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Extensive multiarterial resection attending total duodenopancreatectomy and adrenalectomy for MEN-1-associated neuroendocrine carcinomas

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World Journal of Gastrointestinal Surgery 2012年第10期4卷 238-245页

作者： Vyacheslav Ivanovich Egorov Alexander Felixovich Kharazov Alla Ivanovna Pavlovskaya Roman Valeryevich Petrov Natalia Sergeevna Starostina Eugeny Valerievich Kondratiev Ekaterina Mikhailovna Filippova Department of Hepatopancreatobiliary Surgery Vishnevsky Institute of Surgery117997 MoscowRussia Department of Vascular Surgery Vishnevsky Institute of Surgery117997 MoscowRussia Department of Pathology Blokhin Cancer Research Centre Moscow117997 MoscowRussia Department of Radiology Vishnevsky Institute of Surgery117997 MoscowRussia Department of Pathology Vishnevsky Institute of Surgery117997 MoscowRussia

Pancreatic neuroendocrine tumors(PNTs) are relatively uncommon although these neoplasms have been noted to grow in occurrence in recent *** removal of locally advanced PNTs involving major vessels and adjacent organs is warranted by reason of an appreciably more favorable prognosis as compared to exocrine pancreas *** are reporting a case of successful multi-organ resection combined with a wide excision of the superior mesenteric,common,proper,left and right hepatic arteries(in the presence of the hepatomesenteric trunk variant of aberrant arterial anatomy) for multifocal PNTs in the setting of multiple neuroendocrine neoplasia type 1 *** procedure resulted in pain abolition,a significant improvement in the patient's life quality and allowed her to return to ***-up computed tomography at 15 mo post-surgery showed no evidence of disease recurrence.

关键词： Total duodenopancreatectomy Pancreatic neuroendocrine tumors Islet cell tumors Neuroendocrine carcinoma Multiple endocrine neoplasia type 1 syndrome

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Annular pancreas associated with duodenal carcinoma

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World Journal of Gastroenterology 2010年第25期16卷 3206-3210页

作者： Enrico Bronnimann Silke Potthast Tatjana Vlajnic Daniel Oertli Oleg Heizmann Depart-ment of Surgery University of Basel CH-4031 Basel Switzerland Institute of Diagnostic Radiology University Hospital Basel CH-4031 Basel Switzerland Institute of Pathology University of Basel CH-4031 Basel Switzerland

Annular pancreas (AP) is a rare congenital anomaly. Coexisting malignancy has been reported only in a few cases. We report what is, to the best of our knowledge, the first case in the English literature of duodenal adenocarcinoma in a patient with AP. In a 55-year old woman with duodenal outlet stenosis magnetic resonance cholangiopancreatography showed an aberrant pancreatic duct encircling the duodenum. Duodenojejunostomy was performed. Eight weeks later she presented with painless jaundice. duodenopancreatectomy revealed a duodenal adenocarcinoma, surrounded by an incomplete AP. Thus, co-existent malignancy with AP can be present without obstructive jaundice and without being visible through preoperative diagnostics.

关键词： Duodenal carcinoma Annular pancreas duodenopancreatectomy Whipples operation

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Biliary tree gastrinomas in multiple endocrine neoplasia type 1 syndrome

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World Journal of Gastroenterology 2013年第45期19卷 8312-8320页

作者： Francesco Tonelli Francesco Giudici Gabriella Nesi Giacomo Batignani Maria Luisa Brandi Department of Surgery and Translational Medicine University of Florence50014 Florence Italy

AIM:To describe our patients affected with ectopic biliary tree gastrinoma and review the literature on this ***:Between January 1992 and June 2012,28 patients affected by duodenopancreatic endocrine tumors in multiple endocrine neoplasia type 1(MEN1)syndrome underwent surgery at our *** retrospective review article analyzes our experience regarding seventeen of these patients subjected to duodenopancreatic surgery for Zollinger-Ellison syndrome(ZES).Surgical treatment consisted of duodenopancreatectomy(DP)or total pancreatectomy(TP).Regional lymphadenectomy was always *** hepatic tumoral lesions found were removed during *** MEN1 patients,removal of duodenal lesions can sometimes lead to persistence or recurrence of *** possible explanation for this unfavorable outcome could be unrecognized ectopic localization of gastrin-secreting *** study described three cases among the seventeen patients who were found to have an ectopic gastrinoma located in the biliary ***:Seventeen MEN1 patients affected with ZES were *** mean age was 40 *** patients underwent DP and two *** histopathological examination,duodeno pancreatic endocrine tumors were found in all 17 ***-one gastrinomas were detected in the first three portions of the *** one gastrinoma was found in the *** mean number of gastrinomas per patient was 5(range 1-16).Malignancy was established in 12 patients(70.5%)after lymph node,liver and omental metastases were *** patients exhibited biliary tree gastrinomas as well as duodenal gastrinoma(s).In two cases,the ectopic gastrinoma was removed at the same time as pancreatic surgery,while in the third case,the biliary tree gastrinoma was resected one year after DP because of recurrence of ***:These findings suggest the importance of checking for the presence of ectopic gastrinomas in the biliary tree in MEN1 patients undergoing Z

关键词： Gastrinoma Multiple endocrine neoplasia type 1 Zollinger-Ellison Syndrome Ectopic gastrinoma Biliary tree duodenopancreatectomy

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