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Nakamura T.,Omihachiman Medical Community Center | Masuda K.,Omihachiman Medical Community Center | Harada S.,Omihachiman Medical Community Center | Akioka K.,Omihachiman Medical Community Center | Sako H.,Omihachiman Medical Community Center
International Journal of Surgery Case Reports | Year: 2013

INTRODUCTION The rates of pancreatic cancer development in the early stages of growth remain unclear; but it is generally believed that they demonstrate a rapid degree of progression. There is evidence to suggest that pancreatic cancers measuring less than 1 cm demonstrate better survival rates, hence it is clear that detecting pancreatic cancers less than 1 cm in size is of paramount importance. However, to date, there has been no scientifically adequate research to show the growth rate of small pancreatic cancers less than 1 cm in the early stages. PRESENTATION OF CASE We present the case of a 65-year-old woman whose small pancreatic cancer possibly demonstrated a slow progressive rate as it grew to an invasive carcinoma measuring 1 cm diameter from over the 29 months. DISCUSSION It is reasonable to assume that the progression of some pancreatic cancers until 1 cm size, can take up to 29 months. During this silent period, it is crucial to detect such a small pancreatic cancer by means of the initial US and subsequent EUS and ERCP. It is clear, therefore, that clinicians have to be aware of the growth rate of small pancreatic cancers and in particular high risk patients should be encouraged to monitor size of the main pancreatic duct by means of US on regular basis. CONCLUSION This could give better outcomes for pancreatic cancer patients. Hopefully, by detecting these lethal, pancreatic cancers in their early stages, it will give us an extension of time to perform effective therapies. © 2013 Surgical Associates Ltd. Source


Nakamura T.,Kyoto Prefectural University of Medicine | Nakamura T.,Omihachiman Medical Community Center | Osaka Y.,Omihachiman Medical Community Center | Ishikawa S.,Omihachiman Medical Community Center | And 5 more authors.
Journal of the Pancreas | Year: 2013

Context Lymphoepithelial cysts with sebaceous glands of the pancreas are extremely rare, with only 7 cases, including this case, published in English literature. Case report We herein present the case of a 67-year-old Asian man who underwent a resection of a lymphoepithelial cyst of the pancreas during the follow up care for lung cancer. Fourteen years previously he underwent a right lower lobectomy at the right segment nine for lung cancer. A 20 mm mass in the body of the pancreas was identified by CT scan 4 years ago, and the diagnosis was intraductal papillary mucinous neoplasm (IPMN) at that time. Over a 5-year period, this mass grew to 42 mm without dilatation of the main pancreatic duct. The preoperative evaluation, including endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), indicated a cystic neoplasm with suspicion of malignancy. Intraoperative frozen section revealed a squamous-lined cyst accompanied by sebaceous glands without any malignant findings. Following this pathological finding, resection of the cyst was performed. Consequently, microscopic examination revealed that it was a lymphoepithelial cyst with sebaceous glands of the pancreas. Conclusions Pancreatic lymphoepithelial cysts can be cured by conservative resection, but if they are asymptomatic and are diagnosed before surgery, no treatment is necessary. To our knowledge, this is the first ever published case of a lymphoepithelial cyst with sebaceous glands of the pancreas, which was found during the follow up care for lung cancer. Source

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