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Pancreatic Neoplasms: HELP
Articles by Sandeep P. Deshmukh
Based on 4 articles published since 2009
(Why 4 articles?)

Between 2009 and 2019, Sandeep Deshmukh wrote the following 4 articles about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Review Pancreatic Lymphangioma: A Case Report and Literature Review. 2019

Karajgikar, Jay / Deshmukh, Sandeep. ·Department of Radiology, Thomas Jefferson University School of Medicine, Philadelphia, PA. ·J Comput Assist Tomogr · Pubmed #30371621.

ABSTRACT: We report a case of a 29-year-old woman with a pancreatic lymphangioma who presented clinically as a case of acute pancreatitis. Lymphangiomas are benign tumors of vascular origin with lymphatic differentiation, most commonly found in the head and neck. Pancreatic lymphangiomas are extremely rare, accounting for only 1% of abdominal lymphangiomas, with approximately 60 cases reported in the literature. Although imaging findings are characteristic and can point to the diagnosis, confirmation with fine needle aspiration and histopathologic correlation is necessary. Although these lesions are benign, they can often present a diagnostic dilemma and can be mistaken for other cystic pancreatic lesions, namely, pseudocysts, cysts, cystadenomas, and cystadenocarcinomas.

2 Clinical Trial Phase I evaluation of intravenous ascorbic acid in combination with gemcitabine and erlotinib in patients with metastatic pancreatic cancer. 2012

Monti, Daniel A / Mitchell, Edith / Bazzan, Anthony J / Littman, Susan / Zabrecky, George / Yeo, Charles J / Pillai, Madhaven V / Newberg, Andrew B / Deshmukh, Sandeep / Levine, Mark. ·Myrna Brind Center of Integrative Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America. ·PLoS One · Pubmed #22272248.

ABSTRACT: BACKGROUND: Preclinical data support further investigation of ascorbic acid in pancreatic cancer. There are currently insufficient safety data in human subjects, particularly when ascorbic acid is combined with chemotherapy. METHODS AND FINDINGS: 14 subjects with metastatic stage IV pancreatic cancer were recruited to receive an eight week cycle of intravenous ascorbic acid (three infusions per week), using a dose escalation design, along with standard treatment of gemcitabine and erlotinib. Of 14 recruited subjects enrolled, nine completed the study (three in each dosage tier). There were fifteen non-serious adverse events and eight serious adverse events, all likely related to progression of disease or treatment with gemcitabine or erlotinib. Applying RECIST 1.0 criteria, seven of the nine subjects had stable disease while the other two had progressive disease. CONCLUSIONS: These initial safety data do not reveal increased toxicity with the addition of ascorbic acid to gemcitabine and erlotinib in pancreatic cancer patients. This, combined with the observed response to treatment, suggests the need for a phase II study of longer duration. TRIAL REGISTRATION: Clinicaltrials.gov NCT00954525.

3 Article Common Hepatic Artery Abutment or Encasement Is an Adverse Prognostic Factor in Patients with Borderline and Unresectable Pancreatic Cancer. 2018

Kozak, Geoffrey M / Epstein, Jeffrey D / Deshmukh, Sandeep P / Scott, Benjamin B / Keith, Scott W / Lavu, Harish / Yeo, Charles J / Winter, Jordan M. ·Jefferson Pancreas, Biliary and Related Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA. · Department of Radiology, Jefferson Pancreas, Biliary and Related Cancer Center, Philadelphia, PA, USA. · Sidney Kimmel Medical College at TJU, Jefferson Pancreas, Biliary and Related Cancer Center, Philadelphia, PA, USA. · Department of Surgery, Jefferson Pancreas, Biliary and Related Cancer Center, Philadelphia, PA, USA. · Department of Surgery, Jefferson Pancreas, Biliary and Related Cancer Center, Philadelphia, PA, USA. Jordan.Winter@jefferson.edu. · Department of Surgery, Thomas Jefferson University, 1025 Walnut St, College Building, Suite 605, Philadelphia, PA, 19107, USA. Jordan.Winter@jefferson.edu. ·J Gastrointest Surg · Pubmed #29139084.

