Management of serous cystic neoplasms of the pancreas

Abstract

Pancreatic serous cystadenomas are uncommon benign tumours that are often found incidentally on routine imaging examinations. Radiological imaging techniques alone have proven to be suboptimal to fully characterize cystic pancreatic lesions. Endoscopic ultrasound, with the addition of fine-needle aspiration in difficult cases, has showed greater diagnostic accuracy than conventional imaging techniques. The best management strategy of these neoplasms is still debated. Surgery should be limited only to symptomatic and highly selected cases and most of the patients should only be strictly monitored. In the current paper, we provide an updated overview on pancreatic serous cystadenomas, focusing our attention on epidemiology, clinical characteristics and diagnostic evaluation; finally, we also discuss different management strategies and areas for future research.

A disseminated variant of pancreatic serous cystadenoma causing obstructive jaundice, a very rare entity: a case report and review of the literature

“…Surgical intervention is indicated for patients with symptomatic lesions and those with an uncertain diagnosis [ 25 , 26 ]. Size of the cyst at presentation is still debatable since some reports indicate resection for cysts >4 cm and others do not [ 27 ].…”

Basic pancreatic lesions: Radiologic-pathologic correlation

“…[ 25 ] Calcification in the SCN is often found in polycystic lesions and is characterized by the typical central stellate scar with calcium deposits ( Figure 1 ). [ 12 , 26 , 27 ]…”

“…[ 10 ] “Double-duct sign” or “cutoff sign” is found in PDAC. [ 11 ] In pancreatic cystic neoplasms, SCN was mainly multilocular and multiseptal, [ 12 ] while mucinous cystic neoplasm (MCN) was mainly large and unilocular, [ 13 ] and Intraductal papillary mucinous tumors (IPMN) is communicated with the main duct. [ 14 ] The blood supply of the lesion is also a key clue to our diagnosis.…”

Present status and perspectives of endosonography 2017 in gastroenterology

“…Neoplastic cystic pancreatic lesions differ in their malignant potential according to their pathogenesis. Serous cystadenomas have a very low malignancy risk and, therefore, do not require surgery in the first place [ 168 ]. In mucinous cystadenoma, the malignant potential is as high as 30%; therefore, surgery is recommended as soon as the diagnosis is established [ 101 , 169 - 171 ].…”