Primary Pancreatic Cystic Neoplasms Revisited. Part I: Serous Cystic Neoplasms

Sakorafas, George H.; Smyrniotis, Vasileios; Reid‐Lombardo, Kaye M.; Sarr, Michael G.

doi:10.1016/j.suronc.2010.12.002

Cited by 105 publications

(58 citation statements)

References 63 publications

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“…SCN represents 32%-39% of all cystic neoplasms [2,9] , with a peak of incidence at 62 years of age (although the range is quite wide), a slight prevalence in females (3-4:1) [10] and a slight preference for the pancreatic head (50%) [11] . It is usually asymptomatic unless it is larger than 4 cm, in which case the symptoms are caused by the mass effect.…”

Section: Epidemiological and Clinical Aspectsmentioning

confidence: 99%

Pancreatic cystic lesions: How endoscopic ultrasound morphology and endoscopic ultrasound fine needle aspiration help unlock the diagnostic puzzle

Barresi

Tarantino²,

Granata³

et al. 2012

WJGE

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Cystic lesions of the pancreas are being diagnosed with increasing frequency, covering a vast spectrum from benign to malignant and invasive lesions. Numerous investigations can be done to discriminate between benign and non-evolutive lesions from those that require surgery. At the moment, there is no single test that will allow a correct diagnosis in all cases. Endoscopic ultrasound (EUS) morphology, cyst fluid analysis and cytohistology with EUS-guided fine needle aspiration can aid in this difficult diagnosis.

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Section: Epidemiological and Clinical Aspectsmentioning

confidence: 99%

Pancreatic cystic lesions: How endoscopic ultrasound morphology and endoscopic ultrasound fine needle aspiration help unlock the diagnostic puzzle

Barresi

Tarantino²,

Granata³

et al. 2012

WJGE

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“…In fact pancreatic carcinogenesis should be intended as a multistep phenomenon with progressive changes from the normal pancreatic ductal epithelium to infiltrating carcinoma [79] . The other three well known precursor lesions are: pancreatic intraepithelial neoplasms (PanINs), intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) [78][79][80][81] .…”

Section: Precursor Lesionsmentioning

confidence: 99%

“…Mucinous cystic neoplasms (MCNs) are cystic epithelial neoplasms that occur almost in women, lack of communication with the pancreatic ductal system and have a predilection for the body and tail [80,87] . Malignancy rates of resected MCNs vary from 6% to 36% [80] and usually resembles common ductal adenocarcinoma.…”

Section: Mucinous Cystic Neoplasmsmentioning

confidence: 99%

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Endoscopic ultrasonography for surveillance of individuals at high risk for pancreatic cancer

Lami

Biagini

Galli

2014

WJGE

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Pancreatic cancer is a highly lethal disease with a genetic susceptibility and familial aggregation found in 3%-16% of patients. Early diagnosis remains the only hope for curative treatment and improvement of prognosis. This can be reached by the implementation of an intensive screening program, actually recommended for individuals at high-risk for pancreatic cancer development. The aim of this strategy is to identify premalignant precursors or asymptomatic pancreatic cancer lesions, curable by surgery. Endoscopic ultrasound (EUS) with or without fine needle aspiration (FNA) seems to be the most promising technique for early detection of pancreatic cancer. It has been described as a highly sensitive and accurate tool, especially for small and cystic lesions. Pancreatic intraepithelial neoplasia, a precursor lesion which is highly represented in highrisk individuals, seems to have characteristics chronic pancreatitis-like changes well detected by EUS. Many screening protocols have demonstrated high diagnostic yields for pancreatic pre-malignant lesions, allowing prophylactic pancreatectomies. However, it shows a high interobserver variety even among experienced endosonographers and a low sensitivity in case of chronic pancreatitis. Some new techniques such as contrast-enhanced harmonic EUS, computer-aided diagnostic techniques, confocal laser endomicroscopy miniprobe and the detection of DNA abnormalities or protein markers by FNA, promise improvement of the diagnostic yield of EUS. As the resolution of imaging improves and as our knowledge of precursor lesions grows, we believe that EUS could become the most suitable method to detect curable pancreatic neoplasms in correctly identified asymptomatic at-risk patients.© 2014 Baishideng Publishing Group Inc. All rights reserved. Key words: Endoscopic ultrasonography; Pancreatic cancer; SurveillanceCore tip: In the era of early diagnosis and screening programs, endoscopic ultrasound (EUS) represents the most promising tool able to identify pancreatic precursor neoplasms in high risk individuals. If compared to other imaging techniques, it is highly accurate to diagnose small pancreatic cancer and pre-malignant lesions, with very low rate of complications and limitations. Here are reported the current role of EUS in various international screening programs and its future possible developments.

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“…Therefore the management is mostly to monitor and observe the patient. There are some exceptions to this rule and surgery should be considered for patients with symptoms (e.g., abdominal pain, mass effect, jaundice, and nausea), tumor size greater than 4 cm, or if the diagnosis is uncertain (Sakorafas et al, 2011). Observation is also recommended for SCNs in elderly patients with typical signs on CT scan and smaller size of the lesion (Kimura et al, 2012).…”

Section: Surgerymentioning

confidence: 99%

Pancreatic cystic neoplasms: a review of preoperative diagnosis and management

Bai

Zhang

Masood

et al. 2013

J. Zhejiang Univ. Sci. B

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Pancreatic cystic neoplasms (PCNs) are a diverse group of neoplasms in the pancreas, and are more increasingly encountered with widespread abdominal screening and improved imaging techniques. The most common types of PCNs are serous cystic neoplasms (SCNs), mucinous cystic neoplasms (MCNs), and intraductal papillary mucinous neoplasms (IPMNs). Clinicians frequently feel bewildered in the differential diagnosis and subsequent management among the various types of lesions in the pancreas, which may lead to overtreatment or delayed treatment. The current review provides recent developments in the understanding of the three most common types of PCNs, the latest modalities used in preoperative diagnosis and differential diagnosis, as well as the most up to date management. Suggestions for diagnosis and differential diagnosis of SCNs, MCNs, and IPMNs are also provided for young surgeons. Better understanding of these neoplasms is essential for clinicians to make accurate diagnosis and to provide the best management for patients.

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Primary Pancreatic Cystic Neoplasms Revisited. Part I: Serous Cystic Neoplasms

Cited by 105 publications

References 63 publications

Pancreatic cystic lesions: How endoscopic ultrasound morphology and endoscopic ultrasound fine needle aspiration help unlock the diagnostic puzzle

Pancreatic cystic lesions: How endoscopic ultrasound morphology and endoscopic ultrasound fine needle aspiration help unlock the diagnostic puzzle

Endoscopic ultrasonography for surveillance of individuals at high risk for pancreatic cancer

Pancreatic cystic neoplasms: a review of preoperative diagnosis and management

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