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Pancreatic Neoplasms: HELP
Articles by Giorgio Ercolani
Based on 10 articles published since 2010
(Why 10 articles?)
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Between 2010 and 2020, G. Ercolani wrote the following 10 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review [Pancreatic carcinoma presenting with invasion of the vena porta or the superior mesenteric vein: our experience and review of the literature]. 2010

Ramacciato, G / Mercantini, P / Petrucciani, N / Romano, C / Nigri, G / Aurello, P / D'Angelo, F / Ravaioli, M / Del Gaudio, M / Cucchetti, A / Ercolani, G. ·Università Sapienza di Roma, II Facoltà di Medicina, Ospedale Sant'Andrea, Roma, Italia. ·Minerva Chir · Pubmed #21224793.

ABSTRACT: AIM: Adenocarcinoma of the pancreas can present with invasion of the vena porta or the superior mesenteric vein (SMV). Pancreatectomy with resection of the vena porta and/or the SMV remains controversial although the procedure is potentially curative. The aim of this study was to validate the indication for resection on the basis of our experience and evidence from recently published studies. METHODS: Studies published in the last 10 years on pancreatectomy (duodenocephalopancreatectomy, total and distal pancreatectomy) with resection of the vena porta and/or the SMV were retrieved from the Medline database and reviewed. A total of 18 studies meeting the inclusion criteria were analyzed for information about indications, type of intervention, use of adjuvant therapies, histopathology, perioperative results and survival in 620 patients with adenocarcinoma of the pancreas undergoing pancreatectomy with resection of the vena porta and the SMV. This data set was then compared with our experience with this procedure from the last 3 years. RESULTS: The mortality and postoperative complication rates varied between 0% and 7.7% and 12.5% and 54%, respectively. The median survival varied from 12 to 22 months; the 1 year survival rate was between 31% and 83%; the 5-year survival rate was between 9 and 18% according to the studies reviewed. CONCLUSION: On the basis of evidence from the literature and our experience, en bloc resection of the vena porta and/or the SMV during pancreatectomy appears to be a safe procedure with acceptable outcomes, and should be considered in patients with pancreatic cancer presenting with venous invasion. Venous resection increases the surgical cure rate, prolonging survival in patients selected according to correct indications.

2 Article Searching for novel multimodal treatments in oligometastatic pancreatic cancer. 2020

Filippini, D M / Grassi, E / Palloni, A / Carloni, R / Casadei, R / Ricci, C / Serra, C / Ercolani, G / Brandi, G / Di Marco, M. ·Department of Experimental, Diagnostic and Specialty Medicine University of Bologna, Sant'Orsola-Malpighi Hospital, Massarenti Street 11, 40100, Bologna, Italy. · Department of Experimental, Diagnostic and Specialty Medicine University of Bologna, Sant'Orsola-Malpighi Hospital, Massarenti Street 11, 40100, Bologna, Italy. elisa.grax@gmail.com. · Department of Medical and Surgical Sciences, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy. · Department of Organ Failure and Transplantation, Ultrasound Unit, Sant'Orsola-Malpighi Hospital, Bologna, Italy. · General and Oncologic Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, Forlì, Italy. ·BMC Cancer · Pubmed #32228504.

