Endocrine Malignancies
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Adrenocortical Cancer
Multiple Endocrine Neoplasia /Familial Thyroid Ca.
Pancreas Cancer
Parathyroid Cancer
Pheochromocytoma and Paraganglioma
Pituitary Cancer
Thymoma and Thymic Carcinoma
Thyroid Cancer
Medical Terminology for Cancer: The Endocrine System
Endocrinology / General Resources
Latest Research Publications

Endocrinology / General Resources (5 links)

Latest Research Publications

This list of publications is regularly updated (Source: PubMed).

Gao X, Liu Y, Deeb D, et al.
Anticancer activity of pristimerin in ovarian carcinoma cells is mediated through the inhibition of prosurvival Akt/NF-κB/mTOR signaling.
J Exp Ther Oncol. 2014; 10(4):275-83 [PubMed] Free Access to Full Article Related Publications
Pristimerin isaquinonemethidetriterpenoidthathasshown anticancer activity against some cancer types. However, the antitumor effects of pristimerin (PM) in ovarian cancer cells have not been adequately studied. The objective of the present study was to determine the anticancer activity and its mechanism of action in human ovarian carcinoma cell lines. PM strongly inhibited the proliferation of ovarian cancer cells by inducing apoptosis characterized by increased annexin V-binding, cleavage of poly (ADP-ribose) polymerase (PARP-1) and procaspases-3, -8 and -9. Furthermore, PM caused mitochondrial depolarization. Western blot analysis showed inhibition of prosurvival phospho-AKT (p-AKT), nuclear factor kappa B (NF-κB) (p65) and phospho-mammalian target of rapamycin (p-mTOR) signaling proteins in cells treated with PM. Treatment with PM also inhibited the expression of NF-κB-regulated antiapoptotic Bcl-2, Bcl-xL, c-IAP1 and survivin. Thus, our data showing potent antiproliferative and apoptosis-inducing activity of PM in ovarian carcinoma cells through the inhibition of AKT/ NF-κB/ mTOR signaling pathway warrant further investigation of PM for the management of ovarian cancer.

Related: Apoptosis Mitochondrial Mutations in Cancer Ovarian Cancer AKT1 Signal Transduction MTOR

Guzel AI, Yalinkaya A, Alomeroglu M
A rare case of acute abdomen: torsionated ovarian myoma.
J Exp Ther Oncol. 2014; 10(4):255-7 [PubMed] Related Publications
Ovarian leiomyoma is a rare ovarian tumor and also rare cause of acute abdomen. A 64 year old, postmenopausal woman applied to our clinic with severe acute abdominal pain. On abdominal examination, there were abdominal tenderness, defense and rebound. On ultrasonographic examination, we detected a 6 cm of pelvic mass. Because she had acute abdomen we performed laparotomy by midline incision and excised a 6cm ovarian mass on right ovary. The mass had been reported as ovarian leiomyoma on frozen section by pathology department.

Related: Ovarian Cancer

Baghbanian M, Baghbanian A, Salmanroghani H, et al.
Efficacy of endoscopic ultrasound fine needle aspiration in diagnosing the rare (non-adenocarcinoma) tumors of pancreas.
Acta Gastroenterol Belg. 2014; 77(3):312-7 [PubMed] Related Publications
BACKGROUND: Five percent of pancreatic neoplasms are non- adenocarcinoma tumors. Clinical presentation and imaging characteristics of these tumors are similar to adenocarcinoma. This study aims at evaluating the results and efficacy of Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in diagnosing the pancreatic non-adenocarcinoma tumor in patients with solid pancreatic mass.
METHODOLOGY: The present study which is of a descriptive, prospective and case series nature, has been studying the diagnostic value of EUS-FNA in pancreatic non-adenocarcinoma tumor in 60 patients with pancreatic solid neoplasm. Cytopathologic diagnosis founded on EUS-FNA accepted as final diagnosis in unresectable ones. But the reference standard for the final diagnosis in patients with resectable tumor was surgical pathology. In patients with non diagnostic EUS-FNA specimen, final diagnosis achieved by re-FNA, Computerized Tomography (CT) guided biopsy, or surgery.
RESULTS: Ten patients (17%) found to have non-adenocarcinoma tumor. Half of them were male. EUS-FNA was diagnostic in 8 cases (80%) including the 4 neuroendocrine tumors, one gastrointestinal stromal tumor, one mucinous neoplasm, one pseudopapillary tumor, and one geant cell tumor. Surgical pathology confirmed the EUS-FNA diagnosis in five patients that had resectable tumor. However EUS-FNA recognition accepted as final diagnosis in three patients that had unresectable tumor. EUS-FNA was non-diagnostic in one patient with pancreatic lymphoma and another patient with colon cancer metastasis.
CONCLUSION: EUS FNA is a safe and effective for diagnosing the solid non-adenocarcinoma tumors as well as adenocarcinomas of pancreas.

