Incidence and clinical findings of benign, inflammatory disease in patients resected for presumed pancreatic head cancer

Abstract

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Pancreatic carcinoma coexisting with chronic pancreatitis versus tumor-forming pancreatitis: Diagnostic utility of the time-signal intensity curve from dynamic contrast-enhanced MR imaging

“…The presence of a focal pancreatic mass is generally indicative of a neoplasm, and thus the patients are often subjected to TIC: time-signal intensity curve; Ph: pancreatic head, Pb: pancreatic body; PPPD: pylorus-preserving pancreaticoduodenectomy; DPPHR: duodenum-preserving pancreatic head resection; MP: middle pancreatectomy; DP: distal pancreatectomy; NFICT: non-functioning islet cell tumor. major pancreatic surgery such as pancreaticoduodenectomy for presumed pancreatic malignancy that proves later to be benign in 5% to 11% of all cases [23][24][25][26] . In our series, 2 of 8 patients with tumor-forming pancreatitis underwent a pancreas head resection along with lymphadenectomy, because pancreatic carcinoma could not be ruled out.…”

“…The TIC profile of a mass due to carcinoma always depicted the slowest rise to a peak among the 3 pancreatic TICs, even in carcinomas occurring in patients known to have longstanding chronic pancreatitis, while the TIC profile of the focal mass due to chronic pancreatitis was identical to at least one of the proximal and distal pancreatic TICs in individual patients. Chronic pancreatitis has a risk for pancreatic carcinoma with an incidence of 2% after 10 years and 5.9% after 20 years of documented chronic pancreatitis [4] , and the diagnosis of pancreatic carcinoma in this setting may therefore be difficult or even impossible [1,24,25,27,28] . Thus far, at the time of detection, the majority of patients with pancreatic carcinoma associated with chronic pancreatitis tend to be surgically unresectable.…”

Evaluation of Matrix Metalloproteinase 7 in Plasma and Pancreatic Juice as a Biomarker for Pancreatic Cancer

“…As a consequence, 6% to 9% of pancreatic resections for suspected carcinoma are done inappropriately for chronic pancreatitis (1)(2)(3). Although pylorus-preserving pancreaticoduodenectomy has become a procedure with low mortality and acceptable morbidity, patients with chronic pancreatitis who need surgical intervention are not optimally treated or overtreated with this procedure (4).…”

In Vivo Characterization of Proliferation for Discriminating Cancer from Pancreatic Pseudotumors

“…CT examination is limited in identifying the ductal adenocarcinoma that begins during CP because of the reduced difference in density between the cancerous lesion, which is typically hypovascularized, and the pancreatic parenchyma, which is also typically hypovascularized in CP because of fibrosis (3). Up to 6% of the cases suspected to be malignant have been found to be benign at surgery, which may be associated with a postsurgical complication rate of up to 21% (4). Endoscopic ultrasound (EUS) has become the most accurate modality for the characterization, locoregional staging, and sampling of pancreatic lesions.…”