Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Pancreatic Neoplasms: HELP
Articles from Latin America
Based on 351 articles published since 2010

These are the 351 published articles about Pancreatic Neoplasms that originated from Latin America during 2010-2020.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15
1 Guideline Technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline - March 2017. 2017

Polkowski, Marcin / Jenssen, Christian / Kaye, Philip / Carrara, Silvia / Deprez, Pierre / Gines, Angels / Fernández-Esparrach, Gloria / Eisendrath, Pierre / Aithal, Guruprasad P / Arcidiacono, Paolo / Barthet, Marc / Bastos, Pedro / Fornelli, Adele / Napoleon, Bertrand / Iglesias-Garcia, Julio / Seicean, Andrada / Larghi, Alberto / Hassan, Cesare / van Hooft, Jeanin E / Dumonceau, Jean-Marc. ·Department of Gastroenterology, Hepatology, and Oncology, Medical Centre for Postgraduate Education, Warsaw, Poland. · Department of Gastroenterological Oncology, The M. Skłodowska-Curie Memorial Cancer Centre, Warsaw, Poland. · Department of Internal Medicine, Krankenhaus Märkisch Oderland Strausberg/Wriezen, Academic Teaching Hospital of the Medical University of Brandenburg, Germany. · Nottingham Digestive Diseases Centre, NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, UK. · Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Rozzano, Italy. · Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium. · Endoscopy Unit, Department of Gastroenterology, ICMDM, IDIBAPS, CIBEREHD, Hospital Clínic, Barcelona, Spain. · Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Université Libre de Bruxelles, Hôpital Erasme & Hôpital Saint-Pierre, Brussels, Belgium. · Pancreato-Biliary Endoscopy and Endosonography Division, San Raffaele University, Milan, Italy. · Service de Gastroentérologie, Hôpital NORD AP-HM, Aix-Marseille-Université, Marseille, France. · Gastroenterology Department Instituto Português de Oncologia do Porto, Porto, Portugal. · Anatomic Pathology Unit, AUSL of Bologna, Maggiore Hospital, Bologna, Italy. · Department of Gastroenterology, Ramsay Générale de Santé, Private Hospital Jean Mermoz, Lyon, France. · Gastroenterology Department, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain. · Regional Institute of Gastroenterology and Hepatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. · Digestive Endoscopy Unit, Catholic University, Rome, Italy. · Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands. · Gedyt Endoscopy Center, Buenos Aires, Argentina. ·Endoscopy · Pubmed #28898917.

ABSTRACT: For routine EUS-guided sampling of solid masses and lymph nodes (LNs) ESGE recommends 25G or 22G needles (high quality evidence, strong recommendation); fine needle aspiration (FNA) and fine needle biopsy (FNB) needles are equally recommended (high quality evidence, strong recommendation).When the primary aim of sampling is to obtain a core tissue specimen, ESGE suggests using 19G FNA or FNB needles or 22G FNB needles (low quality evidence, weak recommendation).ESGE recommends using 10-mL syringe suction for EUS-guided sampling of solid masses and LNs with 25G or 22G FNA needles (high quality evidence, strong recommendation) and other types of needles (low quality evidence, weak recommendation). ESGE suggests neutralizing residual negative pressure in the needle before withdrawing the needle from the target lesion (moderate quality evidence, weak recommendation).ESGE does not recommend for or against using the needle stylet for EUS-guided sampling of solid masses and LNs with FNA needles (high quality evidence, strong recommendation) and suggests using the needle stylet for EUS-guided sampling with FNB needles (low quality evidence, weak recommendation).ESGE suggests fanning the needle throughout the lesion when sampling solid masses and LNs (moderate quality evidence, weak recommendation).ESGE equally recommends EUS-guided sampling with or without on-site cytologic evaluation (moderate quality evidence, strong recommendation). When on-site cytologic evaluation is unavailable, ESGE suggests performance of three to four needle passes with an FNA needle or two to three passes with an FNB needle (low quality evidence, weak recommendation).For diagnostic sampling of pancreatic cystic lesions without a solid component, ESGE suggests emptying the cyst with a single pass of a 22G or 19G needle (low quality evidence, weak recommendation). For pancreatic cystic lesions with a solid component, ESGE suggests sampling of the solid component using the same technique as in the case of other solid lesions (low quality evidence, weak recommendation).ESGE does not recommend antibiotic prophylaxis for EUS-guided sampling of solid masses or LNs (low quality evidence, strong recommendation), and suggests antibiotic prophylaxis with fluoroquinolones or beta-lactam antibiotics for EUS-guided sampling of cystic lesions (low quality evidence, weak recommendation). ESGE suggests that evaluation of tissue obtained by EUS-guided sampling should include histologic preparations (e. g., cell blocks and/or formalin-fixed and paraffin-embedded tissue fragments) and should not be limited to smear cytology (low quality evidence, weak recommendation).

