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Solid pseudopapillary neoplasm (SPN) is an extremely rare pancreatic epithelial neoplasm with low malignancy that affects mainly young females. It is characterized by a good prognosis, even in the presence of metastases. SPNs have a particular avidity for 18F-fluorodeoxyglucose (18F-FDG). Nonetheless, there are very few papers in the literature on the use of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F- FDG PET/CT) in the diagnosis and staging of SPNs. A 23-year-old woman presented to our attention with gastric outlet obstruction due to a bulky solid pseudopapillary neoplasm of the pancreatic head. A 18F-FDG PET/CT showed a marked 18F-FDG uptake at the pancreatic head with no abnormal metabolic activity in other abdominal organs. Given the particular avidity for 18F-FDG, SPNs can be easily recognized on 18F-FDG PET/CT. However, this exam is not useful in differentiating this neoplasm from other malignant pancreatic solid lesions, but it could give a contribution to the staging by the ability to identify potential metastases or recurrences. [ABSTRACT FROM AUTHOR]

Endoscopic biopsy of the lower rectal mass showed diffuse sheets of eosinophilic histiocytes with admixed lymphoplasmacytic aggregates infiltrating rectal mucosae (Figure 2). Endoscopic biopsy showed diffuse sheets of eosinophilic histiocytes with admixed lymphoplasmacytic aggregates infiltrating rectal mucosae. [Extracted from the article]

Adenomatosis coil (or familial polyposis of the large bowel) and related syndromes are relatively rare diseases characterized by an autosomal dominant mode of inheritance. In these diseases, the entire colorectal mucosa is covered by hundreds (often innumerable) polyps of various dimensions. In addition, several extracolonic abnormalities have been reported. In the present study, we describe the clinical features of eight families from northern Italy fulfilling the diagnostic criteria of adenomatosis coli. Information was available on 123 unaffected and 30 affected family members. The most relevant findings of the study can be summarized as follows. 1) Gene frequency was calculated to be between 1:7,300 and 1:19,000. Segregation ratio in affected branches was 0.57, with a gene penetrance of nearly 60% and a male:female ratio of 1.73. 2) Extracolonic manifestations were present in all families and in 15 of 30 affected patients, the most frequent being cutaneous cysts and retinal lesions. No case fulfilling the classical criteria of Gardner syndrome was observed. 3) When the diagnosis of adenomatosis followed the appearance of symptoms, colorectal cancer had usually already developed, whereas no malignant changes were observed in individuals diagnosed in the asymptomatic stage. When colectomy with ileorectal anastomosis was the treatment of choice, polyps tended to recur in the rectal stump, and long-term endoscopic follow-up was necessary. In conclusion, adenomatosis coil may account for a definite proportion of colorectal neoplasms observed in the general population. Taking into consideration the genetic base of the disease, it follows that individuals at risk should be closely monitored for several years. Moreover, clinical investigations should not be limited to the large bowel, but should be extended to the skin, upper digestive tract, fundus oculi, bones, and probably other organs. [ABSTRACT FROM AUTHOR]

Background/aims: At present, benefits of surgical resection and appropriate selection criteria in patients affected by both hepatic and pulmonary metastases of colorectal cancer (CRC) are under discussion. Our analysis focused on a surgical series of such patients and our final aim consisted in identifying potential prognostic factors., Methods: Eighty-five patients undergoing resection of both hepatic and pulmonary metastases at 2 Healthcare Institutions from January 1993 to June 2015 were retrospectively reviewed as concerned clinical information, surgical notes and pathological features. Patient, treatment, and outcome variables were analyzed by use of log-rank tests, Cox regression, and Kaplan-Meier methods., Results: Liver turned out as the first site of metastasis in 75% patients, lung in 13% patients, and both sites in 12% patients. Multiple hepatic metastases were detected in 67% patients and pulmonary metastases in 31% patients. Two hundred eighteen surgical interventions were performed (mean 2.56 for each patient). Overall survival (OS) rates at 3-, 5-, and 10-year follow-up from colorectal resection were 94, 79, and 38% respectively. Median OS was 8.31 years. Survival turned out significantly longer for patients with disease-free interval (DFI) exceeding 1 year between first metastasectomy and diagnosis of second metastases and in patients affected by metachronous pulmonary metastases., Conclusions: Surgical resection of both hepatic and pulmonary metastases of CRC represents a safe and effective treatment. It might lead to rewarding long-term survival rates in high selected patients. Shorter DFIs between first metastasectomy and diagnosis of second metastases can determine worse prognoses. In addition, poor outcomes could be predicted also for patients affected by synchronously detected pulmonary CRC metastases, although further confirmatory analyses are strongly required., (© 2019 S. Karger AG, Basel.)