Related: Cancer of the Pancreas Pancreatic Cancer

Wong KC, Summers RM, Kebebew E, Yao J
Tumor growth prediction with hyperelastic biomechanical model, physiological data fusion, and nonlinear optimization.
Med Image Comput Comput Assist Interv. 2014; 17(Pt 2):25-32 [PubMed] Related Publications
Tumor growth prediction is usually achieved by physiological modeling and model personalization from clinical measurements. Although image-based frameworks have been proposed with promising results, different issues such as infinitesimal strain assumption, complicated optimization procedures, and lack of functional information, may limit the prediction performance. Therefore, we propose a framework which comprises a hyperelastic biomechanical model for better physiological plausibility, gradient-free nonlinear optimization for more flexible choices of models and objective functions, and physiological data fusion of structural and functional images for better subject-specificity. Experiments were performed on synthetic and clinical data to verify parameter estimation capability and prediction performance of the framework. Comparisons of using different biomechanical models and objective functions were also performed. From the experimental results on eight patient data sets, the recall, precision, and relative volume difference (RVD) between predicted and measured tumor volumes are 84.85 ± 6.15%, 87.08 ± 7.83%, and 13.81 ± 6.64% respectively.

Related: Cancer of the Pancreas Pancreatic Cancer

Rivera G, Lugo-Vicente H
Thyroid cancer in children.
Bol Asoc Med P R. 2014; 106(3):48-54 [PubMed] Related Publications
Cancer of the thyroid gland in pediatric patients is rare and if left untreated spreads and become lethal. Thyroid nodules in pediatric patients are four times more likely being malignant than adult nodules. The incidence of thyroid cancer in children increases with age, sex, race and nodule size. Exposures to low level of head and neck irradiation at young age, cancer survivors, family history of thyroid cancer and iodine deficiency are specific risk factors to develop thyroid cancer. Thyroid cancer is subdivided into papillary, follicular and medullary thyroid cancer varying in histological characteristics. Children who present with thyroid nodules should undergo ultrasound and fine needle aspiration biopsy to evaluate malignant potential. If biopsy results are positive for malignancy best option is complete surgical resection of the thyroid gland with central lymph node dissection followed by radioactive iodine treatment. Surgeons need to take certain precaution to avoid postoperative complications like hypoparathyroidism or recurrent laryngeal nerve damage. Follow-up is essential in order to evaluate remission or recurrence. An excellent prognosis in pediatric patients is the result of such an aggressive approach that can be supported by the low complications rate and low recurrence rate following surgery.

Related: Thyroid Cancer

Kraft Rovere R, Wensing Raimann B, Marcondes LM, et al.
Multiple myeloma with testicular involvement: a case report and review of the literature.
Bol Asoc Med P R. 2014; 106(3):40-2 [PubMed] Related Publications
We report a case of a very unusual metastasis of multiple myeloma to the testis in a 53-year-old-patient, documented with images and anatomic-pathological exam. Our case report is of interest because it is one of the rarest forms ever reported of advanced multiple myeloma.

Related: Myeloma Myeloma - Molecular Biology

Alvarado M, Ramirez-Vick M, Lopez L, et al.
An uncommon presentation of follicular thyroid carcinoma: when chronic back pain should raise a flag.
Bol Asoc Med P R. 2014; 106(3):36-9 [PubMed] Related Publications
Follicular thyroid carcinoma is the second most common type of thyroid cancer, and its incidence has increased dramatically in recent years. Although it typically presents as a thyroid nodule, it can spread to distant sites via hematogenous dissemination. Bone metastasis is diagnosed clinically in 2%-13% of patients with differentiated thyroid cancer; nevertheless spinal cord compression complicating thyroid carcinoma is rare and only few cases has been reported in the literature. This case illustrates a strange case of a minimally invasive follicular carcinoma that showed an aggressive behavior, and thus the importance of considering metastatic thyroid carcinoma in the differential diagnosis of chronic back pain progressing to spinal cord compression carrying a severe morbidity.

Related: Thyroid Cancer

Omonisi AE, Adisa AO, Olaofe OO, et al.
Carcinoma head of the pancreas masquerading as hepatocellular carcinoma: a case report.
Niger J Med. 2014 Oct-Dec; 23(4):355-7 [PubMed] Related Publications
BACKGROUND: Cancer of the pancreas is the primary malignant tumour of the pancreas commonly seen in the elderly. Hepatitis B virus infection is not a known marker of the disease, but patient with carcinoma head of the pancreas presenting with epigastric mass with positive hepatitis B infection in the region of the world with high endemicity for hepatitis B virus infection may cause diagnostic pitfall.
OBJECTIVE: To present a case of carcinoma head of the pancreas masqueradingas hepatocellular carcinoma
METHODS: A review of the case note, autopsy findings including gross and microscopic examinations and literature was done.
RESULTS: An elderly woman with history of weight loss and cigarette smoking.There was an epigastric mass and the liver was enlarged. The serum hepatitis B antigen was positive. Autopsy revealed an ill-defined mass in the head of the pancreas with metastasis to the liver.
CONCLUSION: Things are not always what they seem.