2 Guideline Pathologic Evaluation and Reporting of Intraductal Papillary Mucinous Neoplasms of the Pancreas and Other Tumoral Intraepithelial Neoplasms of Pancreatobiliary Tract: Recommendations of Verona Consensus Meeting. 2016

Adsay, Volkan / Mino-Kenudson, Mari / Furukawa, Toru / Basturk, Olca / Zamboni, Giuseppe / Marchegiani, Giovanni / Bassi, Claudio / Salvia, Roberto / Malleo, Giuseppe / Paiella, Salvatore / Wolfgang, Christopher L / Matthaei, Hanno / Offerhaus, G Johan / Adham, Mustapha / Bruno, Marco J / Reid, Michelle D / Krasinskas, Alyssa / Klöppel, Günter / Ohike, Nobuyuki / Tajiri, Takuma / Jang, Kee-Taek / Roa, Juan Carlos / Allen, Peter / Fernández-del Castillo, Carlos / Jang, Jin-Young / Klimstra, David S / Hruban, Ralph H / Anonymous6190823. ·*Department of Pathology, Emory University School of Medicine and Winship Cancer Institute, Atlanta, GA †Department of Pathology, Massachusetts General Hospital, Boston, MA ‡Department of Pathology, Tokyo Women's Medical University, Tokyo, Japan §Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY ¶Department of Pathology, University of Verona, Verona, Italy ||Department of Surgery, Massachusetts General Hospital, Boston, MA **Department of Surgery, University of Verona, Verona, Italy ††Department of Surgery, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD ‡‡Departments of Surgery, University of Bonn, Bonn, Germany §§Departments of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands ¶¶Department of Surgery, Edouard Herriot Hospital, HCL, Lyon, France ||||Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands ***Departments of Pathology, Technical University, Munich, Germany †††Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Japan ‡‡‡Department of Pathology, Tokai University Hachioji Hospital, Tokyo, Japan §§§Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea ¶¶¶Department of Pathology, Pontificia Universidad Católica de Chile, Santiago, Chile ||||||Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY ****Department of Surgery, Massachusetts General Hospital, Boston, MA ††††Department of Surgery, Seoul National University Hospital, Seoul, Korea ‡‡‡‡Department of Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD. ·Ann Surg · Pubmed #25775066.

ABSTRACT: BACKGROUND: There are no established guidelines for pathologic diagnosis/reporting of intraductal papillary mucinous neoplasms (IPMNs). DESIGN: An international multidisciplinary group, brought together by the Verona Pancreas Group in Italy-2013, was tasked to devise recommendations. RESULTS: (1) Crucial to rule out invasive carcinoma with extensive (if not complete) sampling. (2) Invasive component is to be documented in a full synoptic report including its size, type, grade, and stage. (3) The term "minimally invasive" should be avoided; instead, invasion size with stage and substaging of T1 (1a, b, c; ≤ 0.5, > 0.5-≤ 1, > 1 cm) is to be documented. (4) Largest diameter of the invasion, not the distance from the nearest duct, is to be used. (5) A category of "indeterminate/(suspicious) for invasion" is acceptable for rare cases. (6) The term "malignant" IPMN should be avoided. (7) The highest grade of dysplasia in the non-invasive component is to be documented separately. (8) Lesion size is to be correlated with imaging findings in cysts with rupture. (9) The main duct diameter and, if possible, its involvement are to be documented; however, it is not required to provide main versus branch duct classification in the resected tumor. (10) Subtyping as gastric/intestinal/pancreatobiliary/oncocytic/mixed is of value. (11) Frozen section is to be performed highly selectively, with appreciation of its shortcomings. (12) These principles also apply to other similar tumoral intraepithelial neoplasms (mucinous cystic neoplasms, intra-ampullary, and intra-biliary/cholecystic). CONCLUSIONS: These recommendations will ensure proper communication of salient tumor characteristics to the management teams, accurate comparison of data between analyses, and development of more effective management algorithms.

3 Editorial Hot topics in epigenetic regulation of cancer self-renewal for pancreatic tumors: future trends. 2019

De Mello, Ramon Andrade / Faleiro, Inês / Apolónio, Joana D / Tabori, Uri / Price, Aryeh J / Roberto, Vânia P / Castelo-Branco, Pedro. ·Department of Biomedical Sciences & Medicine, Algarve Biomedical Center, Division of Oncology, University of Algarve, 8005-139 Faro, Portugal. · Faculty of Medicine, University of Porto, 4200-319, Oporto, Portugal. · Division of Medical Oncology, Bauru State Hospital, & School of Medicine, Universidade Nove de Julho (UNINOVE), 17011-102, Bauru, São Paulo, Brazil. · Centre for Biomedical Research (CBMR), University of Algarve, 8005-139 Faro, Portugal. · Arthur & Sonia Labatt Brain Tumor Research Center, The Hospital for Sick Children, University of Toronto, Toronto, M5G 1X8, ON, Canada. · Division of Biology & Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA. ·Future Oncol · Pubmed #30693809.

ABSTRACT: -- No abstract --

4 Editorial The man from room number seven. 2019

Hernández, Glenn / Llewelyn, Eyleen / Castro, Ricardo. ·Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. glennguru@gmail.com. · Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. ·Intensive Care Med · Pubmed #30284633.


5 Editorial The impact of tobacco tax/law implementation on pancreatic cancer mortality in Mexico, 1999-2015. 2018

Hernández-Garduño, Eduardo. ·Department of Education and Health Research, Instituto de Seguridad Social del Estado de México y Municipios (ISSEMyM), Toluca, México 50080, Mexico. ·Ecancermedicalscience · Pubmed #30483361.

