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Management of exocrine carcinoma of the pancreas

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Gastrointestinal Oncology

Part of the book series: Cancer Treatment and Research ((CTAR,volume 98))

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Abstract

The modern era has witnessed both the triumphs of the first resectional procedures for pancreatic cancer and the failures of most of these operations to cure [1–4]. Similarly, it has seen optimistic first reports and less sanguine follow-ups of various adjunctive radiation therapy and chemotherapy regimens [5–11]. This chapter will briefly review these landmarks and will then cover modern management for the patient with carcinoma of the exocrine pancreas.

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References

  1. Whipple AO, Parsons WB, Mullins CR. 1935. Treatment of cancer of the ampulla of Vater. Ann Surg 102:763–779.

    PubMed  CAS  Google Scholar 

  2. Brunschwig A. 1937. Resection of head of pancreas and duodenum for carcinoma — pancreaticoduodenectomy. Surg Gynecol Obstet 65:681–684.

    Google Scholar 

  3. Trimble IR, Parsons JW, Sherman CP. 1944. A one stage operation for the cure of carcinoma of the ampulla of Vater and of the head of the pancreas. Surg Gynecol Obstet 73:711–722.

    Google Scholar 

  4. Cattell RB, Pyrtek LJ. 1949. An appraisal of pancreatoduodenal resection: a follow-up study of 61 cases. Ann Surg 129:840–849.

    Google Scholar 

  5. Kaiser MH, Ellenberg SS. 1985. Pancreatic cancer: adjuvant combined radiotherapy and chemotherapy following curative resection. Arch Surg 120:899–903.

    Google Scholar 

  6. Douglass HO Jr, Stablein DM. 1990. Ten-year follow-up of first generation surgical adjuvant studies of the Gastrointestinal Tumor Study Group. Adjuv Ther Cancer 6:405–415.

    Google Scholar 

  7. Ishikawa O, Ohigashi H, Teshima T, Chatani M, Inoue T, Tanaka S, Kitamura T, Wada A, Sasaki Y, Imaoka S, Iwanaga T. 1989. Clinical and histopathological appraisal of preoperative irradiation for adenocarcinoma of the pancreatoduodenal region. J Surg Oncol 40:143–151.

    PubMed  CAS  Google Scholar 

  8. Ishikawa O, Ohigashi H, Imaoka S, Sasaki Y, Iwanaga T, Matayoshi Y, Inoue T. 1994. Is the long-term survival rate improved by preoperative irradiation prior to Whipple’s procedure for adenocarcinoma of the pancreatic head? Arch Surg 129:1075–1080.

    PubMed  CAS  Google Scholar 

  9. Hoffman JP, Weese JL, Solin LJ, Agarwal P, Engstrom P, Scher R, Paul AR, Litwin S, Watts P, Eisenberg BL. 1993. A single institutional experience with preoperative chemora-diotherapy for stage I–III pancreatic adenocarcinoma. Am Surg 59:772–781.

    PubMed  CAS  Google Scholar 

  10. Hoffman JP, Weese JL, Ahmad N, Coia LR, Litwin S, Engstrom PF. 1995. Preoperative chemotherapy and radiation therapy for patients with pancreatic carcinoma without demonstrable metastatic disease: the Fox Chase Cancer Center experience. Semin Surg Oncol 11:141–148.

    Google Scholar 

  11. Nitecki SS, Sarr MG, Colby TV, van Heerden. 1995. Long-term survival after resection for ductal adenocarcinoma of the pancreas: is it really improving? Ann Surg 221:59–66.

    PubMed  CAS  Google Scholar 

  12. Crile G Jr. 1970. The advantages of bypass operations over radical pancreaticoduodenectomy in the treatment of pancreatic carcinoma. Surg Gynecol Obstet 130:1048–1053.

    Google Scholar 

  13. Shapiro TM. 1975. Adenocarcinoma of the pancreas: a statistical analysis of biliary bypass vs. Whipple resection in good risk patients. Ann Surg 182:715–721.

