Central Pancreatectomy to Treat a Giant Solid Pseudopapillary Tumor of the Pancreas - An Uncommon Surgical Procedure for a Rare Tumor: A Case Report and Review of the Literature

Context Solid pseudopapillary tumor is a rare tumor of the pancreas. Solid pseudopapillary tumor is nine times more frequent in the body and tail than in the head of the pancreas. It usually does not reach a large size. The majority of patients are young females and most of them are asymptomatic. Neoplasms of the midportion of the pancreas, not suitable for enucleation, can be treated with central pancreatectomy. The central pancreatectomy is commonly proposed for tumors that do not exceed 5 cm of dimension. Case report We report a case of seventeen-years-old woman who was admitted to our institution with abdominal pain and a palpable mass in the left hypochondrial area. US, CT and RMN scan revealed a giant (> 10 cm.) well-demarcated and encapsulated solid mass in the body of the pancreas, with a great amount of intralesional cystic-hemorrhagic component. The patient was treated by a variant of central pancreatectomy without splenectomy and pancreatic duct reconstruction. There was no metastatic disease in either the liver or peritoneum. The histological analysis identifies the tumor as a Solid pseudopapillary tumor of the pancreas. Fifteen years' follow-up period showed no recurrence. Conclusions Solid pseudopapillary tumor of the pancreas behaves like a potentially malignant tumor and has good prognosis. Surgical resection is dictated by tumor location and is the treatment of choice. The increasing interest in parenchyma-sparing pancreatic surgery has found large application in treatment of Solid pseudopapillary tumor, with the aim of preserving exocrine and endocrine pancreatic function, and achieving a better quality of life after surgery. Considering the low malignant potential, the central pancreatectomy can be considered an excellent therapeutic strategy for the treatment of this type of tumor also when they have giant dimensions and are localized in the central-pancreatic portion

Current tissue molecular markers in colorectal cancer: A literature review

BACKGROUND: Colorectal cancer (CRC) is one of the most spread neoplasia types all around the world, especially in western areas. It evolves from precancerous lesions and adenomatous polyps, through successive genetic and epigenetic mutations. Numerous risk factors intervene in its development and they are either environmental or genetic. AIM OF THE REVIEW: Alongside common screening techniques, such as fecal screening tests, endoscopic evaluation, and CT-colonography, we have identified the most important and useful biomarkers and we have analyzed their role in the diagnosis, prevention, and prognosis of CRC. CONCLUSION: Biomarkers can become an important tool in the diagnostic and therapeutic process for CRC. But further studies are needed to identify a noninvasive, cost-effective, and highly sensible and specific screening test for their detection and to standardize their use in clinical practice

PLANEACION DE DESARROLLO EMPRENDEDOR

GUIA DIDACTICA / PLANEACION DIDACTICA (NMS

Diagnostic, Predictive, Prognostic, and Therapeutic Molecular Biomarkers in Third Millennium: A Breakthrough in Gastric Cancer

INTRODUCTION: Gastric cancer is the fifth most common cancer and the third cause of cancer death. The clinical outcomes of the patients are still not encouraging with a low rate of 5 years' survival. Often the disease is diagnosed at advanced stages and this obviously negatively affects patients outcomes. A deep understanding of molecular basis of gastric cancer can lead to the identification of diagnostic, predictive, prognostic, and therapeutic biomarkers. MAIN BODY: This paper aims to give a global view on the molecular classification and mechanisms involved in the development of the tumour and on the biomarkers for gastric cancer. We discuss the role of E-cadherin, HER2, fibroblast growth factor receptor (FGFR), MET, human epidermal growth factor receptor (EGFR), hepatocyte growth factor receptor (HGFR), mammalian target of rapamycin (mTOR), microsatellite instability (MSI), PD-L1, and TP53. We have also considered in this manuscript new emerging biomarkers as matrix metalloproteases (MMPs), microRNAs, and long noncoding RNAs (lncRNAs). CONCLUSIONS: Identifying and validating diagnostic, prognostic, predictive, and therapeutic biomarkers will have a huge impact on patients outcomes as they will allow early detection of tumours and also guide the choice of a targeted therapy based on specific molecular features of the cance

PLANEACIÓN DIDÁCTICA DE LA ASIGNATURA DESARROLLO EMPRENDEDOR

GUÍA DIDÁCTICA / PLANEACIÓN DIDÁCTICA (NMS

The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure

Abstract Introduction The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (SIUCP: Società Italiana Unitaria di Colon-Proctologia) on the diagnosis and management of anal fissure, with the purpose to guide every physician in the choice of the best treatment option, according with the available literature. Methods A panel of experts was designed and charged by the Board of the SIUCP to develop key-questions on the main topics covering the management of anal fissure and to performe an accurate search on each topic in different databanks, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in different rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to the PICO criteria, and the statements developed adopting the GRADE methodology. Conclusions In patients with acute anal fissure the medical therapy with dietary and behavioral norms is indicated. In the chronic phase of disease, the conservative treatment with topical 0.3% nifedipine plus 1.5% lidocaine or nitrates may represent the first-line therapy, eventually associated with ointments with film-forming, anti-inflammatory and healing properties such as Propionibacterium extract gel. In case of first-line treatment failure, the surgical strategy (internal sphincterotomy or fissurectomy with flap), may be guided by the clinical findings, eventually supported by endoanal ultrasound and anal manometry