ABSTRACT: Among the multiple aetiologies identified for pancreatic cancer (PC), cigarette smoking and diabetes are considered "moderate risk factors". Analysis of PC mortality trends is important as changes in incidence and mortality of this tumour can be partially attributable to changes in smoking patterns. A recent Mexican study examined PC mortality trends and showed a favourable trend from 2000 to 2014 [1]. However, the impact of new tobacco tax/laws which were implemented in Mexico in 2007/2008 was not assessed in this study. In this re-analysis we assessed their impact on PC mortality and found a non-statistically significant trend from 1999 to 2008 - however, PC mortality statistically decreased from 2008 with an annual percent change or APC of -1.27, -1.23 and -1.17 in both sexes, females and males respectively, p < 0.05. These declines are likely resulting in part from new tobacco tax/laws which are likely contributing to the decrease over time of smoking prevalence and environmental tobacco smoke exposure.

6 Editorial Pancreatic cancer screening. 2017

Soldan, Mônica. ·- Federal University of Rio de Janeiro, Clementino Fraga Filho University Hospital, Gastroenterology Service, Rio de Janeiro, RJ, Brazil. · - São Vicente de Paulo Hospital, Endoscopy Service, Rio de Janeiro, RJ, Brazil. ·Rev Col Bras Cir · Pubmed #28658327.

ABSTRACT: -- No abstract --


Torres, Orlando Jorge Martins / Vasques, Rodrigo Rodrigues / Torres, Camila Cristina S. ·Department of Surgery, Federal University of Maranhão, São Luiz, MA, Brazil. ·Arq Bras Cir Dig · Pubmed #27438028.

ABSTRACT: -- No abstract --

8 Editorial [Pancreas cancer]. 2016

Rebaza Vásquez, Segundo. ·Editor Asociado de la Revista de gastroenterología del Perú. Lima, Perú. ·Rev Gastroenterol Peru · Pubmed #27409085.

ABSTRACT: -- No abstract --

9 Editorial Endosonography-guided ablation of pancreatic cystic tumors: Is it justified? 2016

Vazquez-Sequeiros, Enrique / Maluf-Filho, Fauze. ·Endoscopy Unit, Gastroenterology Division, University Hospital Ramón y Cajal, IRYCIS, Madrid, Spain. · Endoscopy Unit, Cancer Institute of São Paulo - ICESP, Department of Gastroenterology, University of São Paulo, São Paulo, Brazil. ·Gastrointest Endosc · Pubmed #27102528.

ABSTRACT: -- No abstract --

10 Review Cyst fluid glucose: An alternative to carcinoembryonic antigen for pancreatic mucinous cysts. 2019

Lopes, César Vivian. ·Department of Gastroenterology and Digestive Endoscopy, Santa Casa Hospital, Porto Alegre 91410-000, Brazil. drcvlopes@gmail.com. ·World J Gastroenterol · Pubmed #31148899.

ABSTRACT: Pancreatic cystic lesions (PCLs) have been increasingly recognized in clinical practice. Although inflammatory cysts (pseudocysts) are the most common PCLs detected by cross-sectional imaging modalities in symptomatic patients in a setting of acute or chronic pancreatitis, incidental pancreatic cysts with no symptoms or history of pancreatitis are usually neoplastic cysts. For these lesions, it is imperative to identify mucinous cysts (intraductal papillary mucinous neoplasms and mucinous cystic neoplasms) due to the risk of their progression to malignancy. However, no single imaging modality alone is sufficient for a definitive diagnosis of all PCLs. The cyst fluid obtained by endoscopic ultrasound-guided fine needle aspiration provides additional information for the differential diagnosis of PCLs. Current recommendations suggest sending cyst fluid for cytology evaluation and measurement of carcinoembryonic antigen (CEA) levels. Unfortunately, the sensitivity of cytology is greatly limited, and cyst fluid CEA has demonstrated insufficient accuracy as a predictor of mucinous cysts. More recently, cyst fluid glucose has emerged as an alternative to CEA for distinguishing between mucinous and nonmucinous lesions. Herein, the clinical utility of cyst fluid glucose and CEA for the differential diagnosis of PCLs was evaluated.

11 Review Protein tyrosine phosphatases: promising targets in pancreatic ductal adenocarcinoma. 2019

Ruckert, Mariana Tannús / de Andrade, Pamela Viani / Santos, Verena Silva / Silveira, Vanessa Silva. ·Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes 3900, Ribeirão Preto, São Paulo, Brazil. · Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes 3900, Ribeirão Preto, São Paulo, Brazil. vsilveira@fmrp.usp.br. ·Cell Mol Life Sci · Pubmed #30982078.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreatic cancer. It is the fourth leading cause of cancer-related death and is associated with a very poor prognosis. KRAS driver mutations occur in approximately 95% of PDAC cases and cause the activation of several signaling pathways such as mitogen-activated protein kinase (MAPK) pathways. Regulation of these signaling pathways is orchestrated by feedback loops mediated by the balance between protein tyrosine kinases (PTKs) and protein tyrosine phosphatases (PTPs), leading to activation or inhibition of its downstream targets. The human PTPome comprises 125 members, and these proteins are classified into three distinct families according to their structure. Since PTP activity description, it has become clear that they have both inhibitory and stimulatory effects on cancer-associated signaling processes and that deregulation of PTP function is closely associated with tumorigenesis. Several PTPs have displayed either tumor suppressor or oncogenic characteristics during the development and progression of PDAC. In this sense, PTPs have been presented as promising candidates for the treatment of human pancreatic cancer, and many PTP inhibitors have been developed since these proteins were first associated with cancer. Nevertheless, some challenges persist regarding the development of effective and safe methods to target these molecules and deliver these drugs. In this review, we discuss the role of PTPs in tumorigenesis as tumor suppressor and oncogenic proteins. We have focused on the differential expression of these proteins in PDAC, as well as their clinical implications and possible targeting for pharmacological inhibition in cancer therapy.