ABSTRACT: BACKGROUND: Metastatic pancreatic cancer has a median overall survival of less than 12 months, even if treated with chemotherapy. Selected patients with oligometastatic disease could benefit from multimodal treatments connecting chemotherapy and surgical treatment or radiofrequency ablation (RFA) of metastases. CASE PRESENTATION: We present a patient with oligometastatic pancreatic cancer recurrence who was successfully treated with a multimodal therapeutic approach. A 57-year-old male initially presenting with resectable pancreatic cancer underwent pancreatoduodenectomy. The histopathological diagnosis revealed ductal pancreatic adenocarcinoma with positive surgical resection margins and negative lymph nodes. He completed six cycles of adjuvant therapy with gemcitabine (1000 mg/mq 1,8,15q 28), followed by external radiotherapy (54 Gy in 25 fractions) associated with gemcitabine 50 mg/mq twice weekly. Three years later, the patient developed multiple liver metastases, and he started FOLFIRINOX (oxaliplatin 85 mg/mq, irinotecan 180 mg/mq, leucovorin 400 mg/mq and fluorouracil 400 mg/mq given as a bolus followed by 2400 mg/mq as a 46 h continuous infusion,1q 14) as a first-line treatment. The CT scan showed a partial response after 6 cycles. After multidisciplinary discussion, the patient underwent a laparotomic metastasectomy of the three hepatic lesions. After additional postsurgical chemotherapy with 4 cycles of the FOLFIRINOX schedule, the patient remained free of recurrence for 12 months. A CT scan showed a new single liver metastasis, which was treated with radiofrequency ablation (RFA). A second radiofrequency ablation was performed when the patient developed another single liver lesion 12 months after the first RFA; currently, the patient is free from recurrence with an overall survival of 6 years from the diagnosis. CONCLUSIONS: Our case has benefited from successful multimodal treatment, including surgical and local ablative techniques and systemic chemotherapy. A multimodal approach may be warranted in selected patients with oligometastatic pancreatic cancer and could improve overall survival. Further research is needed to investigate this approach.

3 Article The impact of extent of pancreatic and venous resection on survival for patients with pancreatic cancer. 2019

Serenari, Matteo / Ercolani, Giorgio / Cucchetti, Alessandro / Zanello, Matteo / Prosperi, Enrico / Fallani, Guido / Masetti, Michele / Lombardi, Raffaele / Cescon, Matteo / Jovine, Elio. ·Department of Medical and Surgical Sciences, S. Orsola - Malpighi Hospital, Alma Mater Studiorum - University of Bologna, Bologna, Italy. · Department of Medical and Surgical Sciences, S. Orsola - Malpighi Hospital, Alma Mater Studiorum - University of Bologna, Bologna, Italy. Electronic address: giorgio.ercolani2@unibo.it. · Department of General Surgery, Maggiore Hospital - Bologna Local Health District, Bologna, Italy. ·Hepatobiliary Pancreat Dis Int · Pubmed #31230959.

ABSTRACT: BACKGROUND: Borderline resectable pancreatic cancer may require extended resections in order to achieve tumor-free margins, especially in the case of up-front resections, but it is important to know the limits of surgical therapy in this disease. This study aimed to investigate the impact of extent of pancreatic and venous resection on short- and long-term outcomes in patients with pancreatic adenocarcinoma (PDAC). METHODS: This was a retrospective study from a prospectively maintained database of pancreatic resections for PDAC. Short- and long-term outcomes were analyzed in patients having borderline resectable PDAC submitted to up-front total pancreatectomy (TP) or pancreaticoduodenectomy (PD) with simultaneous portal vein (PV) and/or superior mesenteric vein (SMV) resection. Venous resections were carried out as tangential venous resection (TVR) or segmental venous resection (SVR). Patients were divided into 4 groups: (1) PD + TVR, (2) PD + SVR, (3) TP + TVR, (4) TP + SVR. Uni- and multivariate Cox regression analysis were performed to identify factors associated with survival. RESULTS: Ninety-nine patients were submitted to simultaneous pancreatic and venous resection for PDAC. Among them, 25 were submitted to PD + TVR (25.3%), 12 to PD + SVR (12.1%), 23 to TP + TVR (23.2%), and 39 to TP + SVR (39.4%). Overall, major morbidity (Clavien-Dindo grade ≥ IIIA) was 26.3%. Thirty- and 90-day mortality were 3% and 11.1%, respectively. There were no significant differences among groups in terms of short-term outcomes. Median overall survival of patients submitted to PD + TVR was significantly higher than those to TP+SVR (29.5 vs 7.9 months, P = 0.001). Multivariate analysis identified TP (HR = 2.11; 95% CI: 1.31-3.44; P = 0.002) and SVR (HR = 2.01; 95% CI: 1.27-3.15; P = 0.003) as the only independent prognostic factors for overall survival. CONCLUSIONS: Up-front TP associated to SVR was predictive of worse survival in borderline resectable PDAC. Perioperative treatments in high-risk surgical groups may improve such poor outcomes.