    PubMed  CAS  Google Scholar 

  14. Hertzberg J. 1974. Pancreatico-duodenal resection and bypass operation in patients with carcinoma of the head of the pancreas, ampulla, and distal end of the common duct. Acta Chir Scand 140:523–527.

    PubMed  CAS  Google Scholar 

  15. Bergstrand O, Ahlberg J, Ewerth S, Hellers G, Holmstrom B. 1978. A retrospective study of carcinoma of the pancreas with special reference to the results of surgical treatment. Acta Chir Scand Suppl 482:26–28.

    PubMed  CAS  Google Scholar 

  16. Grace PA, Pitt HA, Tompkins RK. 1986. Decreased morbidity and mortality after pancreaticoduodenectomy. Am J Surg 151:141–149.

    PubMed  CAS  Google Scholar 

  17. Trede M. 1985. The surgical treatment of pancreatic carcinoma. Surgery 97:28–35.

    PubMed  CAS  Google Scholar 

  18. Cameron JL, Pitt HA, Yeo CJ, Lillimoe KD, Kaufman HS, Coleman J. 1993. One hundred and forty-five consecutive pancreaticoduodenectomies without mortality. Ann Surg 217:430–438.

    PubMed  CAS  Google Scholar 

  19. Freeny PC, Marks WM, Ryan JA, Traverso LW. 1988. Pancreatic ductal adenocarcinoma: diagnosis and staging with dynamic CT. Radiology 166:125–133.

    PubMed  CAS  Google Scholar 

  20. Olen R, Pickleman J, Freeark RJ. 1989. Less is better: the diagnostic workup of the patient with obstructive jaundice. Arch Surg 124:791–795.

    PubMed  CAS  Google Scholar 

  21. Warshaw AL, Gu Z, Wittenberg J, Waltman AC. 1990. Preoperative staging and assessment of resectability of pancreatic cancer. Arch Surg 125:230–233.

    PubMed  CAS  Google Scholar 

  22. Cameron JL. 1995. The current management of carcinoma of the head of the pancreas. Ann Rev Med 46:361–370.

    PubMed  CAS  Google Scholar 

  23. McFarland EG, Kaufman JA, Saini S, Halpern EF, Lu DSK, Waltman AC, Warshaw AL. 1996. Preoperative staging of cancer of the pancreas: value of MR angiography versus conventional angiography in detecting portal venous invasion. Am J Roentgenol 166:37–43.

    CAS  Google Scholar 

  24. Warshaw AL, Tepper JE, Shipley WU. 1986. Laparoscopy in the staging and planning of therapy for pancreatic cancer. Am J Surg 151:76–80.

    PubMed  CAS  Google Scholar 

  25. Fernandez-Del Castillo C, Rattner DW, Warshaw AL. 1995. Further experience with laparoscopy and peritoneal cytology in the staging of pancreatic cancer. Br J Surg 82:1127–1129.

    PubMed  CAS  Google Scholar 

  26. Warshaw AL. 1991. Implications of peritoneal cytology for staging of early pancreatic cancer. Am J Surg 161:472–478.

    Google Scholar 

  27. Leach SD, Rose JA, Lowy AM, Lee JE, Charnsangavej C, Abbruzzesse JL, Katz RL, Evans DB. 1995. Significance of peritoneal cytology in patients with potentially resectable adenocarcinoma of the pancreatic head. Surgery 118:472–478.

    PubMed  CAS  Google Scholar 

  28. Tillou A, Schwartz MR, Jordan PH Jr. 1996. Percutaneous needle biopsy of the pancreas: when should it be performed? World J Surg 20:283–287.

    PubMed  CAS  Google Scholar 

  29. Zerbey AL III, Lee MJ, Brugge WR, Mueller PR. 1996. Endoscopic sonography of the upper gastrointestinal tract and pancreas. Am J Roentgenol 166:45–50.

    Google Scholar 

  30. Weiss S, Skibber JM, Mohuiddin M, Rosato FE. 1985. Rapid intra-abdominal spread of pancreatic cancer: influence of multiple operative biopsy procedures. Arch Surg 120:415–416.