Belotto, Marcos / Crouzillard, Bruna do Nascimento Santos / Araujo, Karla de Oliveira / Peixoto, Renata D'Alpino. ·Depa, German Hospital Oswaldo Cruz. · Faculty of Medical Sciences, Santa Casa de São Paulo. · Oncology Service, Nove de Julho University, São Paulo, SP, Brazil. ·Arq Bras Cir Dig · Pubmed #30758476.

ABSTRACT: INTRODUCTION: Pancreatic neuroendocrine tumors (pNET) correspond to about 3% of all tumors in pancreas and could be presented as a difficult diagnosis and management. OBJECTIVE: To review the diagnosis and treatment of the pNET available in scientific literature. METHOD: A bibliographic survey was performed by means of an online survey of MeSH terms in the Pubmed database. A total of 104 articles were published in the last 15 years, of which 23 were selected as the basis for the writing of this article. RESULTS: pNET is an infrequent neoplasia and their incidence, in USA, is about 1:100.000 inhabitants/year. Thereabout 30% of them produce hormones presenting as a symptomatic disease and others 70% of the cases could be silent disease. Magnetic Resonance Imaging (MRI) and/or Computed Tomography (CT) have similar sensitivy to detect pNET. They are very important when associated to nuclear medicine mainly Positron Emission Tomography (PET-CT) Gallium-68 to find primary tumor and its staging. The appropriate treatment should be chosen based on characteristics of the tumor, its staging and associated comorbidities. CONCLUSION: The surgical resection is still the best treatment for patients with ressectable pancreatic NETs. However, the size, grade, tumor functionality, stage and association with multiple endocrine neoplasia type 1 (MEN-1) are important to define who will be eligible for surgical treatment. In general, tumors bigger than 2 cm are eligible for surgical treatment, except insulinomas whose surgical resection is recommended no matter the size.

13 Review Current indications and yield of endoscopic ultrasound and ancillary techniques in pancreatic cystic neoplasms. 2019

Salom, Federico / Prat, Frédéric. ·Departamento de Gastroenterología, Hospital México, San José, 1641-2050, Costa Rica. fedesalom@yahoo.com. · Service de Gastroenterologie, d'endoscopie et de Cancerologie Digestive, APHP-Hopital Cochin, 75014, Paris, France. ·Clin J Gastroenterol · Pubmed #30565189.

ABSTRACT: An increase in the diagnosis of pancreatic cystic neoplasm has been described lately. Surgical treatment or surveillance is advised depending on the type of lesion diagnosed. The most accurate diagnostic approach is needed to make the best therapeutic decision. Endoscopic ultrasound is a very valuable tool in the evaluation of pancreatic cystic neoplasm. It generates high-quality images and allows the possibility of sampling the cystic fluid for cytology, microbiological and molecular evaluation. Even with this evaluation, the sensitivity of this approach is not always adequate. New technological resources have been developed to try to improve the diagnostic accuracy of pancreatic cystic neoplasms. The two most promising techniques are needle-based confocal laser endomicroscopy and contrast-enhanced harmonic endoscopic ultrasound. Needle-based confocal laser endomicroscopy allows a microscopic evaluation of mucosal glands and vascular pattern, to differentiate mucinous from non-mucinous lesions. Contrast-enhanced harmonic endoscopic ultrasound is used for the vascular evaluation of the microcirculation of the cyst wall and mural nodule, mainly to make the difference between malignant nodules and mucus plugs. A combination of these different diagnostic techniques can improve the diagnostic accuracy of pancreatic cystic neoplasms to offer the adequate therapeutic decision.

14 Review Solitary pancreatic metastasis from breast cancer: case report and review of literature. 2019

Apodaca-Rueda, Márcio / Chaim, Fábio Henrique Mendonça / Garcia, Milena da Silva / Saito, Helena Paes de Almeida de / Gestic, Martinho Antonio / Utrini, Murillo Pimentel / Callejas-Neto, Francisco / Chaim, Elinton Adami / Cazzo, Everton. ·Medical Student, Faculdade de Medicina da Pontificia Universidade Católica de Campinas (PUC-Campinas), Campinas (SP), Brazil. · MD. Resident Physician, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil. · MD. Assistant Lecturer, Oncology Unit - Department of Internal Medicine, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil. · MD, MSc. Assistant Lecturer, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil. · MD, MSc. Assistant Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil. · MD, MSc, PhD. Full Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil. · MD, PhD. Adjunct Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil. ·Sao Paulo Med J · Pubmed #29116313.

ABSTRACT: CONTEXT: Pancreatic metastases from primary malignant tumors at other sites are rare, constituting about 2% of the neoplasms that affect the pancreas. Pancreatic metastasis from breast cancer is extremely rare and difficult to diagnose, because its clinical and radiological presentation is similar to that of a primary pancreatic tumor. CASE REPORT: A 64-year-old female developed a lesion in the pancreatic tail 24 months after neoadjuvant therapy, surgery and adjuvant radiation therapy for right-side breast cancer (ductal carcinoma). She underwent distal pancreatectomy with splenectomy and left adrenalectomy, and presented an uneventful outcome. The immunohistochemical analysis on the surgical specimen suggested that the lesion originated from the breast. CONCLUSION: In cases of pancreatic lesions detected in patients with a previous history of breast neoplasm, the possibility of pancreatic metastasis should be carefully considered.

