Survival analysis of pancreatic and periampullary collision cancers

Niu, G.; Jin, Da Yong; Ji, Yuan; Hou, Jun; Wang, Dan Song; Lou, Wen Hui

doi:10.1111/j.1751-2980.2010.00443.x

Cited by 16 publications

(20 citation statements)

References 10 publications

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“…Prognosis of collision malignant tumors is still unclear. In 2010, the largest experience of collision cancers based on ten heterogeneous cases of pancreatic and periampullary cancers was reported [5]. In this series, most collision cancers were IPMNs coexisting with other malignancies (PDAC, NET, lower end of common bile duct, and duodenal ampullary carcinoma) and showed poor prognosis with a median survival time of only 10 months.…”

Section: Discussionmentioning

confidence: 95%

“…Many authors suggested that these tumors may arise from common precursor stem cells [10,[14][15][16] as showed by a recent molecular lineage study [17]. Others hypothesized that the carcinogenesis of collision cancer may lead to alteration of local immunodefence after the development of one tumor or to the effect of a carcinogenic agent able to affect different targets simultaneously [5]. Prognosis of collision malignant tumors is still unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Collision tumors of the pancreas are rare; sporadic cases of concomitant or collision tumors constituted by IPMNs and NET [4][5][6][7], solid pseudopapillary neoplasm and NET [8], and cancer of the bile duct and pancreas [9] have been previously reported, but clinicopathological features and prognosis of these tumors are substantially unclear. The incidence of concomitant IPMNs and NETs has been reported in a range from 2.6 to 4.6%, suggesting a nonrandom association [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

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Collision of ductal adenocarcinoma and neuroendocrine tumor of the pancreas: a case report and review of the literature

et al. 2017

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Background: Simultaneous occurrence of exocrine and neuroendocrine tumors of the pancreas is very infrequent. We report a patient with an endocrine tumor in the pancreatic-duodenal area and extensive exocrine carcinoma involving the whole pancreas. Case presentation: A 69-year-old woman was hospitalized in May 2016 for epigastric pain and weight loss. Her past medical history revealed an undefined main pancreatic duct dilation that was subsequently confirmed at CT scan (23 mm) and endoscopic ultrasound. There was no evidence of pancreatic masses, but the cephalic portion of the main pancreatic duct presented hypoechoic nodules. A diagnosis of the main-duct intraductal papillary mucinous neoplasm was made, and the patient underwent total pancreatectomy. Pathological examination showed a collision tumor constituted by a ductal adenocarcinoma involving the whole pancreas and a neuroendocrine tumor located in the duodenal peripancreatic wall and the head of the pancreas. There was one peripancreatic lymph node metastasis from the ductal adenocarcinoma and eight node metastases from the neuroendocrine tumor. These findings suggested a diagnosis of collision of neuroendocrine and ductal adenocarcinomas of the pancreas. The postoperative course was uneventful. Conclusions: The coexistence of pancreatic endocrine and exocrine tumors is very uncommon. When present, problems in differential diagnosis may arise between mixed exocrine-endocrine carcinoma or the collision of separate tumors.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Collision of ductal adenocarcinoma and neuroendocrine tumor of the pancreas: a case report and review of the literature

et al. 2017

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“…According to some authors, several factors may lead to the tumorigenesis of collisional tumors: (i) a carcinogenic agent can affect multiple targets at the same time; (ii) the decrease of the systemic and local immune defense system after the development of the tumor facilitates the occurrence of another tumor; and (iii) dysfunction of the tumor suppressor mutated gene leads to inadequate repair of a gene mutation, which could result in formation of multiple tumors [10]. Constant irritation of the duodenal mucosa by bile and pancreatic juice with a superimposed bacterial infection may also lead to mucosal damage and induce cell proliferation activity and multiple gene mutations, which could explain duodenal predilection for neoplasms [10,11]. Hypothetically these factors could also be stimuli for FL and mixed pancreatic carcinoma in our case.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous occurrence of pancreatic mixed acinar-ductal adenocarcinoma and primary follicular lymphoma of the duodenum, accompanied by increased number of IgG4 plasma cells in tumor-free parenchyma as concomitant IgG4-related disease or reaction to tumor? A case report