Related: Liver Cancer Cancer of the Pancreas Pancreatic Cancer

Li G, Baek NH, Yoo K, et al.
Surgical outcomes for solid pseudopapillary neoplasm of the pancreas.
Hepatogastroenterology. 2014; 61(134):1780-4 [PubMed] Related Publications
BACKGROUND/AIMS: Solid pseudopapillary neoplasm (SPN) is a rare exocrine tumor of the pancreas with low malignant potential. This study was designed to evaluate surgical outcome of solid pseudopapillary neoplasm (SPN).
METHODOLOGY: From Between January 1994 to November 2013, 41 patients were diagnosed with SPN of the pancreas at Ajou University Medical Center and underwent surgical resection.
RESULTS: Of the 41 patients, 33(80.5%) were female and 8(19.5%) were male with a mean age of 34.5 years (range, 12-63 years). The most common location of SPN was the tail (43.9%). Mean diameters of SPN was 5.5 cm (range, 1.2- 14.5 cm). Nineteen patients (46.3%) had non-specific abdominal symptoms that had been investigated. Surgical treatment included distal pancreatectomy in 21, pancreaticoduodenectomy in 11, segmental resection of pancreas in 4, enucleation in 2, excision in 2 and surgical biopsy in 1. Thirty-nine of the 41 patients were disease-free at a median follow-up of 59 months (range, 1-125 months).
CONCLUSIONS: Patients diagnosed as SPN should receive surgical resection because of the excellent prognosis. Closed follow-up is recommended after surgery, even in patients without pathological malignant potential. For metastasis or recurrence, an aggressive surgical treatment is necessary because of the good possibility of long-term survival.

Related: Cancer of the Pancreas Pancreatic Cancer

Noma Y, Kawamoto H, Kato H, et al.
The efficacy and safety of single-session endoscopic ultrasound-guided fine needle aspiration and endoscopic retrograde cholangiopancreatography for evaluation of pancreatic masses.
Hepatogastroenterology. 2014; 61(134):1775-9 [PubMed] Related Publications
BACKGROUND/AIMS: There have been limited studies evaluating single-session EUS-FNA and ERCP for evaluation of pancreatic masses. The aim of this study was to determine the safety of single-session EUS-FNA and ERCP, and to compare the diagnostic accuracies of cytodiagnosis by EUS-FNA, ERCP, and their combination.
METHODOLOGY: A total of 100 patients with pancreatic masses were prospectively enrolled. All patients underwent single-session EUS-FNA and ERCP. The main outcome measurement was frequency of post-procedural complications. Another measurement was diagnostic accuracy of cytodiagnosis by EUS-FNA, ERCP, and their combination.
RESULTS: Procedure-related pancreatitis occurred in 10 patients, but all patients were conservatively managed. Cytodiagnosis by EUS-FNA was significantly superior to ERCP in accuracy. In patients with a pancreatic head mass, 3 cases of false negative EUS-FNA were positive on ERCP. The combination procedures improved accuracy compared with EUS-FNA alone. By contrast, in the subgroup of the pancreatic body or tail mass, the combination of EUS-FNA and ERCP did not improve cytodiagnosis compared to that with EUS-FNA alone.
CONCLUSIONS: Single-session EUS-FNA and ERCP appears to be as safe as performing each procedure separately. EUS-FNA should be considered the principal procedure for cytodiagnosis. ERCP has only a complementary role in patients with pancreatic head mass.

Related: Cancer of the Pancreas Pancreatic Cancer

Usuba T, Takeda Y, Murakami K, et al.
Clinical outcomes after pancreaticoduodenectomy in elderly patients at middle-volume center.
Hepatogastroenterology. 2014; 61(134):1762-6 [PubMed] Related Publications
BACKGROUND/AIMS: It has been reported that age and hospital volume are risk factors after pancreaticoduodenectomy (PD), however the mortality rate after PD at middle volume center is decreasing by surgical advances and recently PD in the elderly patients is safely performed. The aim of this study is to evaluate the safety and feasibility of PD in the patients over 80 years of age at middle-volume center.
METHODOLOGY: 60 patients who underwent PD between 2004 and 2012 were divided into two groups (≥80 and <80years). The clinical outcomes of the two groups were retrospectively analyzed.
RESULTS: There were no statistical differences in terms of preoperative parameters, co-morbidity, perioperative data, morbidity, mortality and postoperative hospital stay. We achieved zero mortality in patients over 80 years of age and 40% of them are alive without recurrence.
CONCLUSIONS: Clinical outcomes after PD in the elderly patients at middle-volume center are acceptable. Age and hospital volume are not necessarily risk factors after PD.

