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Pancreatic panniculitis and elevated serum lipase in metastasized acinar cell carcinoma of the pancreas: A case report and review of literature

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World Journal of Clinical Cases 2020年第21期8卷 5304-5312页

作者： Rainer Christoph Miksch Tobias S Schiergens Maximilian Weniger Matthias Ilmer Philipp M kazmierczak Markus O Guba martin k angele Jens Werner Jan G D'Haese Department of General Visceraland Transplantation SurgeryLudwig-Maximilians-University MunichMunich 81377BavariaGermany Department of General Visceral Transplantat Vasc&Thorac Surg Campus GrosshadernUniversity of MunichMunich 81377Germany Department of General Ludwig Maximilians-University(LMU)Munich 81377Germany Department of Radiology Ludwig-Maximilians-University MunichMunich 81377Germany Department of Surgery University of MunichKlinikum GrosshadernMunich University HospitalMunich 81377Germany Department of General University of MunichKlinikum GrosshadernHospital of the University of MunichMunich 81377Germany Department of General Klinikum Univ MunchenKlin Allgemeine Viszeral Transplantat Gefass&ThStandort GrosshadernLudwig-Maximilians-University(LMU)Munich 81377Germany

BACkGROUND Pancreatic panniculitis is an extremely rare condition associated with different underlying pancreatic disorders and characterized by subcutaneous fat necrosis induced by elevated serum lipase *** lesions usually affect the lower extremities and may precede abdominal symptoms of pancreatic *** cell carcinoma(ACC)of the pancreas is a rare pancreatic neoplasm,accounting for only 1%-2%of pancreatic tumors in *** present the case of a 72-year-old man with ACC of the pancreatic head and synchronous liver *** the primary tumor and liver metastases were *** lipase was elevated before surgery and decreased to normal *** serum lipase levels at follow-up led to the diagnosis of hepatic *** disease progression was then accompanied by pancreatic panniculitis,with subcutaneous fat necrosis and acute *** the best of our knowledge,only 4 cases have been reported in the literature and each showed a similar association of serum lipase levels with pancreatic panniculitis and progression of *** Clinical symptoms and progression of ACC may correlate with serum lipase levels,suggesting potential usefulness as a follow-up biomarker.

关键词： Pancreatic panniculitis Lipase Acinar cell carcinoma Pancreatic cancer Case report

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Gender differences in trauma,shock and sepsis

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Military Medical Research 2019年第1期6卷 67-77页

作者： Florian Bosch martin k.angele Irshad H.Chaudry Department of General Visceraland Transplant SurgeryLudwig Maximilians-University Munich Center for Surgical Research and Department of Surgery University of Alabama at Birmingham

Despite efforts in prevention and intensive care, trauma and subsequent sepsis are still associated with a high mortality rate. Traumatic injury remains the main cause of death in people younger than 45 years and is thus a source of immense social and economic burden. In recent years, the knowledge concerning gender medicine has continuously increased. A number of studies have reported gender dimorphism in terms of response to trauma, shock and ***, the advantageous outcome following trauma-hemorrhage in females is not due only to sex. Rather, it is due to the prevailing hormonal milieu of the victim. In this respect, various experimental and clinical studies have demonstrated beneficial effects of estrogen for the central nervous system, the cardiopulmonary system, the liver, the kidneys, the immune system, and for the overall survival of the host. Nonetheless, there remains a gap between the bench and the bedside. This is most likely because clinical studies have not accounted for the estrus cycle. This review attempts to provide an overview of the current level of knowledge and highlights the most important organ systems responding to trauma, shock and sepsis. There continues to be a need for clinical studies on the prevailing hormonal milieu following trauma, shock and sepsis.

关键词： Trauma-hemorrhage Cardiopulmonary bypass Gender morphism Hormonal milieu Estrogens

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Radioembolization for neuroendocrine liver metastases is safe and effective prior to major hepatic resection

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Hepatobiliary Surgery and Nutrition 2020年第3期9卷 312-321页

作者： Florian Bosch Harun Ilhan Vanessa Pfahler Michael Thomas Thomas knosel Valentin Eibl Sebastian Pratschke Peter Bartenstein Max Seidensticker Christoph J.Auernhammer Christine Spitzweg Markus O.Guba Jens Werner martin k.angele Department of General Visceraland Transplant SurgeryLudwig-Maximilians-University MunichMunichGermany Interdisciplinary Center of Neuroendocrine Tumors of the Gastro Entero Pancreatic System Ludwig-Maximilians-University MunichMunichGermany Department of Nuclear Medicine University HospitalLudwig-Maximilians-University MunichMunichGermany Department of Radiology Ludwig-Maximilians-University MunichMunichGermany Institute of Pathology Ludwig-Maximilians-University MunichMunichGermany Department of Internal Medicine 4 Ludwig-Maximilians-University MunichMunichGermany

Background:Radioembolization(RE)is well established in the treatment of neuroendocrine liver *** surgery is rarely performed after RE,although liver resection is the gold standard in the treatment of localized neuroendocrine liver ***,aim of the present study was to evaluate the safety and feasibility of liver resection after RE in a homogenous ***:From a prospective surgical(n=494)and nuclear medical(n=138)database patients with NELM who underwent liver resection and/or RE were *** September 2011 and December 2017 eight patients could be identified who underwent liver resection after RE(mean therapeutic activity of 1,746 Mbq).Overall and progression free survival were evaluated as well as epidemiological and perioperative *** surgical specimens were analyzed for necrosis,fibrosis,inflammation,and ***:The mean hepatic tumor load of patients,who had liver surgery after RE,was 31.4%with a mean ki-67 proliferation index of 5.9%.The majority of these patients(7/8)received whole liver RE prior to liver resection,which did not increase morbidity and mortality compared to a surgical *** for RE were oncological(6/8)or carcinoid syndrome associated reasons(2/8).Mean overall survival was 25.1 months after RE and subsequent *** necrosis in radioembolized lesions was 29.4%without evidence of fibrosis and inflammation in hepatic ***:This is the first study analyzing the multimodal therapeutic approach of liver resection following whole liver *** treatment algorithm is safe,does not lead to an increased morbidity and is associated with a favorable oncological ***,patient selection remains a key issue.

关键词： Radioembolization(RE) neuroendocrine tumor liver surgery

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