Ranković¹,

Limbaeck-Stokin²,

Đokić³

et al. 2017

pjp

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Mixed acinar-ductal carcinoma is rare among pancreatic cancers, as is duodenal involvement in follicular lymphoma (FL). Although usually a systemic disease, primary FL of the duodenum occurs, with superficial involvement of the intestinal wall and low risk of progression. We report on a unique case of mixed ductal-acinar carcinoma of the pancreatic head accompanied by low-grade duodenal FL and autoimmune pancreatitis-like changes in adjacent pancreatic parenchyma. To our knowledge this is the first report of concomitant pancreatic mixed acinar-ductal carcinoma and duodenal FL. Clinico-pathological features of this unusual case, possible relationship between the entities and differential diagnosis are discussed.

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“…There is only one reported case of a rare synchronous double tumor in the biliary tract, which was composed of FL of the ampulla of Vater and an endocrine tumor of the common bile duct [8], although this was not a collision tumor. On the other hand, although a relatively high incidence of other malignancies in patients with carcinoma of the ampulla of Vater was revealed, FL was not included in the associated malignancies [15, 16]. …”

Section: Discussionmentioning

confidence: 99%

A Rare Collision Tumor Composed of Follicular Lymphoma and Adenocarcinoma in the Ampulla of Vater: A Case Report

Suzuki

Tanioka

Takatori

et al. 2014

Case Reports in Pathology

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The duodenum is infrequently affected by malignant lymphoma, and follicular lymphomas of the duodenum are rare histological subtypes. There are no reported cases of collision of follicular lymphoma and other tumors in the ampulla of Vater. A 57-year-old Japanese man presented with jaundice, and abdominal computed tomography revealed a tumor of the ampulla of Vater invading the pancreatic head with biliary dilatation and a thickened duodenal wall. The patient underwent subtotal stomach-preserving pancreaticoduodenectomy. Histopathology of the resected specimen revealed lymphoid follicular formations with small-to-medium-sized centrocyte-like cells and some centroblast-like cells. The atypical lymphoid cells were immunohistochemically positive for CD10, CD20, and CD79a but negative for CD5 and cyclin D1. BCL2 protein was highly expressed in the follicle centers. The diagnosis was duodenal follicular lymphoma, Grade 1. The follicular lymphoma, 40 mm in diameter, involved duodenal submucosa and regional lymph nodes without distant metastasis. This duodenal follicular lymphoma was partially overlapped by adenocarcinoma of the ampulla of Vater, measuring 25 × 20 mm, which involved the lower common bile duct, pancreas, and duodenum. We report the first case of a surgically treated collision tumor composed of a rare mass-forming follicular lymphoma and adenocarcinoma of the ampulla of Vater.

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Survival analysis of pancreatic and periampullary collision cancers

Abstract: Collision cancers of the pancreas and periampullary region are difficult to diagnose preoperatively. Their prognosis is poor even after radical resection and adjuvant chemotherapy were given.

Cited by 16 publications

References 10 publications

Collision of ductal adenocarcinoma and neuroendocrine tumor of the pancreas: a case report and review of the literature

Collision of ductal adenocarcinoma and neuroendocrine tumor of the pancreas: a case report and review of the literature

Simultaneous occurrence of pancreatic mixed acinar-ductal adenocarcinoma and primary follicular lymphoma of the duodenum, accompanied by increased number of IgG4 plasma cells in tumor-free parenchyma as concomitant IgG4-related disease or reaction to tumor? A case report

A Rare Collision Tumor Composed of Follicular Lymphoma and Adenocarcinoma in the Ampulla of Vater: A Case Report

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