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Pancreatic malignancy
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Giovanni Morana, Alex Faccinetto, Michele Fusaro
A solid variant of serous cystadenoma has been described. These lesions do not contain any cystic spaces on histopathology, and the cells are arranged in nests, sheets, and trabeculae separated by thick fibrous bands. The stroma demonstrates avid contrast enhancement showing a solid hypervascular appearance, thus incorrectly suggesting a diagnosis of a neuroendocrine tumour, especially on CT (Figure 12.19a) (94). Only MRI is able to correctly characterize these lesions (Figure 12.19b) (94,95). When associated with VHL disease, cystic lesions are multifocal and can involve the pancreatic gland diffusely (Figure 12.20).
The Pancreas and the Periampullary Area
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
These two tumors, benign and malignant, are rare tumors to the pancreas. They may comprise 4 to 10% of all pancreatic cysts with more tendency to be in women than in men. The usual age group is between 45 and 60. These patients usually present with epigastric fullness and pain in the upper part of the abdomen without a history of abdominal trauma, or excessive alcohol consumption. The duration of symptoms can range from 2 months to 2 years, with an average duration of 18 months. These tumors can grow very slowly and never present clinically, and they are discovered at the time of autopsy. On the other hand, those who present clinically may present with associated other conditions including diabetes mellitis, abnormal thyroid function tests, polycystic disease of the liver and kidneys, or biliary disease. Roentgenologically, there are no classical diagnostic signs for these tumors. Occasionally, calcification is seen in the wall of the cyst in about 10% of the cases. Almost two thirds of these tumors are located in the body and the head of the pancreas and one third in the head. Cystadenomas can reach a large size and can be misdiagnosed as pseudocysts and are anastomosed to the back of the stomach or to the bowel. The surgeon should suspect cystadenoma if there is no previous history of pancreatitis, alcoholism, or abdominal trauma. On the other hand, cystadenocarcinomas are usually papillary type, and on opening the cyst, multiple papillae can be seen within the cavity of the cyst. A biopsy and frozen section can differentiate cystadenoma and cystadenocarcinoma from pseudocysts.
Benign Adnexal Masses and Adnexal Torsion
Published in Juan Luis Alcázar, María Ángela Pascual, Stefano Guerriero, Ultrasound of Pelvic Pain in the Non-Pregnant Female, 2019
Serous cystadenoma constitutes about 25% of all benign epithelial ovarian tumors arising from the ovary; 5% of them are bilateral and most of them appear in the fourth to sixth decades of life.1 The typical ultrasound appearance of serous cystadenomas is a smooth, thin-walled, anechoic, fluid-filled lesion with a mean size of 5–8 cm (Figure 1.1a).5,6 Septations may appear in 14% of the cases and irregular wall or even papillary projections may be present in up to 3% of serous cystadenomas (Figure 1.1b).5 Color score may vary from absent to moderate flow within the cystic wall.
Through-the-needle biopsy of pancreatic cystic lesions: current evidence and implications for clinical practice
Published in Expert Review of Medical Devices, 2021
Antonio Facciorusso, Daryl Ramai, Paraskevas Gkolfakis, Alexandra Shapiro, Marianna Arvanitakis, Andrea Lisotti, Konstantinos Triantafyllou, Pietro Fusaroli, Ioannis S Papanikolaou, Stefano Francesco Crinò
As described throughout this review, the main strength of EUS-TTNB is the ability to accurately diagnose PCLs with a higher degree of precision. Even when other methods fail, this technique is capable of yielding a definitive diagnosis due to availability of both stroma and epithelium within the sample [50]. EUS-TTNB provides paramount clinical value when the morphology of the cyst is nonspecific. Exact identification of cyst characteristics is crucial for arriving at a diagnosis and informing the appropriate management strategies. This aspect of clinical care is particularly salient in patients with large unilocular/oligocystic PCLs that lack well-defined connections to the pancreatic ducts, as the management strategies are radically different depending of the PCL characteristics. Management requires invasive surgical intervention for mucinous cystic neoplasm and cystic neuroendocrine tumor, while a serous cystadenoma would not require further follow-up, nor any additional testing.
Prostatic cystadenoma. A case-report illustrating diagnosis and surgical management of an unusual condition
Published in Scandinavian Journal of Urology, 2021
Vibeke M. Kristensen, Thomas Helgstrand, Janne Bayer Andersen, Kristi Krüger, Henrik Jakobsen
Prostatic cystadenoma is a rare condition with less than 30 cases reported [1,2]. Patients often present with obstructive LUTS and constipation due to the presence of a large tumor [1,2,4]. PSA elevation is the norm but not the rule [4]. When encountering a urological patient with obstructive LUTS, cystadenoma should not be the first working diagnosis. However, it should be borne in mind if DRE reveals soft compressible components, cystoscopy shows large and multiple impressions from surrounding tissue, and/or when retroperitoneal cystic tumors are visible from radiological examinations. Moreover, prostatic cystadenocarcinoma, the malignant counterpart, should be considered as a differential diagnosis. In the case of cystadenocarcinoma, it is essential that surgical resection is complete, as the risk of recurrence seems high [1,2,4]. An association between benign cystadenoma and malignant cystadenocarcinoma has been theorized, suggesting a continued spectrum from cystadenoma to cysteadenocarcinom. There is no clear evidence proving the spectrum theory; however, findings of cystadenocarcinoma components within the cystadenoma are a proven argument that appropriate management of the benign condition is essential for management of a potential malignant condition [2,5].
Serum cytokines and CXCR2: potential tumour markers in ovarian neoplasms
Published in Biomarkers, 2020
Douglas Côbo Micheli, Millena Prata Jammal, Agrimaldo Martins-Filho, José Rodolfo Ximenes de Moraes Côrtes, Cristiane Naffah de Souza, Rosekeila Simões Nomelini, Eddie Fernando Candido Murta, Beatriz Martins Tavares-Murta
The anatomopathological analysis showed that most cases of non-neoplastic ovarian lesions were endometrioma (36.4%), followed by simple cysts (21.2%). Patients with benign neoplasia were mainly diagnosed with serous cystadenoma (31.9%), followed by mature cystic teratoma (27.8%) and mucinous cystadenoma (29.2%). In the malignant neoplasia group, papillary serous cystadenocarcinoma was the most frequent diagnosis (20.0%), followed by granulosa cell tumours (16.7%), borderline mucinous tumour (20.0%), borderline serous tumour (6.7%), dysgerminoma (6.7%), clear cell carcinoma (6.7%), and other diagnoses (3.3%). The other items included endometrioid adenocarcinoma, high-grade neoplasia, immature teratoma, Sertoli–Leydig cell tumour, germ cell tumour, endodermal sinus tumour, and giant cell adenocarcinoma, which were exhibited by one individual each.