A narrative review of a type of pancreatitis worthy of attention: acute pancreatitis associated with pancreatic tumors—current problems and future thinking

Abstract

We have newly defined a type of pancreatitis based on clinical practice experience, namely pancreatic tumorassociated pancreatitis (PTP). PTP has many new features in terms of diagnosis and treatment, and it is therefore necessary to describe it in detail.AP has various causes and a complex pathogenesis, and its occurrence and development are affected by many factors.

Preoperative acute pancreatitis and hyperenzymemia are associated with poor prognosis in patients with nonfunctional pancreatic neuroendocrine tumors

“…The underlying mechanism whereby a tumor may cause AP remains unclear. It is suggested that local pancreatic necrosis caused by tumor growth and direct activation of pancreatic enzymes by neoplastic tissue may be possible mechanisms of AP 9,33 . Apart from that, tumor compression or cancer cell invasion may cause the obstruction of the main pancreatic duct and impede the flow of pancreatic enzymes, which leads to inappropriate enzyme activation within the pancreas 20,33 .…”

“…It is suggested that local pancreatic necrosis caused by tumor growth and direct activation of pancreatic enzymes by neoplastic tissue may be possible mechanisms of AP. 9,33 Apart from that, tumor compression or cancer cell invasion may cause the obstruction of the main pancreatic duct and impede the flow of pancreatic enzymes, which leads to inappropriate enzyme activation within the pancreas. 20,33 Interestingly, main pancreatic duct involvement (MPDI) has been demonstrated to be an independent poor prognostic factor for PNETs.…”

“…Alcohol and gallstones are two leading causes of AP. Besides, although rare, pancreatic tumors, such as PDAC, intraductal papillary mucinous neoplasm (IPMN) and other tumors, may cause AP and pancreatic hyperenzymemia (elevated serum amylase and/or lipase) 9 . Furthermore, AP and/or hyperenzymemia have been studied regarding their potential prognostic value in IPMN 10–12 and pancreatic cancer 13–15 .…”

“…Besides, although rare, pancreatic tumors, such as PDAC, intraductal papillary mucinous neoplasm (IPMN) and other tumors, may cause AP and pancreatic hyperenzymemia (elevated serum amylase and/or lipase). 9 Furthermore, AP and/or hyperenzymemia have been studied regarding their potential prognostic value in IPMN [10][11][12] and pancreatic cancer. [13][14][15] Specifically, for PDAC, AP has been reported to not only be a risk factor 16,17 but also to have implications on tumor progression and long-term survival.…”