4 Article Chemoradiotherapy (Gemox Plus Helical Tomotherapy) for Unresectable Locally Advanced Pancreatic Cancer: A Phase II Study. 2019

Passardi, Alessandro / Scarpi, Emanuela / Neri, Elisa / Parisi, Elisabetta / Ghigi, Giulia / Ercolani, Giorgio / Gardini, Andrea / La Barba, Giuliano / Pagan, Flavia / Casadei-Gardini, Andrea / Valgiusti, Martina / Ferroni, Fabio / Frassineti, Giovanni Luca / Romeo, Antonino. ·Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli n. 40, 47014 Meldola, Italy. alessandro.passardi@irst.emr.it. · Unit of Biostatistics and Clinical Trials, IRST-IRCCS, Via P. Maroncelli n. 40, 47014 Meldola, Italy. emanuela.scarpi@irst.emr.it. · Radiotherapy Unit, IRST-IRCCS, Via P. Maroncelli n. 40, 47014 Meldola, Italy. elisa.neri@irst.emr.it. · Radiotherapy Unit, IRST-IRCCS, Via P. Maroncelli n. 40, 47014 Meldola, Italy. elisabetta.parisi@irst.emt.it. · Radiotherapy Unit, IRST-IRCCS, Via P. Maroncelli n. 40, 47014 Meldola, Italy. giulia.ghigi@irst.emr.it. · General and Oncologic Surgery Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, Via C. Forlanini n. 34, 47121 Forlì, Italy. giorgio.ercolani@auslromagna.it. · Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti n. 9, 40138 Bologna, Italy. giorgio.ercolani@auslromagna.it. · General and Oncologic Surgery Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, Via C. Forlanini n. 34, 47121 Forlì, Italy. andrea.gardini@auslromagna.it. · General and Oncologic Surgery Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, Via C. Forlanini n. 34, 47121 Forlì, Italy. giuliano.labarba@tin.it. · Unit of Biostatistics and Clinical Trials, IRST-IRCCS, Via P. Maroncelli n. 40, 47014 Meldola, Italy. flavia.pagan@irst.emr.it. · Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli n. 40, 47014 Meldola, Italy. casadeigardini@gmail.com. · Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli n. 40, 47014 Meldola, Italy. martina.valgiusti@irst.emr.it. · Radiology Unit, IRST IRCCS, Via P. Maroncelli n. 40, 47014 Meldola, Italy. fabio.ferroni@irst.emr.it. · Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli n. 40, 47014 Meldola, Italy. luca.frassineti@irst.emr.it. · Radiotherapy Unit, IRST-IRCCS, Via P. Maroncelli n. 40, 47014 Meldola, Italy. antonino.romeo@irst.emt.it. ·Cancers (Basel) · Pubmed #31086093.

ABSTRACT: The aim of the study was to evaluate the safety and efficacy of a new chemo-radiotherapy regimen for patients with locally advanced pancreatic cancer (LAPC). Patients were treated as follows: gemcitabine 1000 mg/m

5 Article The Health Gain Obtainable from Pancreatic Resection for Adenocarcinoma in the Elderly. 2017

Cucchetti, Alessandro / Ercolani, Giorgio / Pezzilli, Raffaele / Cescon, Matteo / Frascaroli, Giacomo / Pinna, Antonio Daniele. ·Department of Medical and Surgical Sciences - DIMEC, S.Orsola - Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy. aleqko@libero.it. · S. Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy. aleqko@libero.it. · Department of Medical and Surgical Sciences - DIMEC, S.Orsola - Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy. · Surgical Oncology Unit, General Hospital Morgagni - Pierantoni, Forlì, Italy. · S. Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy. ·World J Surg · Pubmed #27826771.

