Vnitr Lek 2013, 59(7):572-577

Cystic tumors of the pancreas - our experience with diagnostics

T. Krechler1,*, J. Ulrych2, M. Dvořák1, D. Hoskovec2, J. Macášek1, T. Švestka1, J. Hořejš3
1 IV. interní klinika - klinika gastroenterologie a hepatologie 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Aleš Žák, DrSc.
2 I. chirurgická klinika - břišní, hrudní a úrazové chirurgie 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Zdeněk Krška, CSc.
3 Radiodiagnostická klinika 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Jan Daneš, CSc.

Number of newly diagnosed cystic pancreatic tumors is permanently increasing. This fact is primarily related to the development of new diagnostic methods. The main representative ones are: serous cystadenoma, mucinous cystic neoplasm, intraductal papillary mucinous neoplasm and solid pseudopapillar tumor. Because of the malignant potential of these lesions, proper indication of surgical treatment is extremely important. The article highlights and describes our experience in diagnostics and therapy of cystic pancreatic tumors diagnosed in the General Teaching Hospital Prague in the period: 1/2008-12/2012. All patients were investigated by computerised tomography and endoscopic ultrasound with fine - needle aspiration biopsy. Thirty seven patients in total were diagnosed with cystic pancreatic tumors: 19 with serous cystadenoma, 5 with mucinous cystic neoplasm, 5 with mucinous cystadenocarcinoma, 5 with intraductal papillary mucinous neoplasm and 3 with solid pseudopapillar tumor. In 14 cases patients were indicated for surgery, in 1 case signs of malignant transformation were found. Determination of the optimal strategy for diagnostic and therapeutic procedures in patients with cystic pancreatic tumors requires the diagnosis, treatment and follow-up observation in adequately equiped specialized centers.

Keywords: cystic pancreatic tumors; serous cystadenoma; mucinous cystic neoplasm; intraductal papillary mucinous neoplasm; solid pseudopapillary tumor; diagnostics; therapy; endoscopic ultrasound; fine-needle apiration biopsy

Received: April 30, 2013; Published: July 1, 2013  Show citation

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Krechler T, Ulrych J, Dvořák M, Hoskovec D, Macášek J, Švestka T, Hořejš J. Cystic tumors of the pancreas - our experience with diagnostics. Vnitr Lek. 2013;59(7):572-577.
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    References

