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Early pancreatic cancer in Ig G4-related pancreatic mass:A case report

World Journal of Gastrointestinal Surgery 2019年第12期11卷 443-448页

作者： Juan Glinka Francisco Calderón Martín de Santibanes Sung Ho Hyon Adrián Gadano eduardo mullen Melina Pol Juan Spina eduardo de Santibanes Department of General Surgery Hepato-bilio-pancreatic UnitHospital Italiano de Buenos AiresBuenos Aires C1181ACHArgentina Department of General Surgery Image Guided Minimally Invasive Surgery UnitHospital Italiano de Buenos AiresBuenos Aires C1181ACHArgentina Hepatology Section Hospital Italiano Buenos AiresBuenos Aires C1181ACHArgentina Department of Surgical Pathology Hospital Italiano de Buenos AiresBuenos Aires C1181ACHArgentina Department of Radiology Hospital Italiano de Buenos AiresBuenos Aires C1181ACHArgentina

BACKGROUND IgG4-related disease can manifest diversely,including autoimmune pancreatitis and IgG4-related *** are reporting a very unusual cause of pancreatic cancer triggered in a previously unknown IgG4-related *** SUMMARY A 75-year-old man was diagnosed with a 43 mm×33 mm pancreatic head tumor after consulting for abdominal pain and jaundice.A pancreaticoduodenectomy was carried out uneventfully,and the histopathology report showed an early stage of acinar-cell pancreatic *** patient reconsulted on the 30th postoperative day with fever,jaundice and *** resonance cholangiopancreatography evidenced an extense bile duct stricture.A percutaneous biliary drainage proved to be ineffective,even after exchanging it with larger bore *** the surgical specimen,features compatible with IgG4-related disease were ***,empiric treatment with steroids was initiated achieving excellent *** IgG4-related disease may cause chronic inflammation of the pancreas and can condition pancreatic malignancies.

关键词： Autoimmune pancreatitis Pancreatic adenocarcinoma Pancreatic cancer IgG4 IgG4-related disease Case report

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Malignant transformation of hepatocellular adenoma in a young female patient after ovulation induction fertility treatment:A case report

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World Journal of Gastrointestinal Surgery 2019年第4期11卷 229-236页

作者： Juan Glinka Rodrigo Sanchez Clariá Eugenia Fratanoni Juan Spina eduardo mullen Victoria Ardiles Oscar Mazza Juan Pekolj Martín de Santiba?es eduardo de Santiba?es Department of General Surgery Hepatobilio-pancreatic Unit Hospital Italiano de Buenos Aires Department of Radiology Hospital Italiano de Buenos Aires Department of Surgical Pathology Hospital Italiano de Buenos Aires

BACKGROUND Hepatocellular adenoma(HCA) is a rare benign liver tumor usually affecting young women with a history of prolonged use of hormonal *** the majority is asymptomatic, a low proportion may have significant complications such as bleeding or malignancy. Despite responding to the hormonal stimulus, the desire for pregnancy in patients with small HCA is not contraindicated. However, through this work we demonstrate that intensive hormonal therapies such as those used in the treatment of infertility can trigger serious complications CASE SUMMARY A 33-year-old female with a 10-year history of oral contraceptive use was diagnosed with a hepatic tumor as an incidental finding in an abdominal ultrasound. The patient showed no symptoms and physical examination was unremarkable. Laboratory functional tests were within normal limits and tests for serum tumor markers were negative. An abdominal magnetic resonance imaging(MRI) was performed, showing a 30 mm × 29 mm focal lesion in segment VI of the liver compatible with HCA or Focal Nodular Hyperplasia with atypical behavior. After a total of six years of follow-up, the patient underwent ovulation induction treatment for infertility. On a following MRI, a suspected malignancy was warned and hence, surgery was decided. The surgical specimen revealed malignant transformation of HCA towards trabecular hepatocarcinoma with dedifferentiated areas. There was non-evidence of tumor recurrence after three years of clinical and imaging follow-up.,CONCLUSION HCAs can be malignant regardless its size and low-risk appearance on MRI when an ovultation induction therapy is indicated.

关键词： Hepatocellular adenoma Malignant transformation Focal liver lesion Adenoma Ovulation induction Case report

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