ABSTRACT: BACKGROUND: In treating pancreatic ductal adenocarcinoma (PDAC), age does not represent a contraindication to surgery, even if aging is known to increase postoperative mortality and morbidity. Furthermore, long-term outcome remains poor and there is much debate on whether to operate or not in elderly patients. The aim of this study was to provide a general framework to evaluate the health gain obtainable from surgery for PDAC in relationship with age and tumor stage. METHODS: A Monte Carlo simulation model was built taking into consideration pertinent literature from population-based studies regarding surgical and non-surgical outcomes for stages I-II PDAC. The health gain obtainable from surgery, in comparison to the choice of not resecting patients, was measured through number needed-to-treat (NNT) calculation. RESULTS: Considering the typical stage I-II PDAC characteristics, the model showed that the mean lifespan after surgery was 28.1 ± 3.9 months and 9.3 ± 1.5 months after non-surgical therapies. The NNT with surgery in order to prevent one death at 5 years was 6 (95% CI 4-10), indicating an overall high gain obtainable from surgery. Sensitivity analyses on patient age and tumor stage suggested that starting from 76 years onward, the NNT progressively increases, resulting in a low cure rate of surgery in the elderly and becoming potentially harmful for patients aged above 80 years. These figures were more pronounced for tumor stages IIA and IIB. CONCLUSIONS: The present general framework suggests that the lifespan benefit obtainable from pancreatectomy in elderly patients is uncertain especially with the advancing of the tumor stage.

6 Article A comprehensive analysis on expected years of life lost due to pancreatic cancer. 2016

Cucchetti, Alessandro / Ercolani, Giorgio / Taffurelli, Giovanni / Serenari, Matteo / Maroni, Lorenzo / Pezzilli, Raffaele / Del Gaudio, Massimo / Ravaioli, Matteo / Cescon, Matteo / Pinna, Antonio D. ·Department of Medical and Surgical Sciences - DIMEC, S.Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy. Electronic address: aleqko@libero.it. · Department of Medical and Surgical Sciences - DIMEC, S.Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy. ·Pancreatology · Pubmed #26951889.

ABSTRACT: BACKGROUND: Pancreatic cancer represents a fatal malignancy leading to premature death and loss of life expectancy. The aim of the present study was to assess how many years of life are lost due to this cancer, in relationship with surgery and ageing. METHODS: Data from 716 consecutive patients discharged from a tertiary referral hospital (2002-2012) with a diagnosis of pancreatic cancer and with complete clinical and follow-up data were used to estimate the number of years of life-lost (YLL) through a semi-parametric extrapolation having an age-, sex- and year-of-onset- matched population derived from national life tables as reference. RESULTS: The mean entire lifespan estimated for the 716 patients was 1.4 years (95% C.I.:0.8-1.9) resulting in a number of YLL after diagnosis of 12 years (95% C.I.:11.5-12.6) per person. Surgical patients (147 cases; 20.5%) were younger and experienced higher post-diagnostic lifespan (3.5 years) than non-surgical older individuals (0.8 years; p < 0.001). These figures were reflected on the number of expected YLL (EYLL) that remained substantially unaffected by surgery (p = 0.821). Patients aged ≤68 years experienced the highest number of EYLL (20.8 years); whereas elderly patients had a loss of life that corresponded to only 6% of the entire life they had already lived. CONCLUSIONS: In a typical pancreatic cancer cohort, surgery was not able to modify population-based statistics because of a different age at tumor onset which nullifies any benefit from a "lifespan from birth" perspective. Pancreatic cancer in younger individuals must be ranked within the very first causes of EYLL due to malignancy.

7 Article Estimation of the Survival Benefit Obtainable From Screening for the Early Detection of Pancreatic Cancer. 2016

Cucchetti, Alessandro / Ercolani, Giorgio / Cescon, Matteo / Brandi, Giovanni / Taffurelli, Giovanni / Maroni, Lorenzo / Ravaioli, Matteo / Pezzilli, Raffaele / Pinna, Antonio Daniele. ·From the Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy. ·Pancreas · Pubmed #26646274.

ABSTRACT: OBJECTIVE: The chance to improve survival from pancreatic adenocarcinoma relies on early diagnosis through screening, but any screening program is subject to lead-time bias and no data are available in this regard. Aim of the present study was to evaluate the benefit obtainable from a screening program for early detection of pancreatic adenocarcinoma, considering screen-related biases. METHODS: Monte Carlo simulation was performed using data from 1000 pancreatic cancer patients admitted in a tertiary referral hospital and from pertinent literature. Lead-time bias was assessed and subtracted from expected survival. RESULTS: Mean expected life expectancy was 13.0 months. Assuming a 20%, 30%, or 50% stage III/IV reduction with screening, pancreatic resections would increase from 217 to 290 in front of a 20% stage III/IV reduction to 324 in front of a 30% reduction and to 385 in front of a 50% reduction. After lead-time adjustment, life expectancies were 14.0, 14.6, and 15.9 months, respectively. The number-needed-to-screen calculation suggests that screening can be harmful in a proportion of patients inversely dependent on the length of follow-up and a significant improvement of survival after diagnosis. CONCLUSIONS: Pancreatic adenocarcinoma screening program would probably be successful in the presence of a considerable improvement of postdiagnostic survival; otherwise, it only increases surgical procedure amount.

