Multifocal High-Grade Pancreatic Precursor Lesions: A Case Series and Management Recommendations.

Journal of Pancreatic Cancer Pub Date : 2019-04-29 eCollection Date: 2019-01-01 DOI:10.1089/pancan.2019.0001
Mazhar Soufi, Michele T Yip-Schneider, Rosalie A Carr, Alexandra M Roch, Howard H Wu, Christian Max Schmidt
{"title":"Multifocal High-Grade Pancreatic Precursor Lesions: A Case Series and Management Recommendations.","authors":"Mazhar Soufi,&nbsp;Michele T Yip-Schneider,&nbsp;Rosalie A Carr,&nbsp;Alexandra M Roch,&nbsp;Howard H Wu,&nbsp;Christian Max Schmidt","doi":"10.1089/pancan.2019.0001","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> The risk of developing invasive cancer in the remnant pancreas after resection of multifocal high-grade pancreatic precursor lesions is not well known. We report three patients who were followed up after resection of multifocal high-grade pancreatic intraepithelial neoplasia (PanIN)-3 or intraductal papillary mucinous neoplasia (IPMN), two of whom eventually developed invasive carcinoma. <b>Presentation:</b> 1) 68-year-old woman who had a laparoscopic distal pancreatectomy for multifocal mixed-type IPMN, identified as high-grade on final pathology, with negative surgical margins. During semiannual monitoring, eight years from the first surgery, the patient developed suspicious features prompting surgical resection of the body with final pathology revealing invasive ductal adenocarcinoma in the setting of IPMN. 2) 48-year-old woman who had a distal pancreatectomy for severe acute/chronic symptomatic pancreatitis, with final pathology revealing multifocal high-grade PanIN-3, with negative surgical margins. Despite semiannual monitoring, two years from the first surgery, the patient developed pancreatic adenocarcinoma with liver metastasis. 3) 55-year-old woman who had a Whipple procedure for symptomatic chronic pancreatitis, with multifocal PanIN-3 on final pathology. The patient underwent completion pancreatectomy due to symptomatology and her high-risk profile, with final pathology confirming multifocal PanIN-3. <b>Conclusion:</b> Multifocal high-grade dysplastic lesions of the pancreas might benefit from surgical resection.</p>","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2019-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pancan.2019.0001","citationCount":"5","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pancreatic Cancer","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1089/pancan.2019.0001","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2019/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 5

Abstract

Background: The risk of developing invasive cancer in the remnant pancreas after resection of multifocal high-grade pancreatic precursor lesions is not well known. We report three patients who were followed up after resection of multifocal high-grade pancreatic intraepithelial neoplasia (PanIN)-3 or intraductal papillary mucinous neoplasia (IPMN), two of whom eventually developed invasive carcinoma. Presentation: 1) 68-year-old woman who had a laparoscopic distal pancreatectomy for multifocal mixed-type IPMN, identified as high-grade on final pathology, with negative surgical margins. During semiannual monitoring, eight years from the first surgery, the patient developed suspicious features prompting surgical resection of the body with final pathology revealing invasive ductal adenocarcinoma in the setting of IPMN. 2) 48-year-old woman who had a distal pancreatectomy for severe acute/chronic symptomatic pancreatitis, with final pathology revealing multifocal high-grade PanIN-3, with negative surgical margins. Despite semiannual monitoring, two years from the first surgery, the patient developed pancreatic adenocarcinoma with liver metastasis. 3) 55-year-old woman who had a Whipple procedure for symptomatic chronic pancreatitis, with multifocal PanIN-3 on final pathology. The patient underwent completion pancreatectomy due to symptomatology and her high-risk profile, with final pathology confirming multifocal PanIN-3. Conclusion: Multifocal high-grade dysplastic lesions of the pancreas might benefit from surgical resection.

多灶高级别胰腺前体病变:病例系列和管理建议。
背景:多灶高级别胰腺前体病变切除后残余胰腺发生浸润性癌的风险尚不清楚。我们报告了3例在切除多灶高级别胰腺上皮内瘤变(PanIN)-3或导管内乳头状粘液瘤变(IPMN)后随访的患者,其中2例最终发展为浸润性癌。1) 68岁女性,因多灶混合型IPMN行腹腔镜远端胰腺切除术,最终病理诊断为高级别,手术切缘阴性。在半年一次的监测中,距首次手术8年,患者出现可疑特征,促使手术切除,最终病理显示IPMN背景下浸润性导管腺癌。2) 48岁女性,因严重急性/慢性症状性胰腺炎行远端胰腺切除术,最终病理显示多灶高级别PanIN-3,手术切缘阴性。尽管半年一次的监测,从第一次手术两年后,患者发展为胰腺腺癌并肝转移。3) 55岁女性,因症状性慢性胰腺炎行惠普尔手术,最终病理显示多灶PanIN-3。由于症状和高危特征,患者接受了完全胰腺切除术,最终病理证实多灶性PanIN-3。结论:胰腺多灶性高级别发育不良病变可行手术切除。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信