    PubMed  CAS  Google Scholar 

  31. Janes RH Jr, Niederhuber JE, Chmiel JS, Winchester DP, Ocwieja KC, Karneil LH, Clive RE, Menck HR. 1996. National patterns of care for pancreatic cancer. Ann Surg 223:261–272.

    PubMed  Google Scholar 

  32. Moossa AR, Levin B. 1981. The diagnosis of ‘early’ pancreatic cancer: the University of Chicago experience. Cancer 47:1688–1697.

    PubMed  CAS  Google Scholar 

  33. Gastrointestinal Tumor Study Group. 1987. Further evidence of effective adjuvant combined radiation and chemotherapy following curative resection of pancreatic cancer. Cancer 59:2006–2010.

    Google Scholar 

  34. Tepper J, Nardi G, Suit H. 1976. Carcinoma of the pancreas: review of MGH experience from 1963 to 1973: analysis of surgical failure and implications for radiation therapy. Cancer 37:1519–1524.

    PubMed  CAS  Google Scholar 

  35. Ishikawa O, Ohigashi H, Imaoka S, Teshima T, Inoue T, Sasaki Y, Iwanaga T, Nakaizumi A. 1991. Concomitant benefit of preoperative irradiation in preventing pancreas fistula formation after pancreatoduodenectomy. Arch Surg 126:885–889.

    PubMed  CAS  Google Scholar 

  36. Pilepich MV, Miller HH. 1980. Preoperative irradiation in carcinoma of the pancreas. Cancer 46:1945–1949.

    PubMed  CAS  Google Scholar 

  37. Kopelson G. 1983. Curative surgery for adenocarcinoma of the pancreas/ampulla of Vater: the role of adjuvant pre or postoperative radiation therapy. Int J Radiat Oncol Biol Phys 9:911–915.

    PubMed  CAS  Google Scholar 

  38. Weese JL, Nussbaum ML, Paul AR, Engstrom PF, Solin LJ, Kowalyshyn MJ, Hoffman JP. 1990. Increased resectability of locally advanced pancreatic and periampullary carcinoma with neoadjuvant chemoradiotherapy. Int J Pancreatol 7:177–185.

    PubMed  CAS  Google Scholar 

  39. Evans DB, Rich TA, Byrd DR, Cleary KR, Connelly JH, Levin B, Charnsangavej C, Fenoglio CJ, Ames FC. 1992. Preoperative chemoradiation and pancreaticoduodenectomy for adenocarcinoma of the pancreas. Arch Surg 127:1335–1339.

    PubMed  CAS  Google Scholar 

  40. Jessup JM, Steele G Jr, Mayer RJ, Posner M, Busse P, Cady B, Stone M, Jenkins R, Osteen R. 1993. Neoadjuvant therapy for unresectable pancreatic adenocarcinoma. Arch Surg 128:559–564.

    PubMed  CAS  Google Scholar 

  41. Wanebo HJ, Posner M, Glicksman A, Stegman J, Koness J, Veziridis M. 1991. Integrated modality protocol for carcinoma of the pancreas: pilot program (abstract). Proc Am Soc Clin Oncol 10:158.

    Google Scholar 

  42. Hoffman JP, Weese JL, Lipsitz S, Solin LJ, Benson AB III, Pisansky TM, Dalton A. 1995. Preoperative chemoradiation for patients with resectable pancreatic adenocarcinoma: an Eastern Cooperative Oncology Group (ECOG) Phase II study (Abstract). Proc Am Soc Clin Oncol 14:201.

    Google Scholar 

  43. Staley CA, Lee JE, Cleary KR, Abbruzzese JL, Fenoglio CJ, Rich TA, Evans DB. 1996. Preoperative chemoradiation, pancreaticoduodenectomy, and intraoperative radiation therapy for adenocarcinoma of the pancreatic head. Am J Surg 171:118–125.

    PubMed  CAS  Google Scholar 

  44. Fuhrman GM, Leach SD, Staley CA, Cusack JC, Charnsangavej C, Cleary KR, El-Naggar AK, Fenoglio CJ, Lee JE, Evans DB. 1996. Rationale for en bloc resection in the treatment of pancreatic adenocarcinoma adherent to the superior mesenteric-portal vein confluence. Ann Surg 223:154–162.

