Cystic Neoplasms of the Pancreas

Lennon, Anne Marie; Wolfgang, Christopher L.

doi:10.1007/s11605-012-2072-6

Cited by 49 publications

(42 citation statements)

References 40 publications

(74 reference statements)

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“…On the other hand, SPNs are seen in younger women (20s-30s) who present with symptoms with a slight predisposition for the pancreatic body or tail, while SCAs are usually present in older women and are similarly found in the body or tail of the pancras. 16 Because the aforementioned characteristics are generalizations, the challenge is an accurate identification of PCL type to adequately guide management decisions. For example, SCAs are benign, non-mucinous lesions that do not require surgical removal or imaging surveillance unless clinically warranted.…”

Section: Classification Of Pancreatic Cystic Lesionsmentioning

confidence: 99%

“…17,18 On the other hand, SPNs are classically seen in young women and given their aggressive metastatic nature are surgically resected. 16,19 Similarly, MCNs can progress to invasive disease and are usually resected rather than continued imaging or endoscopic surveillance. 8 Finally, IPMNs are followed due to slow progression from low or intermediate to high or invasive adenocarcinoma.…”

Section: Classification Of Pancreatic Cystic Lesionsmentioning

confidence: 99%

“…8 Other rare types of PCLs including cystic pancreatic neuroendocrine tumors (cystic-NETs), squamous lined cysts (lymphoepithelial cysts, epidermoid cysts), and cystic degeneration of metastatic cancers pose additional challenges and diagnosis relies significantly on EUS-FNA cytology. 16 The aforementioned management decisions demonstrate the importance of differentiating PCL type with eventual goal of preventing development of pancreatic malignancy.…”

Section: Classification Of Pancreatic Cystic Lesionsmentioning

confidence: 99%

“…16 These cysts are lined by mucin producing tall columnar epithelial cells with mild to severe dysplasia. Based on the International consensus guidelines, MCNs were differentiated from IPMNs based on presence of ovarian stroma.…”

Section: Mucinous Cystic Neoplasmmentioning

confidence: 99%

“…These lesions do not communicate with the main pancreatic duct and consist of branching papillae with myxoid stroma on cytology. 16 Molecular analysis of SPN has fewer genetic alterations compared to other cysts, but always have a missense mutation CTNNB1, present at codon 32, 33, 34, or 37. 41 Other mutations such as TP53 and PIK3CA are rarely found, while KRAS, GNAS, RNF43, CDKN2A, SMAD4, and VHL mutations are never found.…”

Section: Solid Pseudopapillary Neoplasmmentioning

confidence: 99%

See 4 more Smart Citations

An appraisal of pancreatic cyst fluid molecular markers

Modi

Pavurala

Krishna

2017

Int J Gastrointest Interv

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Pancreatic malignancy is the third leading cause of cancer related death in the United States with limited viable screening options. By the end of this decade, cancers are poised to become the leading cause of death with pancreatic cancer projected to be the second leading cause of cancer related mortality. Pancreatic cystic lesions (PCLs) are found in approximately 5%-14% of patients due to the increased utilization of cross-sectional imaging, with approximately 8%-10% of pancreatic cancers originating as PCLs. Current screening guidelines have shown discrepancies between morphologic characteristics of PCLs and identifying advanced pancreatic disease. Molecular analysis has emerged as a novel technology to aid in adequate diagnosis and management decisions of PCLs. Mucinous cysts including intraductal papillary mucinous neoplasms (IPMNs) or mucinous cystic neoplasms have similar oncogenic mutations including KRAS, TP53, SMAD4, PIK3CA, PTEN, or CKDN2A, while GNAS and RNF43 mutations are specific only to IPMNs. Serous cystadenomas have been associated with a loss of tumor suppressor gene VHL, while solid-psuedopapillary neoplasms have an oncogenic mutation CTNNB1. A specific molecular marker to diagnose existing high-grade dysplasia or impending malignant transformation is yet to be identified. Moving forward it is important to advance technology in isolating and identifying high-risk molecular markers from cyst fluid while considering their increased utilization in the evaluation of PCLs.

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Section: Classification Of Pancreatic Cystic Lesionsmentioning

confidence: 99%