Gastrointestinal bleeding in a pregnant woman: mucinous cystic neoplasm of pancreas mimicking gastrointestinal stromal tumor of stomach

Brown, Tim; Menon, Vinod; Richards, D. G.; Griffiths, Ann

doi:10.1007/s00534-009-0159-6

Cited by 19 publications

(14 citation statements)

References 7 publications

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“…Although reports have described a number of anecdotes involving worrisome histories of pregnant women with malignant tumors, including carcinomas of the pancreas [ 16 , 30 , 31 ], pancreatic neuroendocrine tumors [ 14 ], and bleeding neoplasms [ 32 ], or spontaneous SPEN rupture [ 33 ], these cases are generally exceptions rather than the rule. Nevertheless, given the objective of providing optimal care to both mother and child, the determination of an appropriate treatment schedule for any young pregnant woman requires the consideration of a wide range of diagnoses and a number of important factors.…”

Section: Discussionmentioning

confidence: 99%

Adult pancreatic hemangioma in pregnancy – concerns and considerations of a rare case

2015

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BackgroundPancreatic tumors in pregnancy are rare but clinically challenging. Careful diagnostic workup, including appropriate imaging examinations, should be performed to evaluate surgery indications and timing . In the present case a diagnosis of an adult pancreatic hemangioma was made. We were not able to identify a similar case in the very sparse literature on this rare disease.Case presentationA 30-year-old woman at 12 weeks of gestation was diagnosed with a large pancreatic tumor having a cystic pattern based on imaging. Although the preoperative diagnosis was uncertain, patient preference and clinical symptoms and signs suggested surgery. Open distal pancreatic resection including splenectomy was performed, and complete resection of the large cystic tumor was successfully achieved, with no postoperative complications. Although a solid pseudopapillary epithelial neoplasm (SPEN) was suspected, specimen morphology, including immunohistochemistry, supported the diagnosis of an adult benign pancreatic hemangioma.ConclusionAlthough mucinous cystic neoplasm (MCN) and adenocarcinoma are the most common pancreatic tumors during pregnancy, various other malignant and benign lesions can be encountered. This report adds to the very small number of pancreatic hemangiomas reported in the literature and involves the first patient diagnosed with this rare condition during pregnancy. Careful clinical considerations regarding diagnostic workup and treatments are required to ensure that mother and child receive the best possible care.

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Section: Discussionmentioning

confidence: 99%

Adult pancreatic hemangioma in pregnancy – concerns and considerations of a rare case

2015

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“…Pancreatic MCNs usually grow slowly and most of them show benign appearance without infiltrative growth into adjacent tissues 1,2 . However, there have been several case reports showing rapid growth during pregnancy and presenting the critical problem of fetal intrauterine growth restriction 3–14 . Ganepola et al 3 .…”

Section: Discussionmentioning

confidence: 99%

“…MCNs are often found incidentally and may occasionally cause symptoms. However, MCN in pregnant women is extremely rare and only a few cases have been reported to date 3–14 . The predilection of MCNs for women and its rapid growth in pregnancy indicate a major role for the sex hormones in the histogenesis and malignant transformation of MCN, but the details of this relationship remain unclear 3…”

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confidence: 99%

“…However, MCN in pregnant women is extremely rare and only a few cases have been reported to date. [3][4][5][6][7][8][9][10][11][12][13][14] The predilection of MCNs for women and its rapid growth in pregnancy indicate a major role for the sex hormones in the histogenesis and malignant transformation of MCN, but the details of this relationship remain unclear. 3 In this case report, we describe an extremely rare case of a ruptured MCN with an associated invasive carcinoma of the pancreatic head in a 32-year-old pregnant woman.…”

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confidence: 99%

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Ruptured mucinous cystic neoplasm with an associated invasive carcinoma of pancreatic head in a pregnant woman: Report of a case and review of literature

Naganuma

Honda

Noriki

et al. 2010

Pathology International

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Mucinous cystic neoplasm (MCN) of the pancreas is characterized by mucin-producing columnar epithelium and an ovarian-type stroma. It occurs almost exclusively in women and is almost always located in the pancreatic body or tail. Here, we report a case of large MCN located in the pancreatic head but not in the body nor tail in a 32-year-old pregnant woman, which was thought to have grown rapidly during pregnancy. It was ruptured at 34 weeks of gestation and the patient was admitted to the emergency department of the University of Fukui Hospital with an acute abdomen. Emergency cesarean section followed by pancreaticoduodenectomy was performed. The tumor consisted of many small cysts lined by a single-layer of mucinous epithelium with papillary growth and partial solid parts showing invasive growth and sarcomatoid changes, indicating mucinous cystic neoplasm with an associated invasive carcinoma (previously referred as mucinous cystadenocarcinoma). Thickened septa revealed ovarian-type stroma strongly positive for α-inhibin and partly positive for progesterone receptor immunohistochemically. We also review and discuss previous reports of MCNs including those with an associated invasive carcinoma in pregnant patients.

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“…Some patients show unspecific symptoms such as: mild abdominal pain, nausea and vomiting, back pain, epigastric heaviness and fullness [ 9 , 11 , 14 , 15 ]. Less frequently, complications like pancreatitis, jaundice [ 8 , 14 ], and bleedings or anemia may occur [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Mucinous Cystic Neoplasm of Pancreas in a Pregnant Woman Presenting with Severe Anemia and Gastric Bleeding: Case Report and Review of the Literature

et al. 2021

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Mucinous cystic neoplasms of the pancreas are uncommon and especially their occurrence during pregnancy is an extremely rare event which necessitates an individualized and interdisciplinary management. A 33-year old woman was referred to our department during her third trimester of pregnancy (34th week of gestation) with severe anemia and tarry stools. Based on gastroscopic findings, our interdisciplinary team suspected a gastrointestinal stromal tumor and therefore indicated a prompt delivery via cesarean section completed with an oncological resection of the neoplasm. Histological examination subsequently showed a mucinous cystic neoplasm of the pancreas with no evidence of malignancy. To review the prevalence of mucinous cystic neoplasms and to discuss diagnosis and treatment during pregnancy. Moreover, we critically value the indication of preterm delivery and the oncological procedure in the perspective of outcome for mother and infant. A bleeding gastrointestinal tumor during pregnancy represents a life-threatening risk for mother and infant and requires an immediate interdisciplinary treatment. The urgency and radicality of the therapy should be adapted according to individual findings. As our patient’s tumor was suspected of having a malignant progression, an extensive surgical intervention was necessary.

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Gastrointestinal bleeding in a pregnant woman: mucinous cystic neoplasm of pancreas mimicking gastrointestinal stromal tumor of stomach

Cited by 19 publications

References 7 publications

Adult pancreatic hemangioma in pregnancy – concerns and considerations of a rare case

Adult pancreatic hemangioma in pregnancy – concerns and considerations of a rare case

Ruptured mucinous cystic neoplasm with an associated invasive carcinoma of pancreatic head in a pregnant woman: Report of a case and review of literature

Mucinous Cystic Neoplasm of Pancreas in a Pregnant Woman Presenting with Severe Anemia and Gastric Bleeding: Case Report and Review of the Literature

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