Non-neoplastic Epithelial Cysts of the Pancreas: A Rare, Benign Entity

Assifi, M. Mura; Nguyen, Phi D.; Agrawal, Nidhi; Dedania, Nishi; Kennedy, Eugene P.; Sauter, Patricia K.; Prestipino, Anthony; Winter, Jordan M.; Yeo, Charles J.; Lavu, Harish

doi:10.1007/s11605-014-2459-7

Cited by 34 publications

(33 citation statements)

References 21 publications

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“…Among the neoplastic cysts accounting for 10%–15% of all pancreatic cystic lesions,1 the serous type is seen as benign, whereas the mucinous form tends to have malignant potential 2. Reports indicate that common cystic tumours with a mucinous epithelial lining can harbour carcinoma in situ or invasive cancer in up to 60% of resected specimen depending on the size of the lesion, clinical symptoms caused by the lesion as well as signs of malignancy on imaging 3–6.…”

Section: Introductionmentioning

confidence: 99%

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Prospective study on the incidence, prevalence and 5-year pancreatic-related mortality of pancreatic cysts in a population-based study

Kromrey

Bülow

Hübner

et al. 2017

Gut

276

200

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Objective To analyse the prevalence, incidence and clinical relevance of pancreatic cysts detected as incidental finding in a population-based longitudinal study. Design A total of 1077 participants (521 men, mean age 55.8±12.8 years) of 2333 participants from the population-based Study of Health in Pomerania (SHIP) underwent magnetic resonance cholangiopancreaticography (MRCP) at baseline (2008)(2009)(2010)(2011)(2012). MRCP was analysed for pancreatic cysts with a diameter ≥2 mm. 676/1077 subjects received a 5-year follow-up (2014-2016). The prevalence and incidence of pancreatic cysts (weighted for study participation) were assessed in association to age, gender and suspected epidemiological risk factors. Mortality follow-up was performed in 2015 for all SHIP participants (mean follow-up period 5.9 years, range 3.2-7.5 years). results At baseline pancreatic cysts had a weighted prevalence of 49.1%, with an average number of 3.9 (95% CI 3.2 to 4.5) cysts per subject in the subgroup harbouring cysts. Cyst size ranged from 2 to 29 mm. Prevalence (p<0.001), number (p=0.001) and maximum size (p<0.001) increased significantly with age. The 5-year follow-up revealed a weighted incidence of 12.9% newly detected pancreatic cysts. 57.1% of the subjects initially harbouring pancreatic cysts showed an increase in number and/or maximum cyst size. Of all subjects undergoing MRCP, no participant died of pancreatic diseases within mortality follow-up. conclusion The prevalence of pancreatic cysts in the general population is unexpectedly high, and their number and size increase with age. Overall, no pancreatic cancer was observed in this collective during a 5-year follow-up. Nevertheless, prospective follow-up imaging showed minimal progress in more than 50%. Only about 6% of cysts and 2.5% of the study group initially presented with cysts of more than 1 cm and thus might be clinically meaningful. IntrODuctIOnCystic lesions of the pancreas are closed cavities containing liquid or semisolid material, which can either be neoplastic or non-neoplastic. Among the neoplastic cysts accounting for 10%-15% of all pancreatic cystic lesions, 1 the serous type is seen as benign, whereas the mucinous form tends to have malignant potential.2 Reports indicate that common cystic tumours with a mucinous epithelial lining can harbour carcinoma in situ or invasive cancer in up to 60% of resected specimen depending on the size of the lesion, clinical symptoms caused by the PancreasORIgINAl ARTICle

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Section: Introductionmentioning

confidence: 99%

“…Pancreatic cysts represent a small yet increasingly detected entity of pancreatic abnormalities 2. Approximately 70% of pancreatic cystic lesions are discovered incidentally 13 14.…”

Section: Introductionmentioning

confidence: 99%

Prospective study on the incidence, prevalence and 5-year pancreatic-related mortality of pancreatic cysts in a population-based study

Kromrey

Bülow

Hübner

et al. 2017

Gut

276

200

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“…Epithelial cysts are not specific to the spleen. They can also develop at the pancreatic tail, with similar characteristics regarding age, image findings, and elevated serum tumor markers (8)(9)(10). We herein describe a patient with a large splenic cyst, which was difficult to differentiate from a cyst of pancreatic origin, who was followed up for 6 years.…”

Section: Introductionmentioning

confidence: 92%

A Splenic Epithelial Cyst: Increased Size, Exacerbation of Symptoms, and Elevated Levels of Serum Carcinogenic Antigen 19-9 after 6-year Follow-up

et al. 2016

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A 58-year-old man, who had presented with a large cyst between the pancreatic tail and splenic hilum 6 years previously, was referred to our hospital with exacerbation of abdominal distention. Computed tomography revealed a well-demarcated, unilocular cyst, with a beak sign for the pancreas, without wall thickening or nodules suggestive of a non-neoplastic cyst. Compared with 6 years previously, the cyst had increased in size from 14.7 cm to 19.5 cm, and the serum carcinogenic antigen 19-9 level had increased from 635 U/mL to 1,918 U/mL. To prevent spontaneous rupture, laparotomy was performed, and the cyst was pathologically diagnosed as a splenic epithelial cyst.

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“…Nonneoplastic epithelial cysts account for 6.3 % of all resected cysts and were all incorrectly diagnosed preoperatively by endoscopic ultrasound (EUS) cyst fluid analysis in one study [3]. Cystic neoplasms account for two-thirds of all pancreatic cysts, [4] and include mucinous lesions (mucinous cystic neoplasm (MCN), intraductal papillary mucinous neoplasm (IPMN)), and nonmucinous cysts (serous cystadenoma (SCA), solid pseudopapillary neoplasm (SPEN); Table 31.1).…”

Section: Introductionmentioning

confidence: 99%

EUS in Pancreatic Cysts

Lee

2015

ERCP and EUS

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Non-neoplastic Epithelial Cysts of the Pancreas: A Rare, Benign Entity

Cited by 34 publications

References 21 publications

Prospective study on the incidence, prevalence and 5-year pancreatic-related mortality of pancreatic cysts in a population-based study

Prospective study on the incidence, prevalence and 5-year pancreatic-related mortality of pancreatic cysts in a population-based study

A Splenic Epithelial Cyst: Increased Size, Exacerbation of Symptoms, and Elevated Levels of Serum Carcinogenic Antigen 19-9 after 6-year Follow-up

EUS in Pancreatic Cysts

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