2016International Journal of Surgery and MedicineOpen access

PANCREATIC CYSTIC NEOPLASMS: A CASE SERIES

Murat Kılıç, Ahmet Erdoğan, Cengiz Ceylan, Barış Saylam, Mesut Tez

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Abstract

Background: Cystic neoplasms of the pancreas are a special heterogeneous group of pancreatic tumors with variable clinical and diagnostic characteristics. Its incidence has dramatically increased in recent years due to technological improvements in cross-sectional imaging methods, rising in awareness of their existence, and increased in human life-spam. \nAim: To evaluate the clinical, radiological, and surgical characteristics of pancreatic cystic neoplasm. \nMethods: The clinical findings, diagnostic features, therapeutic managements, and oncological outcomes of 16 patients with pancreatic cystic neoplasm were retrospectively evaluated. \nResults: There were nine female and seven male patients, with a mean age of 54 years. More than half of the patients (56.3%) were asymptomatic. Abdominal pain and icterus were the most common symptom and sign, respectively. Computed tomography and magnetic resonance imaging showed the cystic lesion in all patients. Magnetic resonance imaging revealed a connection between cystic tumor with pancreatic duct in 8 (50%) cases. Pancreaticoduodenectomy was the most performed operation. Pancreatic adenocarcinoma with cystic degeneration and solid pseudopapillary neoplasia were the most frequent diagnoses at the final histopathology. Pancreatic fistula was developed in one case. One patient died during the postoperative period. Two patients who had adenocarcinoma developed recurrence during the follow-up period. \nConclusion: The discrimination of pancreatic cystic neoplasms is usually difficult preoperatively. Therefore, the structure and the localization of the lesion, and the involvement of pancreatic ductal system should be clearly demonstrated by imaging modalities for a correct surgical planning.

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Background: Cystic neoplasms of the pancreas are a special heterogeneous group of pancreatic tumors with variable clinical and diagnostic characteristics. Its incidence has dramatically increased in recent years due to technological improvements in cross-sectional imaging methods, rising in awareness of their existence, and increased in human life-spam. \nAim: To evaluate the clinical, radiological, and surgical characteristics of pancreatic cystic neoplasm. \nMethods: The clinical findings, diagnostic features, therapeutic managements, and oncological outcomes of 16 patients with pancreatic cystic neoplasm were retrospectively evaluated. \nResults: There were nine female and seven male patients, with a mean age of 54 years. More than half of the patients (56.3%) were asymptomatic. Abdominal pain and icterus were the most common symptom and sign, respectively. Computed tomography and magnetic resonance imaging showed the cystic lesion in all patients. Magnetic resonance imaging revealed a connection between cystic tumor with pancreatic duct in 8 (50%) cases. Pancreaticoduodenectomy was the most performed operation. Pancreatic adenocarcinoma with cystic degeneration and solid pseudopapillary neoplasia were the most frequent diagnoses at the final histopathology. Pancreatic fistula was developed in one case. One patient died during the postoperative period. Two patients who had adenocarcinoma developed recurrence during the follow-up period. \nConclusion: The discrimination of pancreatic cystic neoplasms is usually difficult preoperatively. Therefore, the structure and the localization of the lesion, and the involvement of pancreatic ductal system should be clearly demonstrated by imaging modalities for a correct surgical planning.

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Available abstract

Background: Cystic neoplasms of the pancreas are a special heterogeneous group of pancreatic tumors with variable clinical and diagnostic characteristics. Its incidence has dramatically increased in recent years due to technological improvements in cross-sectional imaging methods, rising in awareness of their existence, and increased in human life-spam. \nAim: To evaluate the clinical, radiological, and surgical characteristics of pancreatic cystic neoplasm. \nMethods: The clinical findings, diagnostic features, therapeutic managements, and oncological outcomes of 16 patients with pancreatic cystic neoplasm were retrospectively evaluated. \nResults: There were nine female and seven male patients, with a mean age of 54 years. More than half of the patients (56.3%) were asymptomatic. Abdominal pain and icterus were the most common symptom and sign, respectively. Computed tomography and magnetic resonance imaging showed the cystic lesion in all patients. Magnetic resonance imaging revealed a connection between cystic tumor with pancreatic duct in 8 (50%) cases. Pancreaticoduodenectomy was the most performed operation. Pancreatic adenocarcinoma with cystic degeneration and solid pseudopapillary neoplasia were the most frequent diagnoses at the final histopathology. Pancreatic fistula was developed in one case. One patient died during the postoperative period. Two patients who had adenocarcinoma developed recurrence during the follow-up period. \nConclusion: The discrimination of pancreatic cystic neoplasms is usually difficult preoperatively. Therefore, the structure and the localization of the lesion, and the involvement of pancreatic ductal system should be clearly demonstrated by imaging modalities for a correct surgical planning.

Key concepts: Medicine, Series (stratigraphy), General surgery, Radiology, Paleontology, Biology

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