"Ductectatic" mucinous cystadenoma and cystadenocarcinoma of the pancreas.

Abstract

Five cases of localized cystic dilatation of a side branch of the main pancreatic duct due to a new entity ("ductectatic" mucinous cystadenoma and cystadenocarcinoma) are reported. The dilated duct was widely covered by epithelium indistinguishable from that of mucinous cystadenoma (n = 4) or cystadenocarcinoma (n = 1) of the pancreas. All lesions were located in the uncinate process and were about 3 cm in size. On computed tomographic scans and sonograms, lesions were difficult to distinguish from simple cyst of the pancreas unless lobulated or irregular margins were demonstrated. Endoscopic retrograde pancreatography (ERP) or operative pancreatography clearly demonstrated characteristic findings: localized, prominent cystic dilatation of a side branch of the main pancreatic duct with grape-like clusters or pear-shaped pools of contrast material associated with filling defects of various sizes. When a cystic lesion is noted in the uncinate process of the pancreas, ERP is mandatory to confirm or rule out this potentially or overtly malignant disease.

Ductectatic mucinous cystic neoplasms of the pancreas: evaluation with MR cholangiopancreatography.

“…In the remaining five patients. the diagnosis was made on the basis of characteristic findings of ERCP as previouslyreported [2,11,12](a localized and prominentcysticdilatationof a branchduct that showed grapelike clusters or pear-shaped pools of contrast material associated with filling defects of varioussizes with or without dilatationof the main pancreatic duct). Because thetumors inthefivepa tientshad smallcysts (28 mm), lack of mural nod ule, and thickened wall, the cystic lesions were thoughtto be not overtlymalignant,and the patients refused surgical intervention.…”

“…Discussion Ductectaticmucinouscysticneoplasmsof the pancreas,also known asductectatic muci nous cystadenoma and cystadenocarcinoma [2] or mucinous ductal ectasia of the pancreas [3]. are characterized by the presence of a mass lesion that represents localized cystic dilatation of a branch duct of the pancreas.…”

“…are characterized by the presence of a mass lesion that represents localized cystic dilatation of a branch duct of the pancreas. They often contain thick mucoid secretions [2]. These terms reflect their clinical and ra diologic features.…”

“…These tumors originate from ductal epithelial cells within the pancreaticduct branches.This entity is characterized by a cystic dilatation of a branchof the pancreaticduct that often contains thick mucin, frequently locatedin the uncinate process of the pancreas [2]. Macroscopically, the lesion is covered with thin pancreatic paren chyma and consists of a conglomeration of com…”

“…municatingcysts 1-2 cm in diameter [2]. On CT and sonography, the tumor appears as clustered small cystsor asa cystic lesionwith a lobulated or irregular marginandsparse septa, characteris tics that are often associated with dilatation of the pancreatic duct near the lesion [4,5].…”