Cystic Neoplasms of the Pancreas

-Context -Diagnosis and treatment of cystic neoplasms of the pancreas increased significantly in the last decades. There are only a few Brazilian publications on these tumors. The majority of them are limited to reports of one or few cases. Objective -To present our experience with 27 patients with cystic neoplasms of the pancreas. Methods -Demographic data, clinical manifestations, diagnostic exams, surgical procedures, postoperative complications, and follow-up data of 27 patients with cystic neoplasms of the pancreas were analyzed, according to the histological type of the tumor. Results -There were 10 (37%) serous cystic tumors, 10 (37%) mucinous cystic tumors, 4 (15%) intraductal papillary mucinous tumors, and 3 (11%) solid pseudopapillary tumors or Frantz tumor. All serous cystic tumors, 6 (60%) mucinous tumors, 2 (50%) intraductal papillary mucinous tumors, and 2 (67%) solid pseudopapillary tumors were benign. The age of the patients varied from 31 to 82 years and all tumors were more common in female. Two patients had been treated previously as a pseudocyst. Surgical procedures depended on the location and extension of the tumor. Two patients underwent only laparotomy with tumor biopsy, one cholecystectomy with Roux-en-Y hepaticojejunostomy for jaundice treatment, 6 pancreatoduodenectomy, and 18 partial pancreatectomy. The most common postoperative complication was pancreatic fistula (n = 5; 19%). One patient died of necrotic pancreatitis. Of the 10 patients with serous cystic tumor, only 1 had tumor recurrence at the section border. The three patients with mucinous cystoadenocarcinoma in which was not possible to resect the tumor, died 6 to 24 months after laparotomy. The six patients with benign mucinous tumors did not have tumor recurrence. Conclusions -The most common cystic neoplasms of the pancreas are serous and mucinous cysts. These tumors are more frequent in female. Although almost all serous cysts are benign, 40% of mucinous cysts are malign. Misdiagnosis may delay appropriate treatment and increase mortality.

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“…Digestive hemorrhage and weight loss are less frequent symptoms. Many patients with CNP present with no relevant clinical manifestations (4) .…”

Section: Discussionmentioning

confidence: 99%

“…Fluid may be obtained by fine-needle aspiration and may be used for cytologic and tumor markers analysis. Elevated CEA levels (>192 ng/mL) in the fluid aspirated is the best predictor of a mucinous lesion (4) .…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of cystic neoplasms of the pancreas

Coelho¹,

Valle

Ribas

et al. 2010

Arq. Gastroenterol.

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“…Preceding studies have reported 2-10% (Fernandezdel and Warshow, 1995;Le Bodic et al, 1996Brugge et al, 2004) but in a recent study 9-21% (Jani et al, 2008) were reported. Due to great vascular supply of pNETs cystic degeneration is uncommon (Li Destri et al, 2006).…”

Section: Discussionmentioning

confidence: 87%

Role of Endoscopic Ultrasound in Evaluation of Pancreatic Neuroendocrine Tumors - Report of 22 Cases from a Tertiary Center in Iran

Haghighi

Molaei²,

Foroughi³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…A diferencia de los TIPM, que uniformemente poseen la potencialidad de malignizarse, las lesiones quísticas se dividen en serosas o mucinosas, representando ambas diferentes entidades patológicas que poseen diferente potencial en cuanto a malignización 28,29 .…”

Section: Tumores Quísticos (Serosos/mucinosos)unclassified

Tumores quísticos del páncreas

et al. 2008

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Cystic tumors of the pancreas (Rev Méd Chile 2008; 136: 1188-96L os tumores de la glándula pancreática se caracterizan en general por su diagnóstico tardío y mal pronóstico. El tumor pancreático más común es el adenocarcinoma de los conductos y su sobrevida promedio no sobrepasa 5% a 5 años [1][2][3][4] .Durante los últimos años, ha sido posible el diagnóstico de una mayor cantidad de lesiones denominadas «incidentalomas», de las cuales las lesiones quísticas pancreáticas representan una importante proporción.Este fenómeno ha sido claramente descrito por el grupo del Massachussets General Hospital, quienes comunican cómo ellos han duplicado las resecciones pancreáticas efectuadas por tumores quísticos durante la última década 5 . Igual tendencia se observa en el reporte efectuado por Allen, de la experiencia del Memorial Sloan Kettering Center, quienes muestran un aumento en los casos evaluados, con 5 casos en 1995 comparado con 117 en 2004 6 .Debido al aumento en su diagnóstico y a las dificultades que su identificación ofrece, hemos querido analizar las principales características clí-nicas, radiológicas y patológicas de las lesiones más frecuentes del páncreas, con énfasis en todas aquellas diferentes al adenocarcinoma ductal. Tumor intraductal papilar mucinoso (TIPM).Constituye entre 20% y 30% de los tumores quísticos pancreáticos. Se caracteriza por desarrollarse a partir del epitelio del conducto pancreático principal o de alguna de sus ramas y por presentar secreción mucinosa espesa que se asocia a dilatación tanto del conducto como a la formación de quistes 7,8 .Esta lesión fue primeramente descrita en Japón en 1982 por Ohhashi 9 . El término TIPM fue dado recién en 1996 y 1997 por la Organización Mundial de la Salud y el Instituto de Patología de las Fuerzas Armadas, respectivamente 10,11 .Afecta con igual frecuencia a ambos sexos y mayoritariamente a pacientes en la sexta y séptima década 12 .

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Cystic Neoplasms of the Pancreas

Cited by 679 publications

References 46 publications

Surgical treatment of cystic neoplasms of the pancreas

Surgical treatment of cystic neoplasms of the pancreas

Role of Endoscopic Ultrasound in Evaluation of Pancreatic Neuroendocrine Tumors - Report of 22 Cases from a Tertiary Center in Iran

Tumores quísticos del páncreas

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