Multifocal/diffuse pancreatic serous cystic neoplasms: Systematic review with a new case

Wu, Yan‐Dong; Samuels, Jason M.; Harnke, Ben; Negrini, Daniel; Al-Musawi, Mohammed; Meguid, Cheryl; Ahrendt, Steven A.; Schulick, Richard D.; Chiaro, Marco Del; Oba, Atsushi

doi:10.1016/j.pan.2020.04.015

Cited by 4 publications

(4 citation statements)

References 29 publications

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“…Genetic testing detects mutations in nearly 100% of familial cases, whereas sensitivity can be significantly lower for sporadic cases because of disease mosaicism, regardless of the clinical signs 6 . Different from data reported in a recent review, 3 all our patients were young males (mean age at diagnosis, 37.6 years), and genetic testing for VHL-D was performed in all cases with negative result.…”

Section: Discussioncontrasting

confidence: 69%

“…Clinically, patients with diffuse SCNs are often asymptomatic, and very low disease-specific mortality has been described 3 . However, very few cases have been managed with a “wait-and-see” strategy so far, and data about long-term clinical evolution are lacking.…”

Section: Discussionmentioning

confidence: 99%

“…Multifocal or diffuse SCNs are extremely rare and are often associated with von Hippel–Lindau disease (VHL-D). In almost all reported cases, patients underwent surgery, and scanty data about conservative management are available 3 …”

mentioning

confidence: 99%

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Diffuse Pancreatic Serous Cystic Neoplasm

Bellocchi¹,

Mottes²,

Crinò³

et al. 2022

Pancreas

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

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Diffuse Pancreatic Serous Cystic Neoplasm

Bellocchi¹,

Mottes²,

Crinò³

et al. 2022

Pancreas

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“…This is generally well visualized by the use of MRI, but can be difficult to detect in cases of small cysts [20]. The presence of a multifocal cystic lesion is also very characteristic of BD-IPMNs, with the exception of multifocal SCNs that are associated with Von Hipple Lindau Syndrome (VHL) [29]. MCNs and oligocystic SCNs are unifocal, with MCNs almost exclusively affecting females and being located in the body and tail of the pancreas.…”

Section: Cystic Incidentalomas Of the Pancreasmentioning

confidence: 99%

Pancreatic incidentalomas: Investigation and management

2021

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The incidence of pancreatic incidentalomas (PIs) detected in otherwise asymptomatic patients is growing with the increasing quality and use of advanced imaging techniques. PI can present as isolated main pancreatic duct dilation or as a solid or cystic lesion. Although historically thought to be relatively rare, PIs are rather common, particularly cystic lesions of the pancreas, which can be detected in up to 49% of the general population. With the poor prognosis of pancreatic cancer, PIs are an opportunity for prevention and early diagnosis, but when managed poorly, they can also lead to overtreatment and unnecessary morbidity. The management of PI should begin with a dedicated pancreas protocol computed tomography (CT) scan or magnetic resonance imaging (MRI) to accurately characterize duct size, lesion characteristics and establish an accurate baseline for subsequent follow up. Diagnosis and subsequent management depends on the extent of main duct dilation and solid versus cystic appearance. Solid lesions are highly concerning for malignancy. Cystic lesions can be further categorized as intraductal papillary mucinous neoplasms of the pancreas (IPMNs) or mucinous cystic neoplasms (MCNs), both of which harbour malignant potential, or as serous cystic neoplasms (SCNs) that are benign. In this paper, we summarize the major challenges related to PI and present pragmatic suggestions for management.

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