Bitte Info: Pancreatic cystadenocarcinoma mucinous

[Isabelle N.]

Hallo,

ich schreibe aus USA und habe eine Bekannte die folgende (man sagte uns seltene) art Bauchshspeichelduresenkrebs hat (Pancreatic cystadenocarcinoma mucinous).

Sie hat drei kinder und der Krebs wurde waehrend ihrer letzten Schwangerschaft (vor ca. 6 Wochen) endeckt. Sie wurde sofort nach der Geburt es Kindes operiert und man hat ziemlich radikal alles herausgenommen (nur noch ein stueck magen uebrig).

Ihre Eltern sind total verzweifelt und wir wollen alles moeglich tun was wir koennen.

Wo kann man ausfuehrlich information ueber die Nachbehandlung, Ernaehrungsratschlaege, etc. finden. Ich suche im Internet und finde leider nichts, da der englische Name vielleicht etwas anders ist als in Deutsch. Wir sind fuer jede hilfe dankbar.

Bitte jede noch so kleine Hilfe waere super.

Vielen Dank.

Isabelle

[vivien]

RE: Bitte Info: Pancreatic cystadenocarcinoma muci


Hallo Isabelle,
informieren Sie sich bitte über die pilhar.com-Seiten (sehr umfangreich) über die NEUE MEDIZIN. Dort können Sie auch Kontakt suchen, um möglichst Therapeuten, die sich damit auskennen, zu finden. Viel Glück!

Herzlichst Vivien

[Prof. Wust]

RE: Bitte Info: Pancreatic cystadenocarcinoma muci


Habe Ihnen 2 Zusammenfassungen über diese seltene Tumorgruppe aus Medline beigefügt. Diese seltene Untergruppe von Pankreaskarzinomen hat auf jeden Fall eine deutlich bessere Prognose als das übliche Adenokarzinom des Pankreas (5 J > 60%). Die wichtigste Therapie ist die Operati-on. Eine Nachbehandlung findet i.d.R. nicht statt (Chemo oder Radiotherapie). Wenn alles (radikal) entfernt wurde, scheint mir das nicht erforderlich. Diätetische Beratung muß vor Ort stattfinden und entspricht dem, was auch sonst nach ausgedehnten Oberbauchoperationen zu bedenken ist.

The prognosis of intraductal papillary mucinous tumors of the pancreas.
AU: Yamao,-K; Ohashi,-K; Nakamura,-T; Suzuki,-T; Shimizu,-Y; Nakamura,-Y; Horibe,-Y; Yana-gisawa,-A; Nakao,-A; Nimuara,-Y; Naito,-Y; Hayakawa,-T
AD: Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan.
SO: Hepatogastroenterology. 2000 Jul-Aug; 47(34): 1129-34
AB: BACKGROUND/AIMS: Intraductal papillary mucinous tumors of the pancreas have been recognized as a distinct clinical entity. However, their biological behavior has not been clearly defined. The aim of this study was to examine the prognosis of this tumor, to clarify the biological behavior and determine the most appropriate treatment. METHODOLOGY: Correlations between prognosis of operated cases and histopathologic features were investigated. RESULTS: In 105 patients with characteristic clinical features of intraductal papillary mucinous tumors, the lesions were classified as hyperplasias in 21%, intraductal tumors in 48% and invasive carcinomas in 31%. Minimal invasion was apparent in 25%, lymph node metastasis in 21%, and fistula formation in 31% of the invasive lesions. Non-invasive and minimally invasive intraductal papillary mucinous tumors were essentially free from risk of tumor recurrence. Other invasive intraductal papillary mucinous tumors showed a significantly poor prognosis. CONCLUSIONS: Because of the variation in pathological characteristics, patient outcome and the possibility of differential diagnosis, the treatment might be recommended as follows: the case of hyperplasia can be followed-up with close surveillance. Non-invasive and minimally invasive intraductal papillary mucinous tumors should be operated with function-preserving minimal pancreatectomy. For patients with invasive intraductal papillary mucinous tumors evident with preoperative imaging modalities, radical operations with lymph node dissection might be needed.


