et al, 1999). Histologically both microcystic adenomas and microcystic adenocarcinomas are identical and the presence of metastasis in liver or lymph nodes is the only way to differentiate them.…”

Section: Serous Cystic Neoplasms (Scns)mentioning

confidence: 99%

“…The incidence of serous cystadenocarcinoma is very low (Abe et al, 1998;Eriguchi et al, 1998;Wu et al, 1999). The multicenter study of SCNs in Japan showed that out of 172 patients with SCNs only 2 had liver metastasis (Kimura et al, 2012).…”

Section: Surgerymentioning

confidence: 99%

Pancreatic cystic neoplasms: a review of preoperative diagnosis and management

Bai

Zhang

Masood

et al. 2013

J. Zhejiang Univ. Sci. B

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Pancreatic cystic neoplasms (PCNs) are a diverse group of neoplasms in the pancreas, and are more increasingly encountered with widespread abdominal screening and improved imaging techniques. The most common types of PCNs are serous cystic neoplasms (SCNs), mucinous cystic neoplasms (MCNs), and intraductal papillary mucinous neoplasms (IPMNs). Clinicians frequently feel bewildered in the differential diagnosis and subsequent management among the various types of lesions in the pancreas, which may lead to overtreatment or delayed treatment. The current review provides recent developments in the understanding of the three most common types of PCNs, the latest modalities used in preoperative diagnosis and differential diagnosis, as well as the most up to date management. Suggestions for diagnosis and differential diagnosis of SCNs, MCNs, and IPMNs are also provided for young surgeons. Better understanding of these neoplasms is essential for clinicians to make accurate diagnosis and to provide the best management for patients.

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Serous cystadenocarcinoma of the pancreas with liver metastases

Cited by 70 publications

References 8 publications

Association of epidermal growth factor receptor and mitogen-activated protein kinase with cystic neoplasms of the pancreas

Association of epidermal growth factor receptor and mitogen-activated protein kinase with cystic neoplasms of the pancreas

Cystic lesions of the pancreas

Pancreatic cystic neoplasms: a review of preoperative diagnosis and management

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