15 Review Locoregional recurrence of Frantz' tumor: a case report and review of the literature. 2018

Prata, Ana Lamada Pereira / Mendes, Gustavo Gomes / Chojniak, Rubens. ·Imaging Department, A.C.Camargo Cancer Center, São Paulo, Brasil. ·Rev Assoc Med Bras (1992) · Pubmed #30365656.

ABSTRACT: Frantz' tumours or solid pseudopapillary tumours of the pancreas are rare neoplasms with low malignant potential. Young women in the second to third decades of life are more frequently affected. The treatment of choice is resection of the lesion, which is often curative. The recurrence is uncommon when radical surgical resection is used. Radiological characteristics are important for the correct diagnosis, since the preoperative planning is fundamental to obtain the cure. The objective of this study is to report a rare case of locoregional recurrence and to review the radiological findings of solid pseudopapillary tumours of the pancreas in the literature, as well to know the incidence and risk factors of tumor recurrence. This case report is from a 37-year-old female patient evaluated at an Oncologic Hospital, in the city of São Paulo, Brazil, who presented an uncommon evolution of the disease, characterized by local recurrence despite the complete resection of the primary lesion with free margins.

16 Review Rare pancreatic masses: a pictorial review of radiological concepts. 2018

Bezerra, Regis Otaviano Franca / Machado, Marcel Cerqueira / Dos Santos Mota, Micaela Maciel / Ezzedine, Tamara Abou / Siqueira, Luiz Tenório de Brito / Cerri, Giovanni Guido. ·São Paulo State Cancer Institute of the Medical School of the University of São Paulo, Department of Radiology, Av Dr Arnaldo 251-1SS, São Paulo, SP 01246-000, Brazil; Sirio Libanes Hospital, Rua Dona Adma Jafet, 115, 01308-050 São Paulo, Brazil. Electronic address: regis.bezerra@hc.fm.usp.br. · Sirio Libanes Hospital, Rua Dona Adma Jafet, 115, 01308-050 São Paulo, Brazil; Department of Clinical Emergencies, University of São Paulo, School of Medicine, Av. Dr. Arnaldo, 455, 01246903 São Paulo, Brazil. · São Paulo State Cancer Institute of the Medical School of the University of São Paulo, Department of Radiology, Av Dr Arnaldo 251-1SS, São Paulo, SP 01246-000, Brazil. · Presidente Prudente Regional Hospital, 19050680 Presidente Prudente, Brazil; Nossa Senhora das Graças Hospital, 19015140 Presidente Prudente, Brazil. · São Paulo State Cancer Institute of the Medical School of the University of São Paulo, Department of Radiology, Av Dr Arnaldo 251-1SS, São Paulo, SP 01246-000, Brazil; Sirio Libanes Hospital, Rua Dona Adma Jafet, 115, 01308-050 São Paulo, Brazil. ·Clin Imaging · Pubmed #29751204.

ABSTRACT: Non-ductal pancreatic neoplasm (NPN) represents a heterogeneous group of pancreatic masses, in which diagnosis and management remain challenging due to their overall rarity. Knowledge of their radiologic features is essential for differential diagnosis and to guide clinical decisions for optimal management. The purpose of this paper was to present radiological patterns of these rare pancreatic tumors, solid or predominantly solid, with emphasis in the differential diagnosis and surgical management.

17 Review Pain in pancreatic ductal adenocarcinoma: A multidisciplinary, International guideline for optimized management. 2018

Drewes, Asbjørn M / Campbell, Claudia M / Ceyhan, Güralp O / Delhaye, Myriam / Garg, Pramod K / van Goor, Harry / Laquente, Berta / Morlion, Bart / Olesen, Søren S / Singh, Vikesh K / Sjøgren, Per / Szigethy, Eva / Windsor, John A / Salvetti, Marina G / Talukdar, Rupjyoti. ·Centre for Pancreatic Diseases, Department of Gastroenterology, Aalborg University Hospital, Denmark. Electronic address: amd@rn.dk. · Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA. · Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. · Department of Gastroenterology, Erasme University Hospital, Brussels, Belgium. · Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India. · Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. · Department of Medical Oncology, Catalan Institute of Oncology, Barcelona, Spain. · Centre for Algology & Pain Management, University Hospitals Leuven, Pellenberg, Belgium. · Centre for Pancreatic Diseases, Department of Gastroenterology, Aalborg University Hospital, Denmark. · Department of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, MD, 21205, USA. · Section of Palliative Medicine, Copenhagen University Hospital, Copenhagen, Denmark. · Division of Gastroenterology, University of Pittsburgh and UPMC, Pittsburgh, PA, USA. · Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, New Zealand. · Medical Surgical Department, School of Nursing, University of Sao Paulo, Brazil. · Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India. ·Pancreatology · Pubmed #29706482.

