Pancreatic Cancer Cystic Neoplasms And Endocrine Tumors

Pancreatic Cancer, Cystic Neoplasms and Endocrine Tumors: Diagnosis and Management is a modern, expertly crafted and clinically focused guide to the diagnosis, management and best-practice care of patients suffering from pancreatic cancer, cystic neoplasms and endocrine tumours. Packed with outstanding figures and with reference to the leading society guidelines, its main focus is on the many endoscopic and radiologic diagnostic techniques, medical and surgical management of both full-blown cancer and other tumors, and the risks of each form of treatment. Also covered in detail are issues of tumor recurrence and long-term outcome of treatment. Brought to you by highly skilled national and international leaders in the specialty and an experienced editor team, this is an invaluable guide to practicing gastroenterologists and surgeons in the hospital and clinical environment, as well as oncologists and endocrinologists managing patients with pancreatic tumorous lesions.

This book provides a detailed, up-to-date overview of cystic tumors of the pancreas, with coverage of all aspects of diagnosis and treatment (medical, endoscopic, and surgical). After opening chapters on pathology and classification, cytology, molecular biology, and epidemiology, the role of each of the relevant diagnostic methods is carefully examined. The treatment-related chapters describe surgical approaches, including minimally invasive surgery, as well as ablation modalities and chemo-radiotherapy. Thorough guidance is also provided specifically on the management of cystic tumors in high-risk cases and on follow-up. The authors are global opinion leaders in their field who have contributed cutting-edge chapters, with emphasis on clear diagnostic and therapeutic algorithms and with numerous supporting tables and illustrations. Owing to the widespread use of imaging modalities, clinicians are being confronted by an increasing number of patients with cystic tumors of the pancreas, ranging from benign cysts to metastasized malignancies. The widening spectrum of available diagnostic measures has resulted in controversy over the choice of further means of investigation when cystic changes are encountered, and the growth in therapeutic options has similarly been accompanied by considerable debate over their use. Against this background, Cystic Tumors of the Pancreas will be a valuable source of relevant information for both clinicians and surgeons and will also be of interest to radiologists, pathologists, and basic scientists.

The outstanding feature of this publication is that it illustrates in detail the broad range of pancreatic lesions most likely to be encountered on fine needle aspiration of the pancreas, incorporating ancillary testing and differential diagnoses. Detailed descriptions of the cytological features of nonneoplastic entities, ductal and nonductal primary neoplasms, nonneoplastic and neoplastic cystic lesions, and secondary tumors and mesenchymal lesions are included. A multidisciplinary authorship has created a well-rounded presentation of the clinical, imaging, and histopathological features of each lesion. A chapter on specimen processing provides guidance on cytological preparation of samples from solid and cystic lesions. This monograph is written for cytotechnologists, general pathologists, and cytopathologists who work with pancreatic fine needle aspiration in their practice. It is also a useful guide to pancreatic cytology for advanced endoscopists, surgeons, and oncologists who evaluate, manage, and treat patients with pancreatic masses.

This issue of Surgical Oncology Clinics of North America, guest edited by Nipun Merchant, MD, is devoted to Pancreatic Neoplasms. Dr. Merchant has assembled expert authors to review the following topics: Molecular and Genetic Basis of Pancreatic Carcinogenesis: Which Concepts May Be Clinically Relevant?; Role Of EUS and ERCP In The Clinical Assessment Of Pancreatic Neoplasms; Optimal Imaging Modalities For The Diagnosis and Staging Of Periampullary Lesions; Advances in the Surgical Management of Resectable and Borderline Resectable Pancreatic Cancer; Minimally Invasive Approaches to Pancreatic Surgery; Adjuvant and Neoadjuvant Therapy for Pancreatic Cancer; Palliative Management of Unresectable Pancreatic Cancer; Spectrum and Classification of Cystic Lesions of the Pancreas; Therapeutic Approach to Cystic Neoplasms of the Pancreas; Clinical Presentation and Management of Pancreatic Neuroendocrine Tumors; State-of-the-Art Imaging of Pancreatic Neuroendocrine Tumors; Surgical Approaches to Pancreatic Neuroendocrine Tumors; and Medical Management of Pancreatic Neuroendocrine Tumors: Current and Future Therapy.

Uncommon tumors of the pancreas are of increasing interest for clinicians: cross imaging techniques development makes it possible to detect small lesions in the pancreatic gland of asymptomatic patients, and in the last decades a more detailed and specific pathological classification definitivelyopened an unexpected world of more or less rare pancreatic tumors. As a matter of fact, nowadays most surgical procedures deal with these so called uncommon pancreatic tumors such as cystic, endocrine and others unfrequent histotypes, and many patientsexperiencing an accidental discovery of this type of tumor need therefore a specialistic evaluation. The concept behind this volume is the need to give the correct clinical relevance to these “uncommon” tumors, that are ranked at the first place among pancreatic tumors, and that are definitively curable with a multimodal approach. Aim of the book is therefore to get clinicians closer to these pathologies, describing their complexity and the current state of the art in diagnostic, therapeutic and pathological classification strategy, thus providing them with the tools for a modern and updated clinical management of these patients.

Table 1 Cancer is the second most common cause of death in Americans (see www.cdc.gov). Colorectal cancer kills more Incidence and Mortality of the Five Most Common Gastrointestinal Malignancies Americans than any other malignancy except for lung cancer. The incidences and mortalities of the major gastrointestinal a a Site Incidence Mortality (GI) malignancies are shown in Table 1. Taken as a group, the five most common GI malignancies account for more cancers Colorectum 53.9 21.6 and more cancer deaths than for any other site. Pancreas 11.1 10.6 Stomach 9.1 4.9 Flexible endoscopy has given physicians unprecedented Liver/intrahepatic bile ducts 6.2 4.4 access to the GI tract. The ability to endoscopically visu- Esophagus 4.5 4.3 alize, biopsy, and apply therapy has had implications for the management of all the major GI malignancies. Accepted Data from SEER database 1992–2002 (www.seer.cancer.gov). applications of endoscopy range from detection of mal- a Per 100,000.

This book provides a comprehensive review of the imaging of cystic and rare tumors of the pancreas. It is divided into five sections on the following topics: cystic tumors, intraductal cystic tumors, endocrine tumors, rare tumors, and secondary tumors. In each section, individual chapters document the pathology, clinical manifestations, and imaging of these tumors. Therapeutic management is also discussed. Throughout, emphasis is placed on the role of state-of-the-art techniques, and the text is complemented by numerous high-quality illustrations. All of the authors are highly respected authorities in the field, with vast experience in all aspects of pancreatic disease.

Written by a team of expert authors from all members of the multidisciplinary cancer care team, Pancreatic Cancer summarizes our current understanding of the epidemiology, genetics, imaging and treatment of these complex malignancies. Each imaging modality is reviewed, with an emphasis on MDCT, MRI and EUS; the key aspects of image interpretation are covered. Separate chapters focus on diagnosis and staging of ductal adenocarcinoma, cystic pancreatic neoplasms and neuroendocrine tumors; rare neoplasms and benign pancreatic disorders that mimic pancreatic cancer are also considered. All treatment options are discussed in detail, including surgery, chemotherapy and radiation therapy, and the multidisciplinary approach to patients with more advanced disease is fully reviewed. This volume is a state-of-the-art review of current practice and knowledge of pancreatic cancer.