Related: Cancer of the Pancreas Pancreatic Cancer

Suenaga M, Fujii T, Kanda M, et al.
Pattern of first recurrent lesions in pancreatic cancer: hepatic relapse is associated with dismal prognosis and portal vein invasion.
Hepatogastroenterology. 2014; 61(134):1756-61 [PubMed] Related Publications
BACKGROUND/AIMS: The aim of this study was to evaluate patterns of the initial recurrence after pancreatectomy for pancreatic cancer and risk factors in each pattern.
METHODOLOGY: This study included 209 pancreatic cancer patients who underwent pancreatectomy and of whom the detailed information on the first recurrent lesions detected by imaging during postoperative followup were available. Relapse patterns were classified into 4 groups: liver, peritoneal, local and extra-abdominal recurrences. We evaluated their associations with prognosis and various clinicopathological factors to identify relevant risk factors.
RESULTS: Cumulative numbers of patients with liver, peritoneal, local, and extra-abdominal recurrences were 81, 70, 98 and 22, respectively, for the first recurrences. Hepatic relapse was associated with significantly shorter overall survival than other sites (p<0.001) and was an independent prognostic factor in multivariate analysis (p<0.001). Pathological portal vein invasion was the only independent risk factor for hepatic relapse (p=0.045). There was no significant correlation between the depth of invasion and prevalence of hepatic relapse.
CONCLUSIONS: Hepatic relapse was associated with a dismal prognosis and with pathological portal vein invasion. Novel therapeutic strategies are therefore required to reduce the incidence of hepatic relapse, especially in patients with portal vein invasion.

El Nakeeb A, Roshdy S, Ask W, et al.
Comparative study between uncinate process carcinoma and pancreatic head carcinoma after pancreaticodudenectomy (clincopathological features and surgical outcomes).
Hepatogastroenterology. 2014; 61(134):1748-55 [PubMed] Related Publications
BACKGROUND/AIMS: Pancreatic head cancer is considered to have the worst prognosis of the periampullary carcinomas. The clinicopathological features of uncinate process pancreatic cancer are poorly published.
METHODOLOGY: We retrospectively studied patients who underwent pancreaticodudenectomy (PD) for pancreatic head adenocarcinoma. This study included three groups of patients. Group A patients with pure pancreatic head carcinoma (PPHC), group B patients with combined head and uncinate process carcinoma (CPHUC) and group C patients with pure uncinate process carcinoma (PUPC). Preoperative, intraoperative and postoperative variables were collected.
RESULTS: The study included 157 patients. Jaundice was the most common presenting symptoms in PPHC and CPHUC. Abdominal pain was the most common presenting symptoms in PUPC. The mean common bile duct (CBD) and pancreatic duct diameters were significantly smallest in PUPC group (P=0.0001). The venous invasion was significantly observed more in PUPC group and vascular resection was done in 50% of cases. The number of patients with microscopically residual tumor was significantly highest in PUPC group after PD than in other two groups (P=0.001). Recurrence rate occurred in 54.2% in PUPC group, 34.8% in CPHUC group and 22.7% in PPUC group after PD (P=0.007). The median survival was 19 months in PPHC groups, 16 months in CPHUC group, 14 months in PUPC group (P= 0.02).
CONCLUSIONS: PUPC presented with abdominal pain with more vascular infiltration. The recurrence rate was common after PD for uncinate process carcinoma especially locoregional recurrence and the overall survival rate was found to be lower for PUPC.

Related: Cancer of the Pancreas Pancreatic Cancer

Maeda T, Konishi K, Tanouez K, et al.
Minimally invasive image analysis of biliary-pancreatic structure for preoperative simulation.
Hepatogastroenterology. 2014; 61(134):1744-7 [PubMed] Related Publications
For preoperative assessment of the pancreatic tumors, we developed minimally invasive method to extract the pancreatic duct from multidetector row computed tomography (MD-CT) images and to visualize the biliarypancreatic structures, tumor and adjacent organs simultaneously using an image workstation.

Related: Cancer of the Pancreas Pancreatic Cancer

Seicean A, Tefas C, Ungureanu B, Săftoiu A
Endoscopic ultrasound guided radiofrequency ablation in pancreas.
Hepatogastroenterology. 2014; 61(134):1717-21 [PubMed] Related Publications
Radiofrequency ablation of the pancreas represents a more effective tumor-destruction method compared to other ablation techniques. The endoscopic ultrasound guided radiofrequency ablation is indicated for locally advanced, non-metastatic pancreatic adenocarcinoma, without the need of general anesthesia and fast recovery. The main limitations are the encasement of the mesenteric vessels or of the common bile duct in the head pancreatic tumours. The technique is feasible, effective and relatively safe in porcine models, with minimal evidence of fat necrosis in intra-pancreatic and/or extra-pancreatic adipose tissue. It has been successfully applied on insulinomas and pancreatic adenocarcinoma in humans, with few complications, such as duodenal bleeding or mild abdominal pain. Other side effects as biliary fistula, pancreatic fistula or acute pancreatitis seen in intraoperative settings of radiofrequency ablation, have not been reported in endoscopic ultrasound guided radiofrequency ablation.