    PubMed  CAS  Google Scholar 

  45. Klempnauer J, Ridder GJ, Bektas H, Pichlmayer R. 1996. Extended resection of ductal pancreatic cancer — impact on operative risk and prognosis. Oncology 53:47–53.

    PubMed  CAS  Google Scholar 

  46. Whittington R, Bryer MP, Haller DG, Solin LJ, Rosato EF. 1991. Adjuvant therapy of resected adenocarcinoma of the pancreas. Int J Radiat Oncol Biol Phys 21:1137–1143.

    PubMed  CAS  Google Scholar 

  47. Foo ML, Gunderson LL, Nagorney DM, Mcllrath DC, vanHeerden JA, Robinow JS, Kvols LK, Garton GR, Martenson JA, Cha SS. 1993. Patterns of failure in grossly resected pancreatic ductal adenocarcinoma treated with adjuvant irradiation + 5 fluorouracil. Int J Radiat Oncol Biol Phys 26:483–489.

    PubMed  CAS  Google Scholar 

  48. Yeo CJ, Cameron JL, Lillemoe KD, Sitzmann CD, Hruban RH, Goodman SN, Dooley WC, Coleman J, Pitt HA. 1995. Pancreaticoduodenectomy for cancer of the head of the pancreas: 201 patients. Ann Surg 221:721–733.

    PubMed  CAS  Google Scholar 

  49. Evans DB, Abbruzzese, Cleary KR, Lee JE, Bucholz DJ, Rich TA. 1995. Rapidfractionation pre-operative chemoradiation for malignant periampullary neoplasms. J R Coll Surg Edinb 40:319–323.

    PubMed  CAS  Google Scholar 

  50. Conlon KC, Klimstra DS, Brennan MF. 1996. Long-term survival after curative resection for pancreatic ductal adenocarcinoma: clinicopathologic analysis of 5-year survivors. Ann Surg 223:273–279.

    PubMed  CAS  Google Scholar 

  51. Klempnauer J, Ridder GJ, Bektas H, Pichlmayer R. 1995. Surgery for exocrine pancreatic cancer — who are the 5-and 10-year survivors? Oncology 52:353–359.

    PubMed  CAS  Google Scholar 

  52. Gudjonnson B. 1995. Carcinoma of the pancreas: critical analysis of costs, results of resections, and the need for standardized reporting. J Am Coll Surg 181:483–503.

    Google Scholar 

  53. van den Bosch RP, van der Shelling GP, Klinkenbijl JHG, Mulder PGH, van Blankenstein M, Jeekel J. 1994. Guidelines for the application of surgery and endoprosthesis in the palliation of obstructive jaundice in advanced cancer of the pancreas. Ann Surg 219:18–24.

    PubMed  Google Scholar 

  54. Bornman PC, Tobias R, Harries-Jones EP, Van Stiegmann G, Terblanche J. 1986. Prospective controlled trial of transhepatic biliary endoprosthesis versus bypass surgery for incurable carcinoma of head of pancreas. Lancet 1:69–71.

    PubMed  CAS  Google Scholar 

  55. Andersen JR, Sorensen SM, Kruse A, Rokkjaer M, Matzen P. 1989. Randomised trial of endoscopic endoprosthesis versus operative bypass in malignant obstructive jaundice. Gut 30:1132–1135.

    PubMed  CAS  Google Scholar 

  56. Speer AG, Russell RCG, Hatfield ARW, MacRae KD, Cotton PB, Mason RR, Leung JWC, Houghton J, Lennon CA. 1987. Randomised trial of endoscopic versus percutaneous stent insertion in malignant obstructive jaundice. Lancet 2:57–62.

    PubMed  CAS  Google Scholar 

  57. O’Brien S, Hatfield ARW, Craig PI, Williams SP. 1995. A three year follow up of self expanding metal stents in the endoscopic palliation of longeterm survivors with malignant biliary obstruction. Gut 36:618–621.

