title: Metastatic Pancreatic Adenocarcinoma After Total Pancreatectomy Islet Autotransplantation for Chronic Pancreatitis.
abstract: Total pancreatectomy with islet autotransplantation (TPIAT) is being used increasingly as a definitive treatment for chronic pancreatitis. Patients with chronic pancreatitis have an elevated risk of pancreatic cancer, which can also masquerade as acute or chronic pancreatitis, making the diagnosis challenging. We describe here the first case of pancreatic ductal adenocarcinoma developing in the liver of a patient after TPIAT for presumed benign chronic pancreatitis. Retrospective analysis of the patient's preoperative serum revealed normal carbohydrate antigen 19-9 and carcinoembryonic antigen levels but elevated levels of microRNAs -10b, -30c, and -106b compared with controls. Screening guidelines are important to reduce the risk of transplantation of malignant tissue. More sensitive screening tools, including the potential use of microRNAs, are needed to detect early preclinical disease, given the highly malignant nature of pancreatic cancer.
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, MN.
authors.forename: S
authors.initials: S
authors.lastname: Muratore
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, MN.
authors.forename: X
authors.initials: X
authors.lastname: Zeng
authors.affiliation: Department of Medicine and the Pancreatic Cancer Signature Center, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: M
authors.initials: M
authors.lastname: Korc
authors.affiliation: Department of Medicine and the Pancreatic Cancer Signature Center, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: S
authors.initials: S
authors.lastname: McElyea
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, MN.
authors.forename: J
authors.initials: J
authors.lastname: Wilhelm
authors.affiliation: Department of Endocrinology, University of Minnesota, Minneapolis, MN.
authors.forename: M
authors.initials: M
authors.lastname: Bellin
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, MN.
authors.forename: G
authors.initials: G
authors.lastname: Beilman
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology / Q000556:secondary*; D000328:Adult; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects*; D008297:Male; D009362:Neoplasm Metastasis; D010180:Pancreatectomy / Q000009:adverse effects*; D010190:Pancreatic Neoplasms / Q000209:etiology / Q000473:pathology*; D050500:Pancreatitis, Chronic / Q000628:therapy*; D011183:Postoperative Complications; D011379:Prognosis; D014182:Transplantation, Autologous
keywords: autotransplantation; cancer/malignancy/neoplasia; cancer/malignancy/neoplasia: metastatic disease; clinical research/practice; islet transplantation; islets of Langerhans