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Peripancreatic paraganglioma:Lesson from a round table

World Journal of Gastroenterology 2022年第21期28卷 2396-2402页

作者： Federica Petrelli Geri Fratini Andrea Sbrozzi-Vanni Andrea Giusti Raffele Manta claudio vignali Gabriella Nesi Andrea Amorosi Andrea Cavazzana Marco Arganini Maria Raffaella Ambrosio Pathology Unit Azienda Sanitaria Toscana Nord OvestPisa 56121Italy Surgery Unit Azienda Sanitaria Toscana Nord OvestPisa 56121Italy Endoscopic Unit Azienda Sanitaria Toscana Nord OvestPisa 56121Italy Endoscopic Unit Santa Maria Misericordia HospitalPerugia 06122Italy Interventional Radiology Unit Azienda Sanitaria Toscana Nord OvestPisa 56121Italy Department of Health Sciences University of FlorenceFlorence 50139Italy Pathology Unit UniversitàMagna GraeciaCatanzaro 88100Italy

We described the case of a peripancreatic paraganglioma(PGL)misdiagnosed as pancreatic *** exploration revealed an unremarkable pancreas and a large well-defined cystic mass originating at the mesocolon *** enucleation of the mass was performed,preserving the pancreatic ***,a diagnosis of PGL was ***,two previously unreported mutations,one affecting the KDR gene in exon 7 and another on the JAK3 gene in exon 4 were *** mutations are known to be *** and cytologic findings were blindly reviewed by an expert panel of clinicians,radiologists,and pathologists to identify possible causes of the *** major issue was lack of evidence of a cleavage plane from the pancreas at imaging,which prompted radiologists to establish an intraparenchymal *** blinded revision shifted the diagnosis towards an extrapancreatic lesion,as the pancreatic parenchyma showed no structural alterations and no dislocation of the Wirsung *** post,the identified biases were the emergency setting of the radiologic examination and the very thin mesocolon sheet,which hindered clear definition of the lesion *** endoscopic ultrasonography diagnosis was confirmed,emphasizing the intrinsic limit of this technique in detecting large ***,pathologic review favored a diagnosis of PGL due to the morphological features and immonohistochemical *** months after tumor excision,the patient is asymptomatic with no disease relapse evident by either radiology or laboratory *** report strongly highlights the difficulties in rendering an accurate preoperative diagnosis of PGL.

关键词： Peripancreatic paraganglioma Pancreatic neuroendocrine tumor Solid pseudopapillary neoplasm S100 Succinate dehydrogenase subunit B gene and expression Fine needle biopsy

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Clinical impact of selective transarterial chemoembolization on hepatocellular carcinoma:A cohort study

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World Journal of Gastroenterology 2009年第15期15卷 1843-1848页

作者： Rodolfo Sacco Marco Bertini Pasquale Petruzzi Michele Bertoni Irene Bargellini Giampaolo Bresci Graziana Federici Luigi Gambardella Salvatore Metrangolo Giuseppe Parisi Antonio Romano Antonio Scaramuzzino Emanuele Tumino Alessandro Silvestri Emanuele Altomare claudio vignali Alfonso Capria Gastroenterology Department Pisa University Hospital Institute of Interna Medicine University of Foggia Department of Diagnostic and Interventional Radiology Pisa University Hospital

AIM： To prospectively long term clinical impact evaluate the short and of selective transarterial chemoembolization （TACE） on fiver function in patients with hepatocellular carcinoma （HCC）. To assess side effects in relation to treatments. To analyze the overall survival and HCC progression free survival probability. METHODS： One hundred and seventeen cirrhotic patients with HCC were enrolled. Baseline liver function included Child-Pugh score and serum levels of alanine- aminotransferase （ALT）, prothrombin time （PT） and bilirubin. According to Cancer Liver Italian Program （CLIP） and Barcelona Clinic Liver Cancer （BCLC） staging systems, 71 patients were eligible for TACE; 32 had previously received treatment for HCC. No significant differences in liver function were observed between previously treated and not treated patients. TACE was performed by selective catheterization of the arteries nourishing the lesions. While hospitalized, patients underwent clinical, hematologic and ultrasonographic assessments. One month after TACE a CT scan was performed to assess tumor response. A second TACE was performed ＂on demand＂ Liver function tests were checked in all patients every four months. RESULTS： After first TACE, the mean Child-Pugh score increased from a mean baseline 5.62 ±1.12 to 6.11 ±1.57 at discharge time （P 〈 0.0001）, decreasing after four months to 5.81 ± 0.73 （not significant）. ALT, PT and bilirubin significantly （P 〈 0.0001） increased 24 h after TACE and progressively decreased until discharge. After the second TACE, variations in Child-Pugh score, ALT, PT and bilirubin were comparable to that described after the first TACE. No major complications were observed. The mean follow-up was 14.7 ＋ 6.3 mo （median： 16 mo）. Only one patient died. No other patient experienced important long term worsening of clinical status. The overall survival probability at twenty-four months was 98.18% with a correspondent HCC progression free survival probability of 69%. CONCLUSION：

关键词： Hepatocellular carcinoma Transarterialchemoembolization Liver function Liver cirrhosis Child-Pugh score

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