    PubMed  Google Scholar 

  58. Davids PHP, Groen AK, Rauws EAJ, Tytgat GNJ, Huibregtse K. 1992. Randomised trial of self-expanding metal stents versus polyethylene stents for distal malignant biliary obstruction. Lancet 340:1488–1492.

    PubMed  CAS  Google Scholar 

  59. Silvis SE, Sievert CE Jr, Vennes JA, Abeyta BK, Brennecke LH. 1994. Comparison of covered versus uncovered wire mesh stents in the canine biliary tract. Gastrointest Endosc 40(1):17–21.

    PubMed  CAS  Google Scholar 

  60. Seitz U, Vadeyar H, Soehendra N. 1994. Prolonged patency with a new-design teflon biliary prosthesis. Endoscopy 26(5):478–482.

    PubMed  CAS  Google Scholar 

  61. Singh SM, Reber HA. 1989. Surgical palliation for pancreatic cancer. Surg Clin North Am 69:599–611.

    PubMed  CAS  Google Scholar 

  62. Sarr MG, Cameron JL. 1982. Surgical management of unresectable carcinoma of the pancreas. Surgery 92:123–133.

    Google Scholar 

  63. Sarfeh JI, Rypins EB, Jakowatz JG, Juler GL. 1988. A prospective randomized clinical investigation of cholecystoenterostomy and choledochoenterostomy. Am J Surg 155:411–414.

    PubMed  CAS  Google Scholar 

  64. Huguier M, Baumel H, Manderscheid J, Houry S, Fabre J. 1993. Surgical palliation for unresected cancer of the exocrine pancreas. Eur J Surg Oncol 19:342–347.

    PubMed  CAS  Google Scholar 

  65. Brickner WM. 1911. 1000 Surgical Suggestions, 4th ed. Surgery Publishing: New York.

    Google Scholar 

  66. Weaver DW, Wiencek RG, Bouwman DL, Walt AJ. 1987. Gastrojejunostomy: is it helpful for patients with pancreatic cancer? Surgery 102:608–613.

    PubMed  CAS  Google Scholar 

  67. Lucas CE, Ledgerwood AM, Bender JS. 1991. Antrectomy with gastrojejunostomy for unresectable pancreatic cancer-causing duodenal obstruction. Surgery 110(4):583–590.

    PubMed  CAS  Google Scholar 

  68. Lucas CE, Ledgerwood AM, Saxe JM, Bender JS, Lucas WF. 1994. Antrectomy: a safe and effective bypass for unresectable pancreatic cancer. Arch Surg 129:795–799.

    PubMed  CAS  Google Scholar 

  69. Rhodes M, Nathanson L, Fielding G. 1995. Laparoscopic biliary and gastric bypass: a useful adjunct in the treatment of carcinoma of the pancreas. Gut 36:778–780.

    PubMed  CAS  Google Scholar 

  70. Shimi S, Banting S, Cuschieri A. 1992. Laparoscopy in the management of pancreatic cancer: endoscopic cholecystojejunostomy for advanced disease. Br J Surg 79:317–319.

    PubMed  CAS  Google Scholar 

  71. Saltzburg D, Foley KM. 1989. Management of pain in pancreatic cancer. Surg Clin North Am 69:629–649.

    PubMed  CAS  Google Scholar 

  72. Cuschieri A, Shimi SM, Crosthwaite G, Joypaul V. 1994. Bilateral thorocoscopic splanchnicectomy through a posterior thorocoscopic approach. J R Coll Surg Edinb 39:44–47.

    PubMed  CAS  Google Scholar 

  73. Flanigan DP, Kraft RO. 1978. Continuing experience with palliative chemical splanchniectomy. Arch Surg 113:509–511.

    PubMed  CAS  Google Scholar 

  74. Bridenbaugh LD, Moore DC, Campbell DD. 1964. Management of upper abdominal cancer pain: treatment with celiac plexus block with alcohol. JAMA 190(10):877–880.

    PubMed  CAS  Google Scholar 

  75. Lillemoe KD, Cameron JL, Kaufman HS, Yeo CJ, Pitt HA, Sauter PK. 1993. Chemical splanchnicectomy in patients with unresectable pancreatic cancer. Ann Surg 217:447–457.

