Pancreatic adenocarcinoma and pancreatic high-grade neuroendocrine carcinoma: two sides of the moon

Salvia, Anna La; Persano, Irene; Parlagreco, Elena; Audisio, Alessandro; Cani, Massimiliano; Brizzi, Maria Pia

doi:10.1007/s12032-022-01764-2

Cited by 4 publications

(4 citation statements)

References 85 publications

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“…Typically, PanNENs manifest as hyper-vascular lesions with a solid and round shape on contrast-enhanced CT scans [5], and some PanNENs are known to exhibit cystic lesions [6]. A metaanalysis has indicated that the presence of cystic components in PanNENs suggest an indolent biological behavior, as it is associated with a better prognosis compared to PanNENs without cystic lesions [7].…”

Section: Discussionmentioning

confidence: 99%

A case of pancreatic neuroendocrine carcinoma was diagnosed based on the dramatic changes observed in imaging over a two-month period

Miki

2023

J Clin Images Med Case Rep

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Pancreatic Neuroendocrine Carcinoma (PanNEC) is a rare type of cancer with rapid progression and a poor prognosis. In this report, we present a case of PanNEC that was diagnosed after a dramatic change in its imaging features. A 73-year-old woman with upper abdominal pain was referred to our hospital for evaluation of a 28 mm cystic mass found on abdominal computed tomography. The tumor was also visualized as a cyst on endoscopic ultrasound and did not enhance, but it compressed the main pancreatic duct. Two months later, the tumor had increased in size (50 mm) and transformed into a solid lesion. Pathological findings from a specimen obtained by EUS-FNA revealed that the tumor was PanNEC with a Ki-67 index of >80%. The patient’s survival time was only 4 months after the onset. In considering a case of an uncommon pancreatic mass, it’s important to bear in mind the possibility that it could be PanNEC.

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Section: Discussionmentioning

confidence: 99%

A case of pancreatic neuroendocrine carcinoma was diagnosed based on the dramatic changes observed in imaging over a two-month period

Miki

2023

J Clin Images Med Case Rep

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“…Several studies have demonstrated the benefits of surgery even for isolated recurrences of PAC (116). However, <20% of patients are candidates for curative resection (117). Attempted resection rates, margin negative resection rates and pathological response are the outcomes measured for surgical resection (118).…”

Section: Discussionmentioning

confidence: 99%

“…Palliative local treatments are preferred alternatives to surgery (26). However, although only 10-20% of patients are candidates for curative resection, vascular bypass graft techniques and neoadjuvant treatment regimens have increased the curative resection rate (56,117). Attempted resection rates, margin negative resection rates, and pathologic response are the outcomes measured for surgical resection (118).…”

Section: Discussionmentioning

confidence: 99%

A pancreatic adenocarcinoma mimicking hepatoid carcinoma of uncertain histogenesis: A case report and literature review

Iliesiu,

Toma,

Ciongariu

et al. 2023

Oncol Lett

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In rare cases, metastatic adenocarcinomas of different origin may exhibit the features of hepatoid carcinoma (HC), a rare malignant epithelial tumor, most commonly occurring in the ovaries and stomach, as well as in the pancreas and biliary ducts. A case of a 72-year-old female patient who developed a highly aggressive, poorly differentiated pancreatic ductal adenocarcinoma with peritoneal carcinomatosis, demonstrating hepatoid differentiation upon conventional hematoxylin and eosin staining is reported in the present study. The patient presented with severe abdominal pain, and the radiological investigations performed revealed ovarian and hepatic tumor masses and peritoneal lesions, which were surgically removed. The gross examination of the peritoneum and omentum revealed multiple solid, firm, grey-white nodules, diffusely infiltrating the adipose tissue. The microscopic examination revealed a malignant epithelial proliferation, composed of polygonal cells with abundant eosinophilic cytoplasm and irregular, pleomorphic nuclei. Certain cells presented with intracytoplasmic mucus inclusions, raising suspicion of a HC with an uncertain histogenesis. Immunohistochemical staining was performed, and the tumor cells were found to be positive for cytokeratin (CK)7, CK18 and mucin 5AC, whereas negative staining for CK20, caudal-type homeobox transcription factor 2, α-fetoprotein, paired box gene 8, GATA-binding protein 3 and Wilms tumor 1 were documented. Thus, the diagnosis of metastatic pancreatic adenocarcinoma was established. The main aim of the present study was to provide further knowledge concerning poorly differentiated metastatic adenocarcinoma resembling HC, emphasizing the histopathological and immunohistochemical features of these malignant lesions and raising awareness of the diagnostic difficulties that may arise, as well as the importance of the use immunohistochemistry in differentiating carcinomas of uncertain histogenesis.

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“…Over 90% of pancreatic cancers are pancreatic ductal adenocarcinomas (PDAC) [ 2 ]. Pancreatic neuroendocrine neoplasms (PanNEN) are the next most common subtype [ 3 ]. They are rare and more indolent than PDAC, may present in a different manner, with better long term survival, and therefore are not considered in this study [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Elevated Glycated Haemoglobin (HbA1c) Is Associated with an Increased Risk of Pancreatic Ductal Adenocarcinoma: A UK Biobank Cohort Study

McDonnell

Cheang

Wilding

et al. 2023

Cancers

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Background: The role of dysglycaemia as a risk marker for Pancreatic Ductal Adenocarcinoma (PDAC) is uncertain. We investigated the relationship between glycated haemoglobin (HbA1c) and incident PDAC using a retrospective cohort study within the UK Biobank. Methods: A study involving 499,804 participants from the UK Biobank study was undertaken. Participants were stratified by diabetes mellitus (DM) status, and then by HbA1c values < 42 mmol/mol, 42–47 mmol/mol, or ≥48 mmol/mol. Cox proportional hazard models were used to describe the association between HbA1c category (with time-varying interactions) and incident PDAC. Results: PDAC occurred in 1157 participants during 11.6 (10.9–12.3) years follow up [(median (interquartile range)]. In subjects without known DM at baseline, 12 months after recruitment, the adjusted hazard ratios (aHR, 95% CI) for incident PDAC for HbA1c 42–47 mmol/mol compared to HbA1c < 42 mmol/mol (reference group) was 2.10 (1.31–3.37, p = 0.002); and was 8.55 (4.58–15.99, p < 0.001) for HbA1c ≥ 48 mmol/mol. The association between baseline HbA1c and incident PDAC attenuated with increasing duration of time of follow-up to PDAC diagnosis. Conclusions: Dysglycaemia detected by elevated HbA1c is associated with an increased risk of PDAC. The strength of the association between elevated HbA1c and incident PDAC is inversely proportional to the time from detecting dysglycaemia but remains significant for at least 60 months following HbA1c testing.

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Pancreatic adenocarcinoma and pancreatic high-grade neuroendocrine carcinoma: two sides of the moon

Cited by 4 publications

References 85 publications

A case of pancreatic neuroendocrine carcinoma was diagnosed based on the dramatic changes observed in imaging over a two-month period

A case of pancreatic neuroendocrine carcinoma was diagnosed based on the dramatic changes observed in imaging over a two-month period

A pancreatic adenocarcinoma mimicking hepatoid carcinoma of uncertain histogenesis: A case report and literature review

Elevated Glycated Haemoglobin (HbA1c) Is Associated with an Increased Risk of Pancreatic Ductal Adenocarcinoma: A UK Biobank Cohort Study

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