PMID- 22797396
OWN - NLM
STAT- MEDLINE
DCOM- 20121120
LR  - 20181023
IS  - 1590-8577 (Electronic)
IS  - 1590-8577 (Linking)
VI  - 13
IP  - 4
DP  - 2012 Jul 10
TI  - What extent of pancreatic resection do patients with MEN-1 require?
PG  - 402-8
LID - 10.6092/1590-8577/657 [doi]
AB  - CONTEXT: The surgical management of pancreatic endocrine tumors in patients with 
      multiple endocrine neoplasia type 1 (MEN-1) is controversial and complicated by 
      the fact that these tumors are frequently multifocal. The degree of tumor 
      resection is determined by weighing the risk of malignancy or tumor recurrence 
      against the risks of endocrine/exocrine insufficiency with complete gland 
      removal. METHODS: A retrospective review was performed identifying 4 patients 
      with MEN-1 and pancreatic endocrine tumors treated with pancreatic resection over 
      a 2-year period at our institution. RESULTS: Mean age at operation was 35 years. 
      Surgical approach was determined by size of tumor(s) and presence of 
      multifocality. MRI and EUS were performed in all patients. While EUS identified a 
      greater number of tumors when compared to MRI (median 5 versus 1), both studies 
      grossly underestimated the total number of tumors found on final pathology. Three 
      patients underwent laparoscopic total pancreatectomy for multifocal disease with 
      diffuse pancreatic involvement, finding a median of 12 tumors. One patient 
      underwent laparoscopic subtotal pancreatectomy for a presumed single pancreatic 
      tail mass, but was found to have multifocal disease on final pathology consisting 
      of 7 tumors. The average number of tumors found on final pathology was 13.5 with 
      an average size of 2.6 cm. The median number of lymph nodes analyzed was 14. 
      Diffuse, multifocal disease was present in all 4 patients. No major postoperative 
      complications were observed. CONCLUSION: In patients with MEN-1 and pancreatic 
      endocrine tumors, preoperative workup underestimates extent of disease and total 
      pancreatectomy should be considered for complete tumor removal.
FAU - Adkisson, Cameron D
AU  - Adkisson CD
AD  - Department of General Surgery, Mayo Clinic Florida, Jacksonville, FL 32224, USA.
FAU - Stauffer, John A
AU  - Stauffer JA
FAU - Bowers, Steven P
AU  - Bowers SP
FAU - Raimondo, Massimo
AU  - Raimondo M
FAU - Wallace, Michael B
AU  - Wallace MB
FAU - Riegert-Johnson, Douglas L
AU  - Riegert-Johnson DL
FAU - Asbun, Horacio J
AU  - Asbun HJ
LA  - eng
PT  - Journal Article
DEP - 20120710
PL  - England
TA  - JOP
JT  - JOP : Journal of the pancreas
JID - 101091810
SB  - IM
MH  - Adult
MH  - Endosonography
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Multiple Endocrine Neoplasia Type 1/pathology/*surgery
MH  - Pancreatectomy/*methods
MH  - Pancreatic Neoplasms/*surgery
MH  - Retrospective Studies
EDAT- 2012/07/17 06:00
MHDA- 2012/12/10 06:00
CRDT- 2012/07/17 06:00
PHST- 2012/07/17 06:00 [entrez]
PHST- 2012/07/17 06:00 [pubmed]
PHST- 2012/12/10 06:00 [medline]
AID - 10.6092/1590-8577/657 [doi]
PST - epublish
SO  - JOP. 2012 Jul 10;13(4):402-8. doi: 10.6092/1590-8577/657.