Malignant pancreatic serous cystic neoplasms: systematic review with a new case

Abstract

BackgroundThis study analyzes the clinicopathologic and radiologic characteristics of malignant serous cystic neoplasm (SCN) of the pancreas through systematic review and an institutional case report.MethodsA comprehensive literature search was performed in the MEDLINE database to identify studies on malignant SCNs of the pancreas that had detailed clinicopathologic and radiologic information. A computerized systematic search of our institutional database was also performed to identify cases of malignant SCN for addition to the systematic review. Using the final included cases, we analyzed the clinicopathologic and radiologic features of malignant SCNs of the pancreas.ResultsA review of 136 candidate articles identified 26 studies with 26 cases that had detailed clinical information. Our institutional data search added one case. The systematic review of the 27 cases revealed that primary tumors (mean diameter 10.2 ± 4.0 cm) mainly involved the body and tail of the pancreas (n = 16) and frequently invaded adjacent organs (n = 19). Distant metastases occurred in 14 patients (synchronous, n = 5; metachronous, n = 8; both, n = 1), most commonly in the liver (n = 13). Imaging features of malignant SCNs of the pancreas were identical to the benign counterpart, except local invasion or distant metastases. The prognosis was excellent in that 17 were alive at the time of writing with a median follow-up period of 2 years.ConclusionsThe malignant potential of SCNs of the pancreas should be considered in the diagnosis and management of patients with pancreatic SCNs.

Characteristics and long-term survival of resected pancreatic cystic neoplasms in Finland. The first nationwide retrospective cohort analysis

“…The number of IPMN tumours is slightly higher, which can be partially explained by the revised diagnoses after re-reviewing the histopathology. SCN tumours should only be resected when symptomatic, in case of rapid growth, if the diagnosis is uncertain or if there is concern about malignancy 17, 18,19 . However, imaging diagnostics of SCN is not always easy.…”

Unusual Liver Tumors

“…Huh et al 2 in a recent systematic review showed that these patients were between 42 and 87 years of age and the female to male ratio was 2.9. The most common symptoms or signs were abdominal pain (48%), palpable mass (22%), and weight loss (18%), and 11% of the patients presented an incidentally detected SCAc.…”

“…Serous cystadenocarcinoma (SCAc) of the pancreas is a rare but well-established entity first described by George et al in 1989 1 , and since then less than 30 cases have been published 2 . The WHO classification defines it by the presence of distant metastasis, even if the primary tumor presents a benign histologic appearance 3 .…”

“…The most frequent local invasion are adjacent vessels, spleen, peripancreatic fat, stomach, and duodenum 3 . The most common site of distant metastasis is the liver, however, cases of metastasis to the lung, bone, adrenal glands, peritoneum, and spleen have also been described 2 .…”

Diagnostik und Therapie von zystischen Pankreastumoren

“…Seröse zystische Neoplasien wurden von den muzinösen Neoplasien erst 1978 durch Campagno et al [31,32] differenziert. Die ersten malignen SCN wurden 1989 von George et al [31,32] beschrieben. Histologisch ist die Wand der SCN von einer Reihe kuboidaler, glykogenreicher Epithelzellen, welche seröse Flüssigkeit produzieren, ausgekleidet.…”