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Small serotonin-positive pancreatic endocrine tumors caused obstruction of the main pancreatic duct

World Journal of Gastroenterology 2012年第45期18卷 6669-6673页

作者： Masami Ogawa Yoshiaki Kawaguchi atsuko maruno Hiroyuki Ito Toshio Nakagohri Kenichi Hirabayashi Hiroshi Yamamuro Tomohiro Yamashita Tetsuya Mine Department of Gastroenterology Tokai University School of Medicine143 ShimokasuyaIsehara 259-1193Japan Department of Gastroenterological Surgery Tokai University School of Medicine143 ShimokasuyaIsehara 259-1193Japan Department of Pathology Tokai University School of Medicine143 ShimokasuyaIsehara 259-1193Japan Department of Radiology Tokai University School of Medicine143 ShimokasuyaIsehara 259-1193Japan

We report 2 cases of pancreatic endocrine tumors that caused obstruction of the main pancreatic duct(MPD).A 49-year-old asymptomatic man was referred to our institution because dilation of the MPD was revealed by abdominal ultrasonography(US).No tumor was detected by endoscopic ultrasonography,computed tomography(CT),and magnetic resonance imaging(MRI).The diameter of the MPD was > 20 mm at the body,and no dilation was noted at the *** malignancy was not confirmed through cytology or imaging,pancreatic cancer was strongly ***-denectomy was *** and immunohistochemical examination revealed a 5 mm × 3 mm serotonin-positive endocrine *** was present around the MPD and seemed to cause stricture.A 32-year-old asymptomatic man had elevated serum amylase,and US demonstrated dilation of the *** tumor was detected by CT and *** cancer was suspected due to stricture and dilation of the *** of middle part of pancreas was *** and immunohistochemical examination revealed a serotonin-positive endocrine tumor sized 5 mm × 4 *** report 2 cases of serotonin-positive pancreatic endocrine tumors that caused stricture of the MPD in spite of the small size of the tumor.

关键词：恶性肿瘤胰腺癌内分泌羟色胺阳性胰管病理组织学梗阻

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Amenorrhea as a rare drug-related adverse event associated with everolimus for pancreatic neuroendocrine tumors

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World Journal of Gastroenterology 2014年第42期20卷 15920-15924页

作者： Yoshiaki Kawaguchi atsuko maruno Yohei Kawashima Hiroyuki Ito Masami Ogawa Tetsuya Mine Department of Gastroenterology Tokai University School of Medicine

The patient was an asymptomatic 43-year-old woman. Abdominal ultrasonography and enhanced computed tomography showed a tumor lesion accompanied by multiple cystic changes in the liver and the pancreatic tail. Endoscopic ultrasound-fine needle aspiration was performed on the pancreatic tumor lesion and revealed pancreatic neuroendocrine tumor(PNET). As it was unresectable due to multiple liver metastases, the decision was made to initiate treatment with everolimus and transcatheter arterial chemoembolization. The patient ceased menstruating after the start of everolimus administration. When the administration was discontinued due to interstitial lung disease, menstruation resumed, but then again stopped with everolimus resumption. An association between everolimus and amenorrhea was highly suspected. Amenorrhea occurred as a rare adverse event of everolimus. As the younger women might be included in PNETs patients, we should put this adverse event into consideration.

关键词： Amenorrhea Everolimus Neuroendocrine tumor Pancrea

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Risk factors for proximal migration of biliary tube stents

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World Journal of Gastroenterology 2014年第5期20卷 1318-1324页

作者： Yoshiaki Kawaguchi Masami Ogawa Yohei Kawashima Hajime Mizukami atsuko maruno Hiroyuki Ito Tetsuya Mine Department of Gastroenterology Tokai University School of Medicine

AIM: To analyze the risk factors for biliary stent migration in patients with benign and malignant strictures. METHODS: Endoscopic stent placement was performed in 396 patients with bile duct stenosis, at our institution, between June 2003 and March 2009. The indications for bile duct stent implantation included common bile duct stone in 190 patients, malignant lesions in 112, chronic pancreatitis in 62, autoimmune pancreatitis in 14, trauma in eight, surgical complications in six, and primary sclerosing cholangitis(PSC) in four. We retrospectively examined the frequency of stent migration, and analyzed the patient factors(disease, whether endoscopic sphincterotomy was performed, location of bile duct stenosis and diameter of the bile duct) and stent characteristics(duration of stent placement, stent type, diameter and length). Moreover, we investigated retrieval methods for migrated stents and their associated success rates. RESULTS: The frequency of tube stent migration inthe total patient population was 3.5%. The cases in which tube stent migration occurred included those with common bile duct stones(3/190; 1.6%), malignant lesions(2/112; 1.8%), chronic pancreatitis(4/62; 6.5%), autoimmune pancreatitis(2/14; 14.3%), trauma(1/8; 12.5%), surgical complications(2/6; 33.3%), and PSC(0/4; 0%). The potential risk factors for migration included bile duct stenosis secondary to benign disease such as chronic pancreatitis and autoimmune pancreatitis(P = 0.030); stenosis of the lower bile duct(P = 0.031); bile duct diameter > 10 mm(P = 0.023); duration of stent placement > 1 mo(P = 0.007); use of straight-type stents(P < 0.001); and 10-Fr sized stents(P < 0.001). Retrieval of the migrated stents was successful in all cases. The grasping technique, using a basket or snare, was effective for pig-tailed or thin and straight stents, whereas the guidewire cannulation technique was effective for thick and straight stents. CONCLUSION: Migration of tube stents within the bile duct

关键词： Migration Endoscopic biliary stent Risk factor End

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