Overview of the Investigation and Management of Cystic Neoplasms of the Pancreas

Spence, Robert; Dasari, B.; Love, Mark; Kelly, Barry; Mb, Taylor

doi:10.1159/000334758

Cited by 25 publications

(17 citation statements)

References 71 publications

(70 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CEA, CA19-9 [3,8,27]. However, definite preoperative diagnosis was still inconclusive in a large number of asymptomatic cysts incidentally found during abdominal imaging.…”

Section: Discussionmentioning

confidence: 99%

“…According to the WHO classification of pancreatic cystic neoplasms, these lesions have been grouped into serous cystic neoplasms, mucinous cystic neoplasms, intraductal papillary mucinous neoplasms (IPMNs), and solid pseudopapillary neoplasms [3]. Most serous cystic neoplasms are benign and malignant serous cystadenocarcinomas are extremely rare [4,5].…”

Section: Brief Communication (Original)mentioning

confidence: 99%

See 1 more Smart Citation

Surgical treatments of cystic neoplasms of the pancreas: an Asian university hospital experience

Sriussadaporn

Pak‐art

et al. 2015

Asian Biomedicine

View full text Add to dashboard Cite

Background: Premalignant and malignant cystic neoplasms of the pancreas are relatively rare, but absolute indications for surgical resection. Modern imaging modalities have increased recognition of asymptomatic cysts resulting in therapeutic dilemmas of whether surgery or observation is appropriate. Objectives: To examine our surgical experience with cystic neoplasms of the pancreas. Methods: A retrospective study of patients who had cystic neoplasms of the pancreas and underwent surgical resections from June 2000 to April 2013. Presenting symptoms, surgical procedures, pathological diagnoses, and postoperative complications were analyzed. Results: Data from 16 patients were examined. Two patients had asymptomatic cystic neoplasms. Fourteen had symptoms ranging from 2 days to 6 years before diagnosis and surgery. Six patients underwent pylorus preserving pancreaticoduodenectomy, 4 underwent distal pancreatectomy with splenectomy, 2 underwent splenic preserving distal pancreatectomy, and 1 each underwent a classical Whipple operation, total pancreatectomy, distal pancreatectomy with splenectomy with partial resection of the posterior gastric wall, and distal pancreatectomy with splenectomy with left colectomy. The operative time ranged from 150 to 450 minutes. Operative blood transfusion ranged from 0 to 5 units. Four patients had mucinous cystadenoma, 4 had intraductal papillary mucinous neoplasia with varying degree of dysplasia and carcinomatous changes, 6 had other malignancies, and 2 had other benign cysts. Postoperative complications occurred in 3 patients. There was no perioperative mortality. Conclusion: Any suspicion of malignant changes in asymptomatic cysts should have them considered for surgical resection. Meticulous surgical techniques are important for pancreatic resection to minimize the occurrence of postoperative complications.

show abstract

“…CEA, CA19-9 [3,8,27]. However, definite preoperative diagnosis was still inconclusive in a large number of asymptomatic cysts incidentally found during abdominal imaging.…”

Section: Discussionmentioning

confidence: 99%

Section: Brief Communication (Original)mentioning

confidence: 99%

Surgical treatments of cystic neoplasms of the pancreas: an Asian university hospital experience

Sriussadaporn

Pak‐art

et al. 2015

Asian Biomedicine

View full text Add to dashboard Cite

show abstract

“…They allow differentiation of pseudocysts from cystic tumors as well as serous from mucinous neoplasms. The following imaging investigations are used in diagnosis of pancreatic cysts: transabdominal ultrasonography (TUS), contrast enhanced transabdominal ultrasonography (CEUS), computed tomography (CT), magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), EUS (endoscopic ultrasonography) [3,5,17,18,19,28,[36][37][38][39][40][41][42][43][44].…”

Section: Radiological Investigationsmentioning

confidence: 99%

“…EUS alone cannot reliably differentiate between benign and malignant pancreatic cystic lesions, but EUS offers guidance for fine needle aspiration (FNA) of cystic lesions which has been demonstrated to be as accurate as CT-guided FNA. Volmar et al [46] reported that for lesions <3 cm, the EUS-guided FNA had higher accuracy than US or CT. With CT or EUS guidance, samples of the cystic fluid and cyst walls can be taken by fine needle aspiration and brushing for cytology and measurement of tumour markers, viscosity, and amylase (that will be described in the further part of this paper) [17,28,[47][48][49][50][51][52]. Similar to transabdominal US, EUS also allows a therapeutic approach such as EUS-guided pancreatic pseudocyst drainage (that will be discussed in a chapter regarding management) [53][54][55][56][57][58][59][60][61].…”