    PubMed  CAS  Google Scholar 

  76. Cubilla AL, Fitzgerald PJ. 1975. Morphological patterns of primary nonendocrine human pancreas carcinoma. Cancer Res 35:2234–2248.

    PubMed  CAS  Google Scholar 

  77. Bodner E, Glaser K, Weger AR. 1991. Rare exocrine pancreatic cancer — operative treatment. Eur J Surg Oncol 17:183–189.

    PubMed  CAS  Google Scholar 

  78. DeJong SA, Pickleman J. 1993. Nonductal tumors of the pancreas: the importance of laparotomy. Arch Surg 128:730–736.

    CAS  Google Scholar 

  79. Talamini MA, Pitt HA, Hruban RH, Boitnott JK, Coleman J, Cameron JL. 1992. Spectrum of cystic tumors of the pancreas. Am J Surg 163:117–124.

    PubMed  CAS  Google Scholar 

  80. Delcore R, Thomas JH, Forster J, Hermreck AS. 1992. Characteristics of cystic neoplasms of the pancreas and results of aggressive surgical treatment. Am J Surg 164:437–442.

    PubMed  CAS  Google Scholar 

  81. Hodgkinson DJ, ReMine WH, Weiland LH. 1978. A clinicopathologic study of 21 cases of pancreatic cystadenocarcinoma. Ann Surg 188:679–684.

    PubMed  CAS  Google Scholar 

  82. Sclafani LM, Reuter VE, Coit DG, Brennan MF. 1991. The malignant nature of papillary and cystic neoplasm of the pancreas. Cancer 68:153–158.

    PubMed  CAS  Google Scholar 

  83. Yang EYT, Joehl RJ, Talamonti MS. 1994. Cystic neoplasms of the pancreas. J Am Coll Surg 179:747–757.

    PubMed  CAS  Google Scholar 

  84. Stamm B, Burger H, Hollinger A. 1987. Acinar cell cystadenocarcinoma of the pancreas. Cancer 60:2542–2547.

    PubMed  CAS  Google Scholar 

  85. Brenin DR, Talamonti MS, Yang EYT, Sener SF, Haines GK, Joehl RJ, Nahrwold DL. 1995. Cystic neoplasms of the pancreas: a clinicopathologic study, including DNA flow cytometry. Arch Surg 130:1048–1054.

    PubMed  CAS  Google Scholar 

  86. Howard JM. 1989. Cystic neoplasms and true cysts of the pancreas. Surg Clin North Am 69:651–664.

    PubMed  CAS  Google Scholar 

  87. Bergmann LS, Russell JC, Gladstone A, Devers T. 1992. Cystadenomas of the pancreas. Am Surg 58:65–71.

    PubMed  CAS  Google Scholar 

  88. Gazelle GS, Mueller PR, Raafat N, Halpern EF, Cardenose G, Warshaw AL. 1993. Cystic neoplasms of the pancreas: evaluation with endoscopic retrograde pancreatography. Radiology 188:633–636.

    PubMed  CAS  Google Scholar 

  89. Ohta T, Nagakawa T, Akiyama T, Fukushima W, Ueno K, Miyazaki I, Suzuki M, Matsui O, Terada T, Nakanuma Y, Kanno M, Uogishi M, Sodani H. 1992. The ‘duct-ectatic’ variant of mucinous cystic neoplasm of the pancreas: clinical and radiologic studies of seven cases. Am J Gastroenterol 87:300–304.

    PubMed  CAS  Google Scholar 

  90. Tian F, Myles J, Howard JM. 1992. Mucinous ductal ectasia of latent malignancy: an emerging clinicopathologic entity. Surgery 111:109–113.

    PubMed  CAS  Google Scholar 

  91. Iselin CE, Meyer P, Hauser H, Kurt AM, Vermeulen BJM, Rohner A. 1993. Computed tomography and fine-needle aspiration cytology for preoperative evaluation of the pancreas. Br J Surg 80:1166–1169.