Related: Cancer of the Pancreas Pancreatic Cancer

Sato Y, Sawada N, Shimada M, et al.
Hybrid laparoscopic complete untinatectomy of pancreas by Shuriken shaped umbilicoplasty with sliding windows method.
Hepatogastroenterology. 2014; 61(134):1486-8 [PubMed] Related Publications
In this study, we demonstrated the complete resection of untinate process that was performed by the hybrid laparoscopic surgery using our original new technique of Shuriken shaped umbilicoplasty with sliding window`s method. A 70-year-old weman was hospitalized for surgery of intraductal papillary mucinous neoplasm located in the uncinate process of pancreas. Under general anesthesia, a Shuriken shaped umbilical skin incision was made by 7 cm in horizontal and 4cm longitudinal width with 3cm round skin incision. The intermediate skin between outside and inside skin incision was removed. Subcutaneous tissue around the umbilicus and the upper abdominal subcutaneous region was dissected, and the 8cm of upper abdominal minilaparotomy was performed. The complete resection of untinate process was performed by hybrid laparoscopic procedure with the hand-assisted or the laparo-assisted manner. The umbilicoplasty of only 3cm round skin wound was made by the reefing of subcutaneous suture with 5-0 absorbable suture. The patient suffered from pancreas leakage from pancreas stump, however it was recovered spontaneously. Our new procedure could be used for PD, DP, and Major hepatectomy with the hybrid laparoscopic procedure. It might be considered that our method is good for both cosmetic and safety benefits in HPB surgery.

Related: Cancer of the Pancreas Pancreatic Cancer

El Nakeeb A, El Shobary M, El Dosoky M, et al.
Prognostic factors affecting survival after pancreaticoduodenectomy for pancreatic adenocarcinoma (single center experience).
Hepatogastroenterology. 2014 Jul-Aug; 61(133):1426-38 [PubMed] Related Publications
BACKGROUND: Pancreatic cancer is considered to have the worst prognosis of the periampullary carcinomas. This retrospective study was to determine prognostic factors for survival after pancreaticoduodenectomy in patients had pancreatic carcinoma.
METHODS: We retrospectively studied all patients who underwent PD for pancreatic adenocarcinoma originating from the head, neck or uncinate process from January 1996 to January 2011 in our center. Preoperative variables, intraoperative variables and postoperative variables were collected.
RESULTS: The study included 480 patients (282 males and 198 females with a median age of 53 years. At the time of analysis, 180 (37.5%) patients were still alive. The median survival was 19 months. This corresponded to a 1-, 3-, and 5-year actuarial survival of 44 %, 20%, and 15% respectively. Mass size less than 2 cm (P=0.0001), lymph node ratio (P=0.0001), safety margin (P=0.0001), perineural, perivascular infiltration, age above 60 years (P=0.03), gender, preoperative bilirubin, SGPT, liver status, pre and postoperative CEA, CA19- 9 (P=0.0001) were significant predictors of survival.
CONCLUSION: Mass size less than 2 cm, lymph node ratio, safety margin, perineural, perivascular infiltration, age above 60 years, gender, liver status, pre and postoperative CEA, CA19-9 are important predictors of survival in patients undergoing PD for pancreatic cancer.

Related: Cancer of the Pancreas Pancreatic Cancer

Zheng YY, Tang CW, Xu YQ, et al.
Hepatic arterial infusion chemotherapy reduced hepatic metastases from pancreatic cancer after pancreatectomy.
Hepatogastroenterology. 2014 Jul-Aug; 61(133):1415-20 [PubMed] Related Publications
BACKGROUND/AIMS: This study aims to investigate the safety and efficacy of hepatic arterial infusion chemotherapy (HAIC) on liver metastases from pancreatic cancer after pancreatectomy.
METHODOLOGY: We randomly assigned 106 patients with pancreatic cancer after pancreatectomy between 2005 and 2010 to receive 2 cycles of HAIC plus 4 cycles of systemic chemotherapy (Combined Therapy) or 6 cycles of systemic chemotherapy alone (Monotherapy). Both the HAIC and systemic chemotherapy regimen consisted of a 5-hour infusion of 5-fluorouracil 1000 mg/m2 on day 1 followed by gemcitabine 800 mg/m2 as an over 30-min infusion on day 1 and day 8. The treatment was started on an average of 21.2 days after surgery and repeated every 4 weeks. The disease-free survival, overall survival and liver metastases-free survival were compared.
RESULTS: There was no significant difference in adverse effects between two groups. Significant differences were found in 3-year overall survival (Combined Therapy, 23.08 %; Monotherapy, 14.81%; P=0.0473) and liver metastases-free survival (Combined Therapy, 80.77%; Monotherapy, 55.56%; P=0.0014).
CONCLUSIONS: HAIC effectively and safely prevents liver metastases and improves the prognosis of patients with pancreatic cancer after pancreatectomy.