ABSTRACT: Abdominal pain is an important symptom in most patients with pancreatic ductal adenocarcinoma (PDAC). Adequate control of pain is often unsatisfactory due to limited treatment options and significant variation in local practice, emphasizing the need for a multidisciplinary approach. This review contends that improvement in the management of PDAC pain will result from a synthesis of best practice and evidence around the world in a multidisciplinary way. To improve clinical utility and evaluation, the evidence was rated according to the GRADE guidelines by a group of international experts. An algorithm is presented, which brings together all currently available treatment options. Pain is best treated early on with analgesics with most patients requiring opioids, but neurolytic procedures are often required later in the disease course. Celiac plexus neurolysis offers medium term relief in a substantial number of patients, but other procedures such as splanchnicectomy are also available. Palliative chemotherapy also provides pain relief as a collateral benefit. It is stressed that the assessment of pain must take into account the broader context of other physical and psychological symptoms. Adjunctive treatments for pain, depression and anxiety as well as radiotherapy, endoscopic therapy and neuromodulation may be required in selected patients. There are few comparative studies to help define which combination and order of these treatment options should be applied. New pain therapies are emerging and could for example target neural transmitters. However, until better methods are available, management of pain should be individualized in a multidisciplinary setting to ensure optimal care.

18 Review Common and Uncommon Benign Pancreatic Lesions Mimicking Malignancy: Imaging Update and Review. 2018

Torres, Ulysses S / Matsumoto, Carlos / de Macedo Neto, Augusto Cesar / Caldana, Rogério Pedreschi / Motoyama Caiado, Ângela Hissae / Tiferes, Dario Ariel / Warmbrand, Gisele / de Godoy, Laiz Laura / D'Ippolito, Giuseppe. ·Grupo Fleury, São Paulo, Brazil. Electronic address: ulysses.torres@grupofleury.com.br. · Grupo Fleury, São Paulo, Brazil; Department of Imaging, Universidade Federal de São Paulo, São Paulo, Brazil. · Grupo Fleury, São Paulo, Brazil. ·Semin Ultrasound CT MR · Pubmed #29571556.

ABSTRACT: There is a broad range of inflammatory, pseudotumoral, and benign lesions that may masquerade as pancreatic malignancies, often representing a challenge to the radiologist. Unawareness of these entities can lead to inadequate differential diagnoses or misdiagnosis, with important prognostic and therapeutic consequences. The purpose of this article is to revisit a spectrum of lesions, varying from common to exceedingly rare nonmalignant, that may mimic malignant pancreatic neoplasms on imaging, identifying relevant features that may contribute to reaching the correct diagnosis. Representative cases include focal fatty replacement, intrapancreatic accessory spleen, pancreatic lobulation, lipoma, autoimmune pancreatitis, focal pancreatitis, eosinophilic pancreatitis, groove pancreatitis, hemangioma, intrapancreatic aneurysm, tuberculosis, and Castleman's disease.

19 Review A comparison of the efficiency of 22G versus 25G needles in EUS-FNA for solid pancreatic mass assessment: A systematic review and meta-analysis. 2018

Guedes, Hugo Gonçalo / Moura, Diogo Turiani Hourneaux de / Duarte, Ralph Braga / Cordero, Martin Andres Coronel / Santos, Marcos Eduardo Lera Dos / Cheng, Spencer / Matuguma, Sergio Eiji / Chaves, Dalton Marques / Bernardo, Wanderley Marques / Moura, Eduardo Guimarães Hourneaux de. ·Divisao de Endoscopia Gastrointestinal, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, BR. ·Clinics (Sao Paulo) · Pubmed #29451621.

ABSTRACT: Our aim in this study was to compare the efficiency of 25G versus 22G needles in diagnosing solid pancreatic lesions by EUS-FNA. We performed a systematic review and meta-analysis. Studies were identified in five databases using an extensive search strategy. Only randomized trials comparing 22G and 25G needles were included. The results were analyzed by fixed and random effects. A total of 504 studies were found in the search, among which 4 randomized studies were selected for inclusion in the analysis. A total of 462 patients were evaluated (233: 25G needle/229: 22G needle). The diagnostic sensitivity was 93% for the 25G needle and 91% for the 22G needle. The specificity of the 25G needle was 87%, and that of the 22G needle was 83%. The positive likelihood ratio was 4.57 for the 25G needle and 4.26 for the 22G needle. The area under the sROC curve for the 25G needle was 0.9705, and it was 0.9795 for the 22G needle, with no statistically significant difference between them (p=0.497). Based on randomized studies, this meta-analysis did not demonstrate a significant difference between the 22G and 25G needles used during EUS-FNA in the diagnosis of solid pancreatic lesions.

20 Review Contribution of galectin-1, a glycan-binding protein, to gastrointestinal tumor progression. 2017

Bacigalupo, María L / Carabias, Pablo / Troncoso, María F. ·María L Bacigalupo, Pablo Carabias, María F Troncoso, Facultad de Farmacia y Bioquímica, Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Consejo Nacional de lnvestigaciones Científicas y Técnicas, Universidad de Buenos Aires, Buenos Aires C1113AAD, Argentina. ·World J Gastroenterol · Pubmed #28839427.