    PubMed  CAS  Google Scholar 

  92. Pinto MM, Le vine RH. 1992. Carcinoembryonic antigen assay in fine needle aspirate of pancreas: a diagnostic adjunct to cytology. Am J Gastroenterol 87:530–533.

    PubMed  CAS  Google Scholar 

  93. Yang JM, Southern JF, Warshaw AL, Lewandrowski KB. 1996. Proliferation tissue polypeptide antigen distinguishes malignant mucinous cystadenocarcinomas from benign cystic tumors and pseudocysts. Am J Surg 171:126–130.

    PubMed  CAS  Google Scholar 

  94. Compagno J, Oertel JE. 1978. Mucinous cystic neoplasms of the pancreas with overt and latent malignancy (cystadenocarcinoma and cystadenoma). A clinicopathological study of 41 cases. Am J Clin Pathol 69:573–580.

    PubMed  CAS  Google Scholar 

  95. George DH, Murphy F, Michalski R, Ulmer BG. 1989. Serous cystadenocarcinoma of the pancreas: a new entity? Am J Surg Pathol 13:61–66.

    PubMed  CAS  Google Scholar 

  96. Yoshimi N, Sugie S, Tanaka T, Aijin W, Bunai Y, Tatematsu A, Okada T, Mori H. 1992. A rare case of serous cystadenocarcinoma of the pancreas. Cancer 69:2449–2453.

    PubMed  CAS  Google Scholar 

  97. Ohta T, Nagakawa T, Itoh H, Fonseca L, Miyazaki I, Terada T. 1993. A case of serous cystadenoma of the pancreas with focal malignant changes. Int J Pancreatol 14:283–289.

    PubMed  CAS  Google Scholar 

  98. Warshaw AL, Compton CC, Lewandrowski K, Cardenosa G, Mueller PR. 1990. Cystic tumors of the pancreas: new clinical, radiologic, and pathologic observations in 67 patients. Ann Surg 212:432–445.

    PubMed  CAS  Google Scholar 

  99. Pyke CM, vanHeerdon JA, Colby TV, Sarr MG, Weaver AL. 1992. The spectrum of serous cystadenoma of the pancreas: clinical, pathologic, and surgical aspects. Ann Surg 215:132–139.

    PubMed  CAS  Google Scholar 

  100. Frantz VK. 1959. Tumors of the pancreas. Armed Forces Inst Pathol 7:fasc. 27,28,27–73.

    Google Scholar 

  101. Hamoudi AB, Misugi K, Grosfeld JL, Reiner CB. 1970. Papillary epithelial neoplasm of pancreas in a child. Cancer 26:1126–1134.

    PubMed  CAS  Google Scholar 

  102. Jeng LB, Chen M, Tang R. 1993. Solid and papillary neoplasm of the pancreas: emphasis on surgical treatment. Am J Surg 128:433–436.

    CAS  Google Scholar 

  103. Klimstra DS, Heffess CS, Oertel JE, Rosai J. 1992. Acinar cell carcinoma of the pancreas: a clinicopathologic study of 28 cases. Am J Surg Pathol 16:815–837.

    PubMed  CAS  Google Scholar 

  104. Cantrell BB, Cubilla AL, Erlandson RA, Fortner J, Fitzgerald PJ. 1981. Acinar cell cystadenocarcinoma of human pancreas. Cancer 47:410–416.

    PubMed  CAS  Google Scholar 

  105. Prayer L, Schurawitzki H, Mallek R, Mostbeck G. 1992. CT in pancreatic involvement of non-Hodgkin lymphoma. Acta Radiol 33:123–127.

    PubMed  CAS  Google Scholar 

  106. Tuchek JM, DeJong SA, Pickleman J. 1993. Diagnosis, surgical intervention, and prognosis of primary pancreatic lymphoma. Am Surg 59:513–518.

    PubMed  CAS  Google Scholar 

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Hoffman, J.P., Pendurthi, T.K., Johnson, D.E. (1998). Management of exocrine carcinoma of the pancreas. In: Benson, A.B. (eds) Gastrointestinal Oncology. Cancer Treatment and Research, vol 98. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-4977-2_3

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