Diagnosis and Management of Pancreatic Cystic Neoplasms

Pancreatic cystic lesions: classification, diagnosis and treatment

“…35 The survival rate after surgical resection has been approximately 100% over a period of 4 years average follow-up, with isolated reports of recurrence in less than 1% of the cases. 29 …”

“…2,25 On endoscopic Ultrasound (EUS) associated with fine needle puncture of the cyst fluid, antigen carcinoembryonic values above 200ng/mL, 192-favor the diagnosis of MCN; as well as DNA sequence analysis with mutation in the KRAS without mutation of GNAS, favors the diagnosis of MCN at the expense of other cystic lesions. 29 ( Figure 8, 9). According to the guideline of Fukuoka 2012 resection is recommended for all surgical lesions of suggestive of MCN.…”

“…The rationale for this is 17-18% of the risk of malignancy; progression malignant disease even with benign characteristics; inability to predict which lesions contain or will progress to malignancy; and the characteristic of the lesion be distal, in younger patients and healthy, leading to a lower morbidity in operation. 29,32 ( Figure 10). C-macroscopic aspect.…”

“…The variant that affects the main duct presents a high risk of malignancy and requires immediate surgical resection, so it is important to discern the IPMN variants at the time of the diagnosis, in order to guide your management and determine the prognosis. 29 Most patients with IPMN show symptoms when the diagnosis, and abdominal pain the most frequent symptom associated with weight loss, jaundice or obstructive pancreatitis. 29 The are best diagnosed by CT IPMNs (TC) with Protocol for pancreas, venous and arterial phases venous contrast; magnetic resonance cholangiopancreatography (MRCP) with contrast with option of 3D reconstruction.…”

“…29 Most patients with IPMN show symptoms when the diagnosis, and abdominal pain the most frequent symptom associated with weight loss, jaundice or obstructive pancreatitis. 29 The are best diagnosed by CT IPMNs (TC) with Protocol for pancreas, venous and arterial phases venous contrast; magnetic resonance cholangiopancreatography (MRCP) with contrast with option of 3D reconstruction. The accuracy of the MRCP is greater than CT for detecting ductal communication, involvement of the main duct, extent of disease and the high risk features present in cysts.…”