Related: Fluorouracil Cancer of the Pancreas Pancreatic Cancer Gemcitabine

Meng Z, Zhang X, Zheng Q, et al.
Acute pancreatitis as an early indicator of pancreatic head carcinoma.
Hepatogastroenterology. 2014 Jul-Aug; 61(133):1201-6 [PubMed] Related Publications
BACKGROUND: The purpose of this study was to determine if AP is an indicator of pancreatic head carcinoma, and if it is associated with disease stage.
METHODS: A retrospective review of the medical records of 154 patients with pancreatic head cancer who were treated from January 2006 to December 2011 was conducted. Patients were divided into 2 groups: those with AP and those without. Data extracted and compared including age, gender, the presence of AP, and laboratory results.
RESULTS: This study included 103 males (67.8%) and 49 females (32.9%), with an age range of 38-83 years. The frequency of main pancreatic duct dilation (MPD) was higher in patients without pancreatitis than in patients with AP (P = 0.018). There were 18, 14, 4, and 2 patients in the AP group, and 34, 26, 31, and 23 patients in nonpancreatitis group with stage I, II, III, and IV disease, respectively, (P = 0.007). The median length of tumors in AP group was 3.41 cm, and that in the non-pancreatitis group was 4.15 cm (P = 0.028).No correlation was found between disease stage and the presence of MPD dilatation (P = 0.646). The area under the receiver operating characteristic curve (AUC) of 0.66 (P = 0.003; 95% confidence interval [CI] 0.568-0.753) indicated that AP itself was insufficient for predicting disease stage.
CONCLUSIONS: AP is an early manifestation of pancreatic head carcinoma, although the presence of AP is insufficient to predict disease stage.

Related: Cancer Screening and Early Detection Cancer of the Pancreas Pancreatic Cancer

Kanda M, Sonoyama A, Ohara N
Normal-sized ovary carcinoma syndrome (NOCS) detected with FDG-PET/CT.
Eur J Gynaecol Oncol. 2014; 35(5):597-9 [PubMed] Related Publications
BACKGROUND: Normal-sized ovary carcinoma syndrome (NOCS) is an ovarian cancer with ovaries being of normal size, accompanied by diffuse metastatic disease of the peritoneal cavity.
CASE: A 39-year-old woman presented with lower abdominal pains. The computed tomopraphy (CT) of the chest, esophagogastroduodenography, and colonoscopy showed no remarkable findings. Amagnetic resonance imaging (MRI) displayed a slightly enlarged right ovary, thickening of the peritoneum, and massive ascites. The right ovary showed high intensity on T2 images and scattered low intensity spots on diffusion-weighted images. The cytology of ascites suspected adenocarcinoma cells. A positron emission tomography (PET) and CT using 18F-fluorodeoxyglucose (FDG) demonstrated markedly increased FDG uptake at the right ovary and peritoneum. The presumptive diagnosis of normal-sized ovary carcinoma syndrome was made. She underwent a total hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy, and partial omentectomy. The pathological examination revealed serous cystadenocarcinoma of the right ovary.
CONCLUSION: FDG-PET/CT is useful for the detection of NOCS.

Related: Ovarian Cancer

Pestana I, Costal A, Mota R, et al.
Paraneoplastic limbic encephalitis--neurologic paraneoplastic syndrome associated with ovarian malignancy--the importance of clinical recognition.
Eur J Gynaecol Oncol. 2014; 35(5):592-4 [PubMed] Related Publications
Paraneoplastic limbic encephalitis (PLE) is a rare disorder and it is also under-reported due to the difficulty in establishing the diagnosis. The delay in treatment could potentially lead to devastating neurological outcomes. The authors report a 32-year-old Caucasian, nullipara woman, who presented with a subacute dementia associated to generalized tonic-clonic seizure with rapid progression to coma. The diagnosis of immature ovarian teratoma surgical Stage FIGO IA R0 with PLE was confirmed. The patient began earlier oral corticosterois and human intravenous immunoglobulin. She was discharged one month after surgery with no neurologic deficit and remains three years later in oncological remission. A diagnosis of PLE should be considered in the differential diagnosis of unexplained dementias. Early diagnosis, treatment of the underlying malignancy, and prompt intervention with immunotherapy in this patient at the onset of presentation facilitated regression of the neurological syndrome and explains the favorable neurological outcome.

Related: Ovarian Cancer

Xin G, Du J, Xu Y
Isolated sacral metastases as the initial presentation from an endometroid ovarian carcinoma: a case report.
Eur J Gynaecol Oncol. 2014; 35(5):589-91 [PubMed] Related Publications
Bone metastases are rarely in ovarian carcainoma. It usually occurrs only when the cancer is advanced or recurrent. A case of endometrioid carcinoma in right ovary with intact capsule is reported. The isolated sacral metastasis was found as the initial presentation, and no distant metastases were reported.