Section: Endoscopic Ultrasnonography (Eus)mentioning

confidence: 99%

Pancreatic cysts: etiology, diagnosis and management

Jabłońska

2014

Open Medicine

View full text Add to dashboard Cite

AbstractPancreatic cysts involve a wide spectrum of pathologies from post-inflammatory cysts to malignant neoplasms. Pancreatic pseudocysts, serous cystadenomas, mucinous cystadenomas, intraductal papillary mucinous neoplasms (IPMNs) and solid pseudopapillary tumors occur most frequently. Differential diagnosis involves the following imaging investigations: transabdominal ultrasonography (TUS), contrast enhanced ultrasonography (CEUS) and endoscopic ultrasonography (EUS), computed tomography (CT), magnetic resonance (MR) and magnetic resonance cholangiopancretography (MRCP), endoscopic retrograde cholangiopancretography (ERCP). The cyst fluid cytology is performed in difficult differential diagnosis between pseudocysts and benign and potentially malignant or malignant tumors. Most frequently, viscosity, amylase, CEA and CA 19-9 levels are determined. Imaging findings should be correlated with cytology. The management depends on the cyst type and size. Small asymptomatic pseudocysts, serous cystadenomas and branchduct IPMNs should be carefully observed, whereas symptomatic large or uncertain serous cystadenomas and cystadenocarcinomas, mucinous cystadenomas and cystadenocarcinomas, main-duct IPMNs and large branch-duct IPMNs with malignant features, serous and mucinous cystadenocarcinomas, and solid pseudopapillary tumors require surgery. Pseudocysts are usually drained. Percutaneous / EUS-guided or surgical cyst drainage can be performed. Complicated and uncertain pseudocysts and cystic tumors need surgical resection. The type of surgery depends on cyst location and size and includes proximal, central, distal, total pancreatectomies and enucleation.

show abstract

“…A livello anatomico si possono distinguere lesioni che coinvolgono il dotto pancreatico [1] principale e lesioni che coinvolgono i dotti pancreatici secondari. Questi due sottotipi si differenziano per il rischio di evoluzione maligna.…”

Section: Perché Descriviamo Questo Casounclassified

Main-duct intraductal papillary mucinous neoplasm of the pancreas: a case report

Manetti

Faini

Bucciero

et al. 2012

CMI

View full text Add to dashboard Cite

INTRODUZIONELe neoplasie mucinose cistiche del pancreas possono essere classificate in due gruppi ben distinti: neoplasie papillari mucinose intraduttali (IPMN) e neoplasie mucinose cistiche (MCN) (Tabella I).Queste ultime sono maligne o potenzialmente tali anche se con una crescita molto lenta rispetto alle IPMN [2]. Spesso interessano donne di mezza età e la sintomatologia di esordio consiste principalmente in dolore addominale e presenza di una massa palpabile in epigastrio. Sono solitamente localizzate nella coda del pancreas e sono costituite da cisti mucinose uniloculari o multiloculari ben circoscritte con dimensioni medie di 7-10 cm [3,4] Caso clinico AbstractThree distinct entities among non-inflammatory cystic lesions of the pancreas have been defined: intraductal papillary mucinous neoplasm (IPMN), serous cystic neoplasm (SCN) and mucinous cystic neoplasm (MCN). IPMN is characterized by intraductal papillary growth and thick mucus secretion: its incidence has dramatically increased since its initial description. These lesions probably can progress towards invasive carcinoma. IPMNs are symptomatic in most cases: the typical presentation is a recurrent acute pancreatitis, without evident cause, of low or moderate severity. The diagnosis is usually based upon the imaging (CT/cholangio-MRI) demonstrating a pancreatic cystic mass, involving a dilated main duct, eventually associated to some filling defects, or a normal Wirsung duct communicating with the cyst lesion. Surgical treatment is generally indicated for main duct IPMN and branch duct IPMN with suspected malignancy (tumour size ≥ 30 mm, mural nodules, dilated main pancreatic duct, or positive cytology) or prominent symptoms. Herein we present a case of IPMN of the main duct which occurred with abdominal and back pain associated with weight loss. After the diagnosis, she successfully underwent surgery and is now in a follow-up program.

show abstract

Overview of the Investigation and Management of Cystic Neoplasms of the Pancreas

Cited by 25 publications

References 71 publications

Surgical treatments of cystic neoplasms of the pancreas: an Asian university hospital experience

Surgical treatments of cystic neoplasms of the pancreas: an Asian university hospital experience

Pancreatic cysts: etiology, diagnosis and management

Main-duct intraductal papillary mucinous neoplasm of the pancreas: a case report

Contact Info

Product

Resources

About