8 Article Characterization of pancreatic ductal adenocarcinoma using whole transcriptome sequencing and copy number analysis by single-nucleotide polymorphism array. 2015

Di Marco, Mariacristina / Astolfi, Annalisa / Grassi, Elisa / Vecchiarelli, Silvia / Macchini, Marina / Indio, Valentina / Casadei, Riccardo / Ricci, Claudio / D'Ambra, Marielda / Taffurelli, Giovanni / Serra, Carla / Ercolani, Giorgio / Santini, Donatella / D'Errico, Antonia / Pinna, Antonio Daniele / Minni, Francesco / Durante, Sandra / Martella, Laura Raffaella / Biasco, Guido. ·Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola‑Malpighi Hospital, Bologna I‑40100, Italy. · Interdepartmental Center of Cancer Research, Sant'Orsola‑Malpighi Hospital, Bologna I‑40100, Italy. · Department of Medical and Surgical Sciences, Sant'Orsola‑Malpighi Hospital, Bologna I‑40100, Italy. · Department of Digestive Diseases and Internal Medicine, Sant'Orsola‑Malpighi Hospital, Bologna I‑40100, Italy. · Liver and Multiorgan Transplant Unit, Sant'Orsola‑Malpighi Hospital, Bologna I‑40100, Italy. · Pathology Unit, Sant'Orsola‑Malpighi Hospital, Bologna I‑40100, Italy. ·Mol Med Rep · Pubmed #26397140.

ABSTRACT: The aim of the current study was to implement whole transcriptome massively parallel sequencing (RNASeq) and copy number analysis to investigate the molecular biology of pancreatic ductal adenocarcinoma (PDAC). Samples from 16 patients with PDAC were collected by ultrasound‑guided biopsy or from surgical specimens for DNA and RNA extraction. All samples were analyzed by RNASeq performed at 75x2 base pairs on a HiScanSQ Illumina platform. Single‑nucleotide variants (SNVs) were detected with SNVMix and filtered on dbSNP, 1000 Genomes and Cosmic. Non‑synonymous SNVs were analyzed with SNPs&GO and PROVEAN. A total of 13 samples were analyzed by high resolution copy number analysis on an Affymetrix SNP array 6.0. RNAseq resulted in an average of 264 coding non‑synonymous novel SNVs (ranging from 146‑374) and 16 novel insertions or deletions (In/Dels) (ranging from 6‑24) for each sample, of which a mean of 11.2% were disease‑associated and somatic events, while 34.7% were frameshift somatic In/Dels. From this analysis, alterations in the known oncogenes associated with PDAC were observed, including Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations (93.7%) and inactivation of cyclin‑dependent kinase inhibitor 2A (CDKN2A) (50%), mothers against decapentaplegic homolog 4 (SMAD4) (50%), and tumor protein 53 (TP53) (56%). One case that was negative for KRAS exhibited a G13D neuroblastoma RAS viral oncogene homolog mutation. In addition, gene fusions were detected in 10 samples for a total of 23 different intra‑ or inter‑chromosomal rearrangements, however, a recurrent fusion transcript remains to be identified. SNP arrays identified macroscopic and cryptic cytogenetic alterations in 85% of patients. Gains were observed in the chromosome arms 6p, 12p, 18q and 19q which contain KRAS, GATA binding protein 6, protein kinase B and cyclin D3. Deletions were identified on chromosome arms 1p, 9p, 6p, 18q, 10q, 15q, 17p, 21q and 19q which involve TP53, CDKN2A/B, SMAD4, runt‑related transcription factor 2, AT‑rich interactive domain‑containing protein 1A, phosphatase and tensin homolog and serine/threonine kinase 11. In conclusion, genetic alterations in PDCA were observed to involve numerous pathways including cell migration, transforming growth factor‑β signaling, apoptosis, cell proliferation and DNA damage repair. However, signaling alterations were not observed in all tumors and key mutations appeared to differ between PDAC cases.