Related: Ovarian Cancer

Ki EY, Park JS, Mun JB, Hur SY
Primary ovarian malignant mixed mesodermal tumor: report of four cases.
Eur J Gynaecol Oncol. 2014; 35(5):584-8 [PubMed] Related Publications
Malignant mixed mesodermal tumors (MMMTs) are highly aggressive and usually diagnosed at advanced stages. MMMT originates from either the ovary or the uterus. Because this disease is relatively rare, an optimal treatment modality has not yet been established. The authors report four cases of ovarian MMMT (one heterologous MMMT and three homologous MMMTs) during 1990-2011. The patients underwent operation immediately after histopathologically confirmation and were treated with platinum-based combination chemotherapy. The extent of operation, the outcomes of radiation therapy, and the proper chemotherapeutic regimen are still controversial. The authors report herein four cases of ovarian MMMTs alone with a brief literature review.

Related: Ovarian Cancer

Qiao N, Zhu Y, Li H, et al.
Expression of heat shock protein 20 inversely correlated with tumor progression in patients with ovarian cancer.
Eur J Gynaecol Oncol. 2014; 35(5):576-9 [PubMed] Related Publications
OBJECTIVE: To investigate a possible correlation between expression levels of heat shock protein 20 (HSP20) and tumor progression in patients with ovarian cancer.
MATERIALS AND METHODS: The study included 34 patients with ovarian cancer who were to undergo surgery, seven patients with ovarian carcinoid tumors, and five patients with normal ovaries as a control group. Ovarian tissues were obtained from patients by surgical resection and then analyzed by western blot.
RESULTS: Expression levels of HSP20 were inversely correlated with the grade of malignancy.
CONCLUSION: The present findings suggest that HSP20 may play a protective role against the progression of ovarian cancer. Thus, HSP20 may represent a new target for the prediction and treatment of ovarian cancer.

Related: Ovarian Cancer

Tianmin X, Weiqin C, Shuying W, et al.
Protection of ovarian function during chemotherapy for ovarian cancer.
Eur J Gynaecol Oncol. 2014; 35(5):562-5 [PubMed] Related Publications
The protection of ovarian function during chemotherapy is an urgent issue to be resolved after the fertility preserving surgery on patients with ovarian cancer. The paper summarizes and analyzes the research progress on the protective measures in the aspects of gonadotropin releasing hormone analogue (GnRHa), cell protecting agents, and traditional Chinese medical science and drugs.

Related: Ovarian Cancer

Jin Z, Gu J, Xin X, et al.
Expression of hexokinase 2 in epithelial ovarian tumors and its clinical significance in serous ovarian cancer.
Eur J Gynaecol Oncol. 2014; 35(5):519-24 [PubMed] Related Publications
"Warburg effect" emphasizes that malignant cells exhibit active glycolysis even under aerobic conditions. Hexokinase 2 (HK2) is a key glycolytic enzyme that helps to exhibit a "Warburg effect". In the present study, the main aim was to detect the expression of HK2 in epithelial ovarian tumor tissues. Immunohistochemistry and qRT-PCR were used to examine the expression of HK2 in different epithelial ovarian tissues. The expression of HK2 in ovarian cancer tissues was significantly higher than that in normal ovarian, benign, and borderline tumors both in protein (p < 0.001) and mRNA (p < 0.05) levels. HK2 expression was significantly higher in Stage III/IV compared to Stage III (p < 0.001). Expression of HK2 in poorly-differentiated carcinoma was higher than that in well-differentiated carcinoma (p = 0.008). The level of HK2 was higher in serous groups than in non-serous groups in both protein (p = 0.008) and mRNA (p < 0.05) level. Collectively, HK2 is highly expressed in epithelial ovarian cancer, especially in serous groups. Its expression is related with clinical stage and histological differentiation.

Related: Ovarian Cancer

Martins Filho A, Jammal MP, Nomelini RS, Murta EF
The immune response in malignant ovarian neoplasms.
Eur J Gynaecol Oncol. 2014; 35(5):487-91 [PubMed] Related Publications
The objective of this study was to review studies that have investigated the immune response in the presence of a malignant ovarian neoplasia. A review of the literature was performed to identify studies of malignant ovarian neoplasia, particularly studies that addressed the potential for cytokines, nitric oxide, and lymphocytes to mediate an immune response against ovarian cancer. Certain subsets of tumor-infiltrating leukocytes and/or tumor-associated leukocytes have been found to correlate with an improved disease prognosis, while other lymphocyte subsets (such as CD3+/CD4+/CD25+ T cells) have been associated with a poor prognosis. These data suggest that cytokines can have a protective role, or can promote an immune system defense against a cancer. In particular, certain cytokines (e.g., IL 8, IL 10) represent attractive candidates for the development of new diagnostic, prognostic, and therapeutic strategies for the treatment of ovarian cancer.

