BACKGROUND: Cystic neoplasms of pancreas comprise pathologically heterogeneous groups of tumors with many shared clinical features. Although relatively uncommon, they have a very important place in the surgical pathology of the pancreas because of their high cure rate and their potential confusion with far more common pancreatic pseudocysts. METHODS: We analysed clinical features of 23 patients with pancreatic cystic neoplasm that we treated within 8-years` period (13 women, 10 men, mean age; 47.2 years old) The cystic neoplasms of pancreas comprise 5 serous cystadenoma, 3 benign mucinous cystic tumor, 3 borderline malignancy of mucinous cystic tumor and 4 mucinous cystadenocarcinoma, 4 papillary cystic tumor, 1 cystic teratoma, 1 cystic mesothelioma, 1 lymphoepithelial cyst. 1 mucinous ductal ectasia. RESULTS: Mean tumor size was 6.8cm(3 to 15cm). 73.9 percent had abdominal pain and 26.1 percent had abdominal mass. Computed tomography, ultrasonography and MRI were useful in detecting cystic mass in all cases but was not reliable to distinguish serous from mucinous tumor, benign from malignant. For the treatment of the tumor, 17 distal pancreatectomy with splenectomy, 1 distal pancreatectomy with spleen preserving, 1 proximal pancreatic resection, 2 local excision of pancreas and 1 PPPD were performed. During the period of follow up (mean: 29 months) after surgical resection, 1 recurrence occurred in the patient who underwent local excision for mucinous cystic tumor showing borderline malignancy on histologic finding. All the patients are alive except 2 patients who were lost to follow-up. CONCLUSION: Pancreatic cystic neoplasms are rare and their prognosis are acceptable when they are treated early and properly. So early detection and surgical treatment is the mainstay of management of cystic neoplasm of pancreas.
Abdominal Pain ; Cystadenocarcinoma, Mucinous ; Cystadenoma, Serous ; Dilatation, Pathologic ; Female ; Follow-Up Studies ; Humans ; Lost to Follow-Up ; Magnetic Resonance Imaging ; Male ; Mesothelioma, Cystic ; Mucins ; Pancreas* ; Pancreatectomy ; Pancreatic Cyst ; Pancreatic Pseudocyst ; Pathology, Surgical ; Prognosis ; Recurrence ; Spleen ; Splenectomy ; Teratoma ; Ultrasonography

BACKGROUND: In gastric cancer, lymph-node status is the most important discriminant of patient outcome. In spite of its prognostic importance, lymph-node status is usually examined by a routine histological examination using only one hematoxylin and eosin (H-E) section prepared from a representative cut surface of each lymph node. In order to overcome this drawback, new means based on the polymerase chain reaction (PCR) have recently developed to detect micrometastases in lymph nodes. METHODS: Gastric cancer tissues and lymph nodes were obtained from 9 primary gastric adenocarcinoma patients who underwent gastric resection. A total of 80 lymph nodes and 9 gastric cancer tissues were analyzed by both histologic and molecular examination of keratin 19 mRNA. Regional lymph nodes obtained from patients with benign peptic ulcer perforation were used as normal control lymph nodes. RESULTS: 1) Keratin 19 mRNA was expressed in all patients with gastric cancers, but in none of the 10 normal control lymph nodes. 2) Keratin 19 mRNA was detected in all of the 8 lymph nodes which were histologically metastasis-positive. Of the 72 lymph nodes which were histologically metastasis- negative, 67 were found not to express keratin 19 mRNA, but 5 were found to express keratin 19 mRNA. 3) Especially, of the 3 early gastric cancers which were histologically metastasis-negative, one was found not to express keratin 19 mRNA, but two were found to express keratin 19 mRNA. CONCLUSIONS: Keratin 19 reverse transcripture (RT)-PCR a more sensitive method than histological examination for the detection of gastric micrometastases in lymph nodes and may serve as a useful clinical factor in establishing accurate staging for prognosis and in planning optimum management.
Adenocarcinoma ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Keratin-19* ; Lymph Nodes* ; Neoplasm Micrometastasis* ; Peptic Ulcer Perforation ; Polymerase Chain Reaction ; Prognosis ; RNA, Messenger* ; Stomach Neoplasms*