9 Article Efficacy and cost-effectiveness of immediate surgery versus a wait-and-see strategy for sporadic nonfunctioning T1 pancreatic endocrine neoplasms. 2015

Cucchetti, Alessandro / Ricci, Claudio / Ercolani, Giorgio / Campana, Davide / Cescon, Matteo / D'Ambra, Marielda / Pinna, Antonio Daniele / Minni, Francesco / Casadei, Riccardo. ·Department of Medical and Surgical Sciences - DIMEC, S. Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy. ·Neuroendocrinology · Pubmed #25228538.

ABSTRACT: BACKGROUND: Whether patients with small (<2 cm), sporadic nonfunctioning pancreatic endocrine tumors (NF-PETs) should directly undergo pancreatic surgery or should be followed longitudinally to detect growth and malignancy still has to be defined. STUDY DESIGN: Based on the pertinent literature of the past decade, a Markov model was developed to investigate this issue. In the wait-and-see strategy arm, surgery was performed if the tumor attained a size ≥2 cm or surpassed 20% of the initial size. In a Monte Carlo probabilistic analysis, 100 hypothetical patients undergoing a wait-and-see strategy were compared to 100 patients directly undergoing surgery, with the aim of investigating the efficacy and cost-effectiveness of the two strategies. RESULTS: During the postdiagnostic lifetime, 63 NF-PETs in the wait-and-see group showed significant growth and underwent surgery: 38 were stage I, 10 were stage II, 15 were stage III and none were stage IV. In the base-case scenario, the mean life expectancy and quality-adjusted life expectancy were found to be superior after immediate surgery [26.1 years and 11.8 quality-adjusted life years (QALYs)] than with the wait-and-see strategy (22.1 years and 8.3 QALYs) as the consequence of ageing during the wait-and-see follow-up which increased mortality due to surgery, when surgery was needed. The model was sensitive to starting age and length of follow-up; in particular, for patients >65 years of age, the two strategies provided similar results but the wait-and-see strategy was more cost-effective. CONCLUSIONS: The wait-and-see strategy for NF-PETs <2 cm represents a reasonable approach in patients over 65 years of age; otherwise, immediate surgery is preferable.

10 Article Sarcoidosis and sarcoid-like reaction associated with pancreatic malignancy: are you able to read a riddle? 2012

Mastroroberto, Marianna / Berardi, Sonia / Fraticelli, Lucilla / Pianta, Paolo / Ercolani, Giorgio / Cancellieri, Alessandra / Sama, Claudia. ·Unit of Liver Transplantation, Department of Digestive Diseases and Internal Medicine, Sant'Orsola-Malpighi Hospital, Alma Mater Studiorum-University of Bologna, Bologna, Italy. marianna.mastroroberto@gmail.com ·JOP · Pubmed #22797406.

ABSTRACT: CONTEXT: The sarcoidosis is an idiopathic multisystem inflammatory disease characterized by the presence of non-caseating granulomas in the affected organs. The clinical picture includes non-specific systemic symptoms and organ-specific symptoms, but it is frequently asymptomatic. Although not fully understood, a clear association between sarcoidosis and malignancies has been reported. In neoplastic patient, beside classical sarcoidosis, cases of sarcoid-like reaction have been extensively described, a condition characterized by the presence of non-caseating granulomas in the lymph nodes draining the tumor or, less commonly, in the distant lymph nodes; this is considered a benign non progressive condition, potentially regressive following neoplasm eradication. CASE REPORT: We report the first case of sarcoidosis/sarcoid-like reaction associated with neuroendocrine tumors of the pancreas. CONCLUSION: This clinical case highlights the difficulty and importance of differential diagnosis of lymphadenopathy in the management of neoplastic disease, and in view of the evolving clinical picture, if a distinction between sarcoidosis and sarcoid-like reaction is a clinical reality or if they is just represent different stage of the same disease. Therefore, we believe that a follow-up is necessary even in case of sarcoid-like reaction, since no data are reported in the literature on the long-term of this condition once treated the associated tumor.