Related: Cytokines Ovarian Cancer

Herrigel DJ, Moss RA
Diabetes mellitus as a novel risk factor for gastrointestinal malignancies.
Postgrad Med. 2014; 126(6):106-18 [PubMed] Related Publications
Evidence of an emerging etiologic link between diabetes mellitus and several gastrointestinal malignancies is presented. Although a correlation between pancreatic cancer and diabetes mellitus has long been suspected, the potential role diabetes mellitus plays in the pathogenicity of both hepatocellular carcinoma and colon cancer is becoming increasingly well defined. Further supporting the prospect of etiologic linkage, the association of diabetes mellitus with colon cancer is consistently demonstrated to be independent of obesity. An increasing incidence of diabetes and obesity in the United States has led to a recent surge in incidence of hepatocellular cancer on the background of nonalcoholic fatty liver disease, and this disease is expected to commensurately grow in incidence. Widespread recognition of this emerging risk factor may lead to a change in screening practices. Although the mechanisms underlying the correlation are still under investigation, the role of insulin, the insulin-like growth factor-I, and related binding and signaling pathways as regulators of cell growth and cell proliferation are implicated in carcinogenesis and tumor growth. The potential role of metformin and other medications for diabetes mellitus in the chemoprevention, carcinogenesis, and treatment of gastrointestinal malignancies is also presented.

Related: Colorectal (Bowel) Cancer Liver Cancer Cancer of the Pancreas Pancreatic Cancer

Wei IH, Harmon CM, Arcerito M, et al.
Tumor-associated macrophages are a useful biomarker to predict recurrence after surgical resection of nonfunctional pancreatic neuroendocrine tumors.
Ann Surg. 2014; 260(6):1088-94 [PubMed] Related Publications
OBJECTIVE: Patients with nonfunctional pancreatic neuroendocrine tumors (NF-PNETs) have poorer survival than those with functional PNETs. Our objective was to identify risk factors for recurrence after resection to better define surveillance parameters to improve long-term outcomes.
METHODS: A retrospective analysis was performed for NF-PNET patients who underwent resection at the University of Michigan from 1995 to 2012. Immunohistochemical staining of tissues from patients with and without disease recurrence was performed for Ki-67 and the macrophage marker CD68, as tumor-associated macrophages are important for PNET development and progression. Clinicopathological factors and patient outcomes were measured.
RESULTS: Ninety-seven NF-PNET patients underwent surgical resection. There was a recurrence rate of 14.4% (14/97). The median time to recurrence was 0.61 years, with 10 (71%) patients recurring within the first 2 years. Six of 7 patients (86%) monitored at 6-month surveillance intervals were diagnosed with recurrence on their first computed tomographic scan or during the intervening intervals. By Cox proportional hazards analysis, the most significant independent risk factors for recurrence were higher grade, stage, and intraoperative blood loss. High CD68 score and Ki-67 index correlated with recurrence risk, and Ki-67 index inversely correlated with time to recurrence. In patients who otherwise had few risk factors, a high CD68 score was a significant prognostic factor for recurrence.
CONCLUSIONS: In patients with NF-PNETs, risk factors associated with recurrence were high EBL, grade, stage, CD68 score, and Ki-67 index. The CD68 score was an important prognostic factor in patients who otherwise had few clinicopathological risk factors; therefore, the CD68 score should be considered when planning surveillance strategies. We recommend that NF-PNET patients at high risk of recurrence undergo initial surveillance every 3 months for 2 years after surgery.

Related: Cancer of the Pancreas Pancreatic Cancer USA

Kandalaft PL, Gown AM, Isacson C
The lung-restricted marker napsin A is highly expressed in clear cell carcinomas of the ovary.
Am J Clin Pathol. 2014; 142(6):830-6 [PubMed] Related Publications
OBJECTIVES: We recently observed expression of the "lung" marker napsin A in ovarian clear cell carcinomas and therefore sought to determine the extent of napsin A expression in a subset of ovarian neoplasms.
METHODS: We identified an archival series of ovarian clear cell carcinomas (n = 36), serous borderline tumors (n = 21), high-grade serous carcinomas (n = 37), and endometrioid adenocarcinomas (n = 29). Using standard immunohistochemical techniques on whole sections of formalin-fixed, paraffin-embedded specimens, we employed a panel of antibodies: napsin A (IP64), estrogen receptor (SP1), WT-1 (6F-H2), PAX-8 (BC12), and TTF-1 (SPT24).
RESULTS: Thirty-six of 36 clear cell carcinomas showed napsin A expression, typically in a uniform pattern. None of the serous borderline tumors or high-grade serous carcinomas manifested napsin A expression. Napsin A was expressed in three (10%) of 29 endometrioid adenocarcinomas, generally in a focal pattern.
CONCLUSIONS: Our study showed that napsin A is an extremely sensitive (100%) marker of ovarian clear cell carcinomas and exhibits very high specificity (100%) in distinguishing clear cell carcinomas from high-grade serous carcinomas and serous borderline tumors and 90% specificity in discriminating clear cell carcinomas from endometrioid carcinomas.

Related: Ovarian Cancer

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