Pancreatic cancer causing acute pancreatitis: a comparative study with cancer patients without pancreatitis and pancreatitis patients without cancer

Minato, Yohei; Kamisawa, Terumi; Tabata, Taku; Hara, Seiichi; Kuruma, Sawako; Chiba, Kazuro; Kuwata, Go; Fujiwara, Takashi; Egashira, Hideto; Koizumi, Koichi; Saito, Itaru; Endo, Yuka; Koizumi, Satomi; Fujiwara, Junko; Arakawa, Takeo; Momma, Kumiko; Kurata, Masahiro; Honda, Goro

doi:10.1007/s00534-013-0598-y

Cited by 37 publications

(33 citation statements)

References 17 publications

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“…[ 30 ] In our study, the diagnosis of PC was delayed by 2 to 660 days (median 101 days). Minato et al [ 31 ] suspected that diffuse pancreatic inflammation might have masked the presence of an underlying lesion in the pancreas or a small-sized tumor may preclude an early diagnosis of cancer. Another cause might be that a pancreatic mass was difficult to found on the images in the early stage of cancer.…”

Section: Discussionmentioning

confidence: 99%

Acute pancreatitis in patients with pancreatic cancer

Tian²

2017

Medicine

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Acute pancreatitis (AP) is a rare manifestation of pancreatic cancer (PC). The relationship between AP and PC remains less distinct.From January 2009 to November 2015, 47consecutive patients with PC who presented with AP were reviewed for this study. Clinical features, clinicopathologic variables, postoperative complications, and follow-up evaluations of patients were documented in detail from our database. In order to identify cutoff threshold time for surgery, receiver operating curve (ROC) was built according to patients with or without postoperative complications. Cumulative rate of survival was calculated by using the Kaplan–Meier method. The study was conducted in accordance with the principles of the Declaration of Helsinki and the guidelines of West China Hospital.This study included 35 men (74.5%) and 12 women (25.5%) (mean age: 52 years), with a median follow-up of 40 months. AP was clinically mild in 45 (95.7%) and severe in 2 (4.3%). The diagnosis of PC was delayed by 2 to 660 days (median 101 days). Thirty-nine (83.0%) cases underwent surgery. Eight (17.0%) cases performed biopsies only. Of 39 patients, radical surgery was performed in 32 (82.1%) cases and palliative in 7 (19.9%) cases. Two (8.0%) patients were needed for vascular resection and reconstruction. Postoperative complications occurred in 12 (30.8%) patients. About 24.5 days was the best cutoff point, with an area under curve (AUC) of 0.727 (P = 0.025, 95% confidence interval: 0.555–0.8999). The survival rate of patients at 1 year was 23.4%. The median survival in patients with vascular resection and reconstruction was 18 months, compared with 10 months in patients without vascular resection (P = 0.042). For the primary stage (T), Tix was identified in 3 patients, the survival of whom were 5, 28, 50 months, respectively. And 2 of them were still alive at the follow-up period.The severity of AP was mainly mild. Surgical intervention after 24.5 days may benefit for reducing postoperative complications. Patients with vascular resection and reconstruction, thus achieving tumor-free margins, had a long-time survival.

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Section: Discussionmentioning

confidence: 99%

Acute pancreatitis in patients with pancreatic cancer

Tian²

2017

Medicine

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“…It was recently reported that AP may be an early manifestation of pancreatic cancer [ 6 – 8 ]. Hence, many pancreatic cancer patients may be misdiagnosed as AP, even delaying their diagnosis and treatment [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Significant increased CA199 levels in acute pancreatitis patients predicts the presence of pancreatic cancer

Teng

Sun

et al. 2018

Oncotarget

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Background and study aimsCarbohydrate antigen 19-9 (CA199) has been identified as a tumor marker for pancreatic cancer but also increases in benign lesions of the digestive system. However, literature associated with the relationship between CA199 and acute pancreatitis (AP) is limited. This study aimed to focus on serum CA199 level measurements in AP patients and the associated clinical significance.Materials and methodsFrom January 2006 to December 2015, 1,609 consecutive patients with AP were admitted to our department and included in the study. The relationships among the etiology of AP, the disease severity, the incidence of pancreatic cancer during hospitalization and CA199 levels were analyzed.ResultsSerum CA199 levels were measured for 693 of 1,609 AP patients. Of those patients, 186 (26.8%) had elevated CA199 levels (> 37 U/ml). Patients with high CA199 levels were older and had predominantly biliary causes in comparison with patients with normal CA199 levels. There were no definite specific correlations between CA199 levels and disease severity in AP. In addition, serum levels of CA199 positively correlated with serum alanine aminotransferase, aspartate transaminase, glutamyl transpeptidase, alkaline phosphatase and creatinine levels. After stratification, the incidence of pancreatic cancer increased proportionally to CA199 levels in AP patients.ConclusionsSerum CA199 levels was elevated in patients with AP, especially in patients with biliary pancreatitis. AP patients with significantly increased CA199 levels may have a higher risk for the presence of pancreatic cancer. We recommended routinely monitoring CA199 levels during hospitalization for AP patients.

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“…The latter was seen around the MPD in which the lumen was almost occupied by APC invasion. It is well known that pancreatic cancer is a rare etiology of acute pancreatitis, accounting for only 1.2% of cases 5) .…”

Section: Discussionmentioning

confidence: 99%

Anaplastic pancreatic carcinoma growing within the main pancreatic duct complicated by a large pseudocyst

Uemura

Maeda

Tsujii

et al. 2019

Ann. Cancer Res. Therap.

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A 71-year-old woman with epigastric pain and fever visited our hospital. She had elevated levels of serum amylase and C-reactive protein, and computed tomography revealed a large, 20 cm diameter, pancreatic cyst. A low-density nodule was also identified in the head of the pancreas with mild dilation of the distal main pancreatic duct (MPD). The patient was diagnosed with pancreatic ductal carcinoma complicated by a pancreatic pseudocyst (PPC). After drainage of the cyst, a pancreaticoduodenectomy was safely performed. Histological examination revealed anaplastic pancreatic carcinoma (APC) composed of spindle cells and osteoclast-like giant cells. The tumor occupied the lumen of the MPD and acute and chronic obstructive pancreatitis was evident. Although her postoperative course was uneventful, the tumor recurred as multiple liver metastases three months after surgery, and she died of disease progression four months after surgery. PPCs are often caused by alcohol use, biliary tract disease, or blunt trauma. However, PPCs caused by APC is rarely seen. Although extremely rare, pancreatic cancer or APC should be considered as a cause of PPCs. A spindle cell component to the tumor seems to be associated with a dismal prognosis, while growth within the pancreatic duct is reported to carry a better prognosis.

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Pancreatic cancer causing acute pancreatitis: a comparative study with cancer patients without pancreatitis and pancreatitis patients without cancer

Abstract: Anatomic evaluation of the pancreas should be performed in patients with acute pancreatitis with no obvious etiology, even if the pancreatitis is mild, to search for underlying malignancy.

Cited by 37 publications

References 17 publications

Acute pancreatitis in patients with pancreatic cancer

Acute pancreatitis in patients with pancreatic cancer

Significant increased CA199 levels in acute pancreatitis patients predicts the presence of pancreatic cancer

Anaplastic pancreatic carcinoma growing within the main pancreatic duct complicated by a large pseudocyst

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