ABSTRACT: Gastrointestinal cancer is a group of tumors that affect multiple sites of the digestive system, including the stomach, liver, colon and pancreas. These cancers are very aggressive and rapidly metastasize, thus identifying effective targets is crucial for treatment. Galectin-1 (Gal-1) belongs to a family of glycan-binding proteins, or lectins, with the ability to cross-link specific glycoconjugates. A variety of biological activities have been attributed to Gal-1 at different steps of tumor progression. Herein, we summarize the current literature regarding the roles of Gal-1 in gastrointestinal malignancies. Accumulating evidence shows that Gal-1 is drastically up-regulated in human gastric cancer, hepatocellular carcinoma, colorectal cancer and pancreatic ductal adenocarcinoma tissues, both in tumor epithelial and tumor-associated stromal cells. Moreover, Gal-1 makes a crucial contribution to the pathogenesis of gastrointestinal malignancies, favoring tumor development, aggressiveness, metastasis, immunosuppression and angiogenesis. We also highlight that alterations in Gal-1-specific glycoepitopes may be relevant for gastrointestinal cancer progression. Despite the findings obtained so far, further functional studies are still required. Elucidating the precise molecular mechanisms modulated by Gal-1 underlying gastrointestinal tumor progression, might lead to the development of novel Gal-1-based diagnostic methods and/or therapies.

21 Review Unraveling molecular pathways of poorly differentiated neuroendocrine carcinomas of the gastroenteropancreatic system: A systematic review. 2017

Girardi, Daniel M / Silva, Andrea C B / Rêgo, Juliana Florinda M / Coudry, Renata A / Riechelmann, Rachel P. ·Discipline of Radiology and Oncology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, São Paulo, Brazil. Electronic address: danielmgirardi@gmail.com. · Discipline of Radiology and Oncology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, São Paulo, Brazil. Electronic address: andreacbs87@gmail.com. · Unit of Oncology and Hematology, Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte, Rio Grande do Norte, Brazil. Electronic address: juliana.oncologia@gmail.com. · Oncology Center, Hospital Sírio Libanês, São Paulo, Brazil. Electronic address: renata.coudry@gmail.com. · Discipline of Radiology and Oncology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, São Paulo, Brazil; Oncology Center, Hospital Sírio Libanês, São Paulo, Brazil. Electronic address: rachelri2005@gmail.com. ·Cancer Treat Rev · Pubmed #28456055.

ABSTRACT: BACKGROUND: Poorly differentiated neuroendocrine carcinomas (NECs) are rare and aggressive tumors. Their molecular pathogenesis is still largely unknown, and consequently, the best therapeutic management also remains to be determined. We conducted a systematic review on molecular alterations found in gastroenteropancreatic NECs (GEP-NECs) and discuss potential applications of targeted therapies in setting. MATERIALS AND METHODS: Systematic review of studies about molecular features in tumor tissues of patients with GEP-NECs. The Medline, Lilacs, Embase, Cochrane, Scopus and Opengrey databases were sought, without time, study design or language restrictions. RESULTS: Of the 1.564 studies retrieved, 41 were eligible: 33 were retrospective studies and eight were case reports. The studies spanned the years 1997-2017 and involved mostly colorectal, stomach and pancreas primary tumors. Molecular alterations in the TP53 gene and the p53 protein expression were the most commonly observed, regardless of the primary site. Other consistently found molecular alterations were microsatellite instability (MSI) in approximately 10% of gastric and colorectal NEC, and altered signaling cascades of p16/Rb/cyclin D1, Hedgehog and Notch pathways, and somatic mutations in KRAS, BRAF, RB1 and Bcl2. In studies of mixed adeno-neuroendocrine carcinomas (MANECs) the molecular features of GEP-NEC largely resemble their carcinoma/adenocarcinomas tumor counterparts. CONCLUSIONS: Despite the paucity of data about the molecular drivers associated with GEP-NEC, some alterations may be potentially targeted with new cancer-directed therapies. Collaborative clinical trials for patients with advanced GEP-NEC are urgently needed.

22 Review Omega-3 therapeutic supplementation in a patient with metastatic adenocarcinoma of the pancreas with muscle mass depletion. 2017

Ramalho, R / Ramalho, P / Couto, N / Pereira, P. ·Instituto Superior de Ciências da Saúde Egas Moniz, Nutrition Consultation, Campus Universitário Quinta da Granja, Monte de Caparica, Portugal. · Centro de Investigação Interdisciplinar Egas Moniz (CiiEM). Campus Universitário Quinta da Granja, Monte de Caparica, Portugal. · Grupo de Estudos em Nutrição Aplicada (GENA)-ISCSEM, Campus Universitário Quinta da Granja, Monte de Caparica, Portugal. · Champalimaud Foundation, Champalimaud Clinic Centre - Digestive Cancer Unit. Avenida Brasília, Lisboa, Portugal. ·Eur J Clin Nutr · Pubmed #28378854.

ABSTRACT: Pancreatic adenocarcinoma has an extremely poor prognosis. With the best available treatments, the median overall survival duration is still less than 1 year. Most patients develop anorexia and major muscle mass loss that interfere with chemotherapy tolerance and survival. In this paper, we present a case in which these problems were a major concern. A multidisciplinary approach with chemotherapy and close nutritional support permitted better control of the disease and longer survival. We also review the literature on nutritional interventions that show an improvement in quality of life and survival in these patients.

