With increased awareness of dry eye disease (DED), a multitude of therapeutic options have become available. Nevertheless, the treatment of severe DED remains difficult. In a patient whose DED is related to the loss of lacrimal function without severe destruction of the salivary glands, autologous transplantation of the latter as functioning exocrine tissue to rebuild a stable tear film is an attractive idea. All three major and minor salivary glands have been used for such transplantation. Due to the complications associated with and unfavorable prognosis of parotid duct and sublingual gland transplantation, surgeons now prefer to use the submandibular gland (SMG) for such procedures. The transplantation of the SMG not only has a high survival rate, but also improves dry eye symptoms and signs for more than 20 years post-surgery. The regulation of the secretion of the transplanted SMG is critical because the denervated SMG changes its mechanism of secretion. Innovative procedures have been developed to stimulate secretion in order to prevent the obstruction of the Wharton’s duct and to decrease secretion when postoperative “epiphora” occurs. Among the minor salivary glands, the transplantation of the labial salivary glands is the most successful in the long-term. The measurement of the flow rates of minor salivary glands and donor-site selection are critical steps before surgery.
Background: Pancreatic perivascular epithelioid cell tumors (PEComas) are exceedingly uncommon mesenchymal tumors. Herein we have mainly focused on the radiologic features of pancreatic PEComas to achieve a better knowledge of the disease. Case report: We present the case of a 41-year-old woman who had a benign pancreatic PEComa that was misinterpreted as a malignant tumor based on a preoperative CT scan before undergoing surgery for a hysteromyoma. Laboratory tests revealed no significant abnormal findings except an elevated CA-125 (428 U/L). CT and MRI images showed a solid, well-defined, hypovascular nodule approximately 10 mm in diameter in the pancreatic uncinate process that was hyperintense on diffusion-weighted imaging (DWI) and hypointense on apparent diffusion coefficient (ADC) maps. Because of a suspected malignant pancreatic neoplasm, she underwent a pancreaticoduodenectomy. The pathologic examination confirmed the diagnosis of a pancreatic PEComa. Conclusions: Because of the rarity of pancreatic PEComas, we highlighted the radiologic characteristics to facilitate the diagnosis and therapy.