ABSTRACT: BACKGROUND: Localized and unresectable pancreatic ductal adenocarcinoma (PDA) comprises one third of new diagnoses and includes borderline resectable (BR) and locally advanced (LA) unresectable disease. In a cohort of patients who were treated and followed at a single institution, we assessed clinical and radiographic predictors of outcome. METHODS: The study included 69 consecutive patients with BR or LA PDA. Serial imaging studies were reviewed by both a pancreatic surgeon and a radiologist for vascular abutment or encasement by cancer, and they were recorded. RESULTS: The cohort included 25 patients with BR and 44 patients with LA PDA, with median overall survivals (OS) of 15 and 14 months, respectively (p = 0.802). Fifteen patients were resected (22%), with a median OS of 21 months from diagnosis (HR 2.50, p = 0.006) and 13 months from resection. Median OS from diagnosis was 33 months in patients without lymph node metastases at resection (n = 10), but just 17 months with lymph node metastases (n = 5, HR = 8.95, p = 0.011). There were 12 two-year survivors in the total cohort (17%), and seven of them never underwent resection. First-line treatments consisted of gemcitabine (n = 13), modern first-line combinations (FOLFIRNOX or gemcitabine/nab-paclitaxel, n = 24), or alternative multi-agent therapies (n = 32); there were no statistical differences between treatment subgroups (OS of 10, 13, and 16 months, respectively). Common hepatic artery (CHA) abutment or encasement at diagnosis was associated with poor survival (adjusted hazard ratio, CHA abutment = 2.47 (p = 0.015) and CHA encasement = 2.16 (p = 0.036)). CONCLUSION: In this cohort, common hepatic arterial abutment or encasement and residual lymph node disease at resection portended a particularly poor outcome in patients with localized, unresectable PDA.

4 Article Acute nontraumatic splenic infarctions at a tertiary-care center: causes and predisposing factors in 123 patients. 2016

Cox, Mougnyan / Li, Zhenteng / Desai, Vishal / Brown, Lauren / Deshmukh, Sandeep / Roth, Christopher G / Needleman, Laurence. ·Radiology Resident, Thomas Jefferson University Hospitals, 132 South 10th Street, 1087 Main Building, Philadelphia, PA, 19107, USA. mougnyan.cox@gmail.com. · Radiology Resident, Thomas Jefferson University Hospitals, 132 South 10th Street, 1087 Main Building, Philadelphia, PA, 19107, USA. · Temple University School of Medicine, 3500 North Broad Street, Suite 124, Philadelphia, PA, 19140, USA. · Thomas Jefferson University Hospitals, 132 South 10th Street, 1087 Main Building, Philadelphia, PA, 19107, USA. ·Emerg Radiol · Pubmed #26797023.

ABSTRACT: Acute splenic infarcts classically present with left upper quadrant pain, but may be discovered incidentally in many hospitalized patients with otherwise vague complaints. The purpose of our study was to document causes or predisposing conditions in patients found to have acute splenic infarctions on imaging. Following IRB approval, a retrospective review of an imaging database from May 2008 to May 2015 was performed for cases of acute splenic infarctions. The electronic medical record was then reviewed for potential predisposing factors or known causes. Specific note was made of cases with active malignancy, vascular disorders, or inflammatory conditions with an increased risk of vasculopathy. Echocardiogram and electrocardiogram results were reviewed when available. One hundred twenty-three patients with acute splenic infarcts were identified, 65 female and 58 male. The average age was 57 years (range of 22 to 88). Active malignancy was present in 40 patients or 33 %. The most common malignancy in patient with nontraumatic splenic infarctions was pancreatic cancer, present in 16 patients (13 %). In these patients, splenic infarction was due to direct invasion of vessels in the splenic hilum. Acute pancreatitis (severe) was directly responsible for splenic infarction in seven additional cases (6 %). Additional visceral infarcts were present in 18 patients (15 %), most commonly concomitant hepatic or renal infarcts. Documented atrial fibrillation was present in 12 patients, but only 2 cases of left-sided cardiac thrombi were seen on CT (1 atrial, and 1 ventricular thrombus). Eight cases of endocarditis with valvular vegetations were documented on echocardiography (7 %). Splenomegaly was present in 32 patients (26 %) with acute splenic infarction. In patients with nontraumatic splenic infarctions, there appears to be a relatively high association with active malignancy (up to a third of patients). Pancreatic disorders, malignant and inflammatory, also appear to be an important cause of splenic infarction, presumably due to the close proximity of the pancreas to the splenic vessels.