Cystadenomas and cystadenocarcinomas of the pancreas: a multiinstitutional retrospective study of 398 cases. French Surgical Association.
AU: Le-Borgne,-J; de-Calan,-L; Partensky,-C
AD: Department of Surgery, Centre Hospitalo-Universitaire, Nantes, France.
SO: Ann-Surg. 1999 Aug; 230(2): 152-61
OBJECTIVE: To review the features of patients with benign and malignant cystadenomas of the pancreas, focusing on preoperative diagnostic accuracy and long-term outcome, especially for nonoperated serous cystadenomas and resected cystadenocarcinomas. SUMMARY BACK-GROUND DATA: Serous cystadenomas (SCAs) are benign tumors. Mucinous cystic neoplasms should be resected because of the risk of malignant progression. A correct preoperative diagno-sis of tumor type is based on morphologic criteria. Despite the high quality of recent imaging procedures, the diagnosis frequently remains uncertain. Invasive investigations such as endoso-nography and diagnostic aspiration of cystic fluid may be helpful, but their assessment is limited to small series. The management of typical SCA may require resection or observation. Survival after pancreatic resection seems better for cystadenocarcinomas (MCACs) than for ductal ade-nocarcinomas of the pancreas. METHODS: Three hundred ninety-eight cases of cystadenomas of the pancreas were collected between 1984 and 1996 in 73 institutions of the French Surgical Association. Clinical presentation, radiologic evaluation, and surgical procedures were analyzed for 144 operated SCAs, 150 mucinous cystadenomas (MCAs), and 78 MCACs. The outcome of 372 operated patients and 26 nonoperated patients with SCA was analyzed. RESULTS: Cysta-denomas represented 76% of all primary pancreatic cystic tumors (398/522). An asymptomatic tumor was discovered in 32% of patients with SCA, 26% of those with MCA, and 13% of those with MCAC. The tumor was located in the head or uncinate process of the pancreas in 38% of those with SCA, 27% of those with MCA, and 49% of those with MCAC. A communication bet-ween the cyst and pancreatic duct was discovered in 0.6% of those with SCA, 6% of those with MCA, and 10% of those with MCAC. The main investigations were ultrasonography and com-puted tomography (94% for SCA, MCA, and MCAC), endosonography (34%, 28%, and 22% for SCA, MCA, and MCAC respectively), endoscopic retrograde cholangiopancreatography (16%, 14%, 22%), and cyst fluid analysis (22%, 31%, 35%). An accurate preoperative diagnosis of tumor type was proposed for 20% of those with SCA (144 cases), 30% of those with MCA, and 29% of those with MCAC. An atypical unilocular macrocyst was observed in 10% of SCA cases. The most common misdiagnosis for mucinous cystic tumors was pseudocyst (9% of MCAs, 15% of MCACs). Intraoperative frozen sections (126 cases) allowed a diagnosis according to definiti-ve histologic examination in 50% of those with SCA and MCA and 62% of those with MCAC. For management, 93% of patients underwent surgery. Nonoperated patients (7%) had exclusively typical SCA. A complete cyst excision was performed in 94% of benign cystadenomas, with an operative mortality rate of 2% for SCA and 1.4% for MCA. Resection was possible in 74% of cases of MCAC. Mean follow-up of 26 patients with nonresected SCAs was 38 months, and no patients required surgery. For resected MCACs, the actuarial 5-year survival rate was 63%. CONCLUSIONS: Spiral computed tomography is the examination of choice for a correct prediction of tumor type. Endosonography may be useful to detect the morphologic criteria of small tumors. Diagnostic aspiration of the cyst allows differentiation of the macrocystic form of SCA (10% of cases) and the unilocular type of mucinous cystic neoplasm from a pseudocyst. Surgical resection should be performed for symptomatic SCAs, all mucinous cystic neoplasms, and cystic tumors that are not clearly defined. Conservative management is wholly justified for a well-documented SCA with no symptoms. An extensive resection is warranted for MCAC because the 5-year survival rate may exceed 60%.

[Isabelle N.]

RE: Bitte Info: Pancreatic cystadenocarcinoma muci


Vielen vielen Dank fuer Ihre Hilfe. Ich finde es ausserordentlich, dass Sie
die Zeit nehmen anderen zu helfen. Moege Gott Sie segnen fuer Ihre Muehe.

Alles liebe.

Isabelle Neubauer