23 Review Oxidative Stress: A New Target for Pancreatic Cancer Prognosis and Treatment. 2017

Martinez-Useros, Javier / Li, Weiyao / Cabeza-Morales, Marticela / Garcia-Foncillas, Jesus. ·Translational Oncology Division, OncoHealth Institute, Health Research Institute, University Hospital Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain. javier.museros@oncohealth.eu. · Translational Oncology Division, OncoHealth Institute, Health Research Institute, University Hospital Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain. weiyao.li@quironsalud.es. · Facultad de Medicina, Universidad de Cartagena, Cartagena 2463, Colombia. marticelacabezamorales@gmail.com. · Translational Oncology Division, OncoHealth Institute, Health Research Institute, University Hospital Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain. jgfoncillas@gmail.com. ·J Clin Med · Pubmed #28282928.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal types of tumors, and its incidence is rising worldwide. Survival can be improved when tumors are detected at an early stage; however, this cancer is usually asymptomatic, and the disease only becomes apparent after metastasis. Several risk factors are associated to this disease. Chronic pancreatitis, diabetes, and some infectious disease are the most relevant risk factors. Incidence of PDAC has increased in the last decades. It is hypothesized it could be due to other acquired risk habits, like smoking, high alcohol intake, and obesity. Indeed, adipose tissue is a dynamic endocrine organ that secretes different pro-inflammatory cytokines, enzymes, and other factors that activate oxidative stress. Reactive oxygen species caused by oxidative stress, damage DNA, proteins, and lipids, and produce several toxic and high mutagenic metabolites that could modify tumor behavior, turning it into a malignant phenotype. Anti-oxidant compounds, like vitamins, are considered protective factors against cancer. Here, we review the literature on oxidative stress, the molecular pathways that activate or counteract oxidative stress, and potential treatment strategies that target reactive oxygen species suitable for this kind of cancer.

24 Review Surveillance strategy for small asymptomatic non-functional pancreatic neuroendocrine tumors - a systematic review and meta-analysis. 2017

Sallinen, Ville / Le Large, Tessa Y S / Galeev, Shamil / Kovalenko, Zahar / Tieftrunk, Elke / Araujo, Raphael / Ceyhan, Güralp O / Gaujoux, Sebastien. ·Department of Abdominal Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Department of Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. Electronic address: ville.sallinen@helsinki.fi. · Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands. · General Surgery Department, Saint Luke's Clinical Hospital, Saint-Petersburg, Russia. · Federal Medical and Rehabilitation Center, Department of Surgical Oncology, Moscow, Russia. · Department of Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. · Department of Upper Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Barretos Cancer Hospital, Barretos, São Paulo, Brazil. · Department of Digestive and Endocrine Surgery, Cochin Hospital, APHP, Paris, France; Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, France. Electronic address: sebastien.gaujoux@aphp.fr. ·HPB (Oxford) · Pubmed #28254159.

ABSTRACT: BACKGROUND: Non-functional pancreatic neuroendocrine tumors (NF-PNET) are rare neoplasms being increasingly diagnosed. Surgical treatment or expectant management are both suggested for small NF-PNETs. The aim of this study was to evaluate the outcome of surveillance strategy for small NF-PNETs. METHODS: A systematic search was performed up to March 2016 in MEDLINE, EMBASE and the Cochrane Library according to the PRISMA guidelines. Data was pooled using the random-effects model. RESULTS: Nine articles including 344 patients with sporadic and 64 patients with MEN1 related NF-PNET were selected. Tumor growth was observed in 22% and 52%, development of metastases were reported on 0% and 9%, and rate of secondary surgical resection was 12% and 25% in patients with sporadic or MEN1 related NF-PNETs, respectively. All metastases (1 distant, 4 nodal) were reported by a single study in patients with MEN1. Reason for secondary surgery was tumor growth in half of patients undergoing surgery. DISCUSSION: Expectant management of small asymptomatic, sporadic, NF-PNETs could be a reasonable option in highly selected patients. However, the level of evidence is low and longer follow-up is needed to identify patients could benefit from upfront surgery instead of expectant treatment.

25 Review Microbiota dysbiosis: a new piece in the understanding of the carcinogenesis puzzle. 2016

García-Castillo, Valeria / Sanhueza, Enrique / McNerney, Eileen / Onate, Sergio A / García, Apolinaria. ·Department of Microbiology, School of Biological Sciences, Bacterial Pathogenicity Laboratory, University of Concepción, Concepción, Biobío, Chile. · Molecular Endocrinology and Oncology Laboratory, School of Medicine, University of Concepción, Concepción, Biobío, Chile. ·J Med Microbiol · Pubmed #27902422.

ABSTRACT: Cancer is defined as an uncontrolled proliferation of malignant cells in a host and it is one of the main causes of death worldwide. Genetic and environmental factors play an important role in its development, and the involvement of microbial communities has also recently been recognized. The close relationship that characterizes the colonization by human commensal communities involves health risks, particularly when the homeostasis is disturbed. It has been hypothesized that this process may lead to cancer by modulating the inflammatory response of the host, by the production of carcinogenic metabolic products or by the production of toxins, which disrupt the cell cycle. The metabolic effects of the intestinal microbiota have been studied in greater detail in the gastrointestinal tract, and it has been recognized that microbial communities of other body surfaces can cause effects either locally or at a distance. In vitro and in vivo studies have allowed the characterization of the microbiota and the establishment of a cause and effect relationship with some types of cancer. Nevertheless, despite the results, representative studies are necessary to validate the findings and definitively establish the role of microbiota in cancer development in order to open the possibility of promising therapeutic and diagnostic applications. Thus, the aims of this review are to briefly examine the available evidence, and to analyse the mechanisms described for pancreatic, lung, colorectal cancer , oral squamous cell carcinoma and hepatocellular carcinoma and the impact of the current knowledge about the effects of the microbiota on carcinogenesis.