Characteristics of cystic neoplasms of the pancreas and results of aggressive surgical treatment

K-ras Oncogene Mutations Indicate Malignancy in Cystic Tumors of the Pancreas

“…Such a relatively high proportion of asymptomatic tumors was reported earlier by others,6'9 '16 whereas in other studies tumor-related symptoms were observed in up to 100% of patients. [17][18][19][20] Lewandrowski et al24 reported that a high level of carcinoembryonic antigen in the cyst fluid yielded a sensitivity and specificity of 100% in predicting a mucinous cystic neoplasm. However, tumor markers assayed in the cyst fluid do not reliably allow determination of the malignant potential of the tumor.…”

“…If this result can be confirmed in larger series, the management-resection or observation-of small asymptomatic tumors could be based on the K-ras mutation analysis in fine-needle aspirates. Asymptomatic tumors that carry no K-ras mutation could be observed clinically, especially in elderly and high-risk patients, because resection of these tumors is associated with a significant morbidity rate (around 30% to 40%).1617,19,20 However, symptomatic tumors that show K-ras mutations should undergo aggressive resection, because 5-year survival rates of 70% to 100% are common in cystic neoplasms of the pancreas after RO 2-7 17, 19,20 resection.…”

Retroperitoneal Bronchogenic Cyst as a Differential Diagnosis of Pancreatic Mucinous Cystic Tumor

“…Potential long-term survivors among pancreatic malignancies are to be found in the group of patients with mucinous cystic tumors subjected to surgical resection [3, 19, 20]. In patients where preoperative investigations have indicated a potential mucinous cystic tumor of the pancreas, management should be directed against obtaining the entire cyst wall for complete histological examination [21, 22].…”

Mucinous Tumors of the Exocrine Pancreas

“…In a review of 21 cases of cystadenocarcinomas, Hodgkinson and colleagues 28 noted a 5-year survival rate of 68% after complete excision compared with a 14% rate for those who had partial excision. Delcore and colleagues 29 reported 90% long-term disease-free survival among 10 patients with resectable mucinous cystadenocarcinomas, whereas 3 patients who underwent palliative resection died within 9 months. These two studies emphasize the prognosis and survival in these patients; localized and therefore resectable cystadenocarcinomas are highly curable, while those with distant spread have a dismal prognosis similar to patients with ductal adenocarcinoma.…”