Evidence map›Paper›PMID 36694023›Full record

SynthesisLangenbeck's archives of surgery2023

Granular cell tumour of the pancreas: a case report and systematic review.

Kevin Tree, Krishna Kotecha, Shreya Mehta, Talia L Fuchs, Christopher W Toon, Anthony J Gill, Jaswinder S Samra, Anubhav Mittal

Open access · hybridAbstract readSystematic ReviewCase ReportsMeta-Analysis
In one paragraph

Synthesis in Langenbeck's archives of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Kevin TreeUpper Gastrointestinal Surgical Unit, Royal North Shore Hospital, St Leonards, NSW, Australia. kevin.tree@newcastle.edu.au.ORCID http://orcid.org/0000-0001-6435-0526
Krishna KotechaUpper Gastrointestinal Surgical Unit, Royal North Shore Hospital, St Leonards, NSW, Australia.
Shreya MehtaUpper Gastrointestinal Surgical Unit, Royal North Shore Hospital, St Leonards, NSW, Australia.
Talia L FuchsCancer Diagnosis and Pathology Group, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, Australia.
Christopher W ToonCancer Diagnosis and Pathology Group, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, Australia.
Anthony J GillSydney Medical School Northern, University of Sydney, Sydney, NSW, Australia.
Jaswinder S SamraUpper Gastrointestinal Surgical Unit, Royal North Shore Hospital, St Leonards, NSW, Australia.
Anubhav MittalUpper Gastrointestinal Surgical Unit, Royal North Shore Hospital, St Leonards, NSW, Australia.
Royal North Shore Hospital · AUThe University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeGranular cell tumours (GCTs) of the pancreas are mostly benign and exceptionally rare, with no unique identifying radiological features. Following a case discussion of a patient with GCT, a comprehensive review of available literature was conducted to identify the common diagnostic features associated with GCT.

methodsFollowing a case report identified in our institution, a systematic review was conducted by two authors in accordance with Preferred Reporting Items for Systematic review and Meta-Analysis protocols (PRISMA) guidelines. Databases MEDLINE, EMBASE, Scopus, World of Science, and grey literature were searched on August 2021. Inclusion criteria were histopathology diagnosed granular cell tumour of the pancreas.

resultsA 37-year-old male presented with 1 month of abdominal pain and an MRI demonstrating a dilated main pancreatic duct, distal parenchymal atrophy, but no focal lesion. Repeat MRI at 6 months re-demonstrated similar findings and subsequent endoscopic ultrasound was suspicious for main duct IPMN. Following multidisciplinary team discussion, a spleen-preserving distal pancreatectomy was performed. Histopathology demonstrated granular cell tumour with cells diffusely positive for S100 and no malignant transformation. 11 case reports were identified in the literature with diagnosis confirmed on tissue histopathology based on positive immunohistochemical staining for S-100 protein. Eight patients presented with gastrointestinal symptoms with abdominal pain the main presenting complaint (50%). 10 patients underwent CT with portal venous contrast and all underwent endoscopic examination. Imaging findings were similar in five studies for EUS which demonstrated a hypoechoic lesion with homogenous appearance. On non-contrast CT GCT was iso-enhancing, and with portal venous contrast demonstrated hypo-enhancement that gradually enhanced on late phases. Pre-operative diagnosis of pancreatic carcinoma was described in six cases based on imaging and biopsy, resulting in progression to surgical resection. Nine patients were managed surgically and no complications identified on follow-up (6-52 months).

conclusionThe currently proposed management pathway includes EUS with biopsy and CT, and surgical resection recommended due to malignancy risk. Improved sample collection with EUS-FNA and microscopic assessment utilising S-100 immunohistochemistry may improve pre-operative diagnosis. Limitations include rare numbers in reported literature and short follow-up not allowing an assessment of GCT's natural history and malignancy risk. Additional cases would expand the current dataset of GCTs of the pancreas, so that surgical resection may be avoided in the future.

Indexed as

Granular Cell TumorPancreatic NeoplasmsAbdominal PainAdultEndosonographyHumansMalePancreasDiagnosisGranular cell tumourInvestigationPancreasSystematic review

Identifiers

PMID36694023
PMCPMC9873710
OpenAlexW4317889330

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.