    1. Singhal D, Kakodkar R, Sud R el al. Issues in the management of pancreatic pseudocysts. JOP 2006; 7: 502-507. Go to PubMed...
    2. Warshaw AL. Pancreatic cysts and pseudocysts: new rules for a new game. Br J Surg 1989; 76: 533-534. Go to original source... Go to PubMed...
    3. Yamaguchi T, Takahashi H, Kagawa R et al. Huge pseudocysts of the pancreas caused by poorly differential invasive ductal adenocarcinoma with osteoclas-like cells: report of a case. Hepatogastroenterology 2007; 54: 599-601. Go to PubMed...
    4. Oehler U, Jürs M, Klöppel G et al. Osteoclast-like giant cell tumour of the pancreas presenting as pseudocyst-like lesion. Virchows Arch 1997; 431: 215-218. Go to original source... Go to PubMed...
    5. Jin YM, Yim H, Choi IJ et al. Pancreas serous cystadenoma mimicking pseudocyst. Yonsei Med J 1997; 38: 63-65. Go to original source... Go to PubMed...
    6. Myung SJ, Kim MN, Lee SK et al. Adenosquamous carcinoma of the pancreas: differentiation from pancreatic pseudocyst. Gastrointest Endosc 1998; 47: 410-413. Go to original source... Go to PubMed...
    7. Volkan Adsay N. Cystic lesions of the pancreas. Mod Pathol 2007; 20 (Suppl 1): S71-S93. Go to original source... Go to PubMed...
    8. Strobbel O, Z'graggen K, Schmitz-Winnenthal FH et al. Risk of malignancy in serous cystic neoplasms of the pancreas. Digestion 2003; 68: 24-33. Go to original source... Go to PubMed...
    9. Tseng IF, Warshaw AL, Sahani DV et al. Serous cystadenoma of the pancreas: tumour growth rates and recommendations for treatment. Ann Surg 2005; 242: 413-421. Go to original source... Go to PubMed...
    10. Goh BK, Tan YM, Yap YM et al. Pancreas serous oligocystic adenomas: clinicopathologic features and a comparison with serous microcystic adenomas and mucinous cystic neoplasma. World J Surg 2006; 30: 1553-1559. Go to original source... Go to PubMed...
    11. Salvia R, Festa J, Butturini G et al. Pancreatic cystic tumours. Minerva Chir 2004; 59: 185-207. Go to PubMed...
    12. Campbell F, Azadeh B. Cystic neoplasms of the exocrine pancreas. Histopathology 2008; 52: 539-551. Go to original source... Go to PubMed...
    13. Tanaka M, Chari S, Adsay NV et al. International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas. Pancreatology 2006; 6: 17-32. Go to original source... Go to PubMed...
    14. Singh M, Maitra A. Precursor lesions of pancreatic cancer: molecular pathology and clinical implications. Pancreatology 2007; 7: 9-19. Go to original source... Go to PubMed...
    15. Tanaka M. Intraductal papillary mucinous neoplasm of the pancreas: diagnosis and management. Pancreas 2004; 28: 282-288. Go to original source... Go to PubMed...
    16. Nagai K, Doi R, Kida A et al. Intraductal papillary mucinous neoplasms of the pancreas: clinicopathologic characteristic and long-term follow-up after resection. World J Surg 2008; 32: 271-280. Go to original source... Go to PubMed...
    17. Sohn TA, Yeo CI, Cameron JL et al. Intraductal papillary mucinous neoplasms of the pancreas: an updated experience. Ann Surg 2004; 239: 788-799. Go to original source... Go to PubMed...
    18. Shima Y, Mori M, Takakura N et al. Diagnosis and management of cystic pancreatic tumours with mucin production. Br J Surg 2000; 87: 1041-1047. Go to original source... Go to PubMed...
    19. Yamaguchi T, Ogawa Y, Chijiiwa K et al. Mucin-hypersecreting tumours of the pancreas: assessing the grade of malignancy preoperatively. Am J Surg 1996; 171: 427-431. Go to original source... Go to PubMed...
    20. Traverso LW, Peralta EA, Ryan JA Jr et al. Intraductal neoplasms of the pancreas. Am J Surg 1998; 175: 426-432. Go to original source... Go to PubMed...
    21. Sugiyama M, Atomi Y. Intraductal papillary mucinous tumours of the pancreas: imaging studies and treatment strategies. Ann Surg 1998; 228: 685-691. Go to original source... Go to PubMed...
    22. Matsumoto M, Aramaki M, Yada K et al. Optimal management of the branch duct type intraductal papillary mucinous tumours of the pancreas. J Clin Gastroenterol 2003; 36: 261-265. Go to original source... Go to PubMed...
    23. Sugiyama M, Izumisato Y, Abe N et al. Predictive factors for malignancy in intraductal papillary-mucinous tumours of the pancreas. Br J Surg 2003; 90: 1244-1249. Go to original source... Go to PubMed...
    24. Rodriguez IR, Salvia R, Crippa S et al. Branch-duct intraductal papillary mucinous neoplasms: observations in 145 patients who underwent resection. Gastroenterology 2007; 133: 72-79. Go to original source... Go to PubMed...
    25. Del Chiaro M, Verbeke C, Salvia R et al. European experts consensus statement on cystic tumours of the pancreas. Dig Liver Dis 2013. In press. Go to original source... Go to PubMed...
    26. D'Angelica M, Brennan MF, Suriawanata AA et al. Intraductal papillary mucinous neoplasms of the pancreas: an analysis of clinicopathologic features and outcome. Ann Surg 2004; 239: 400-408. Go to original source... Go to PubMed...
    27. Michaels PJ, Brachtel EF, Bounds BC et al. Intraductal papillary mucinous neoplasm of the pancreas: cytologic features predict histologic grade. Cancer 2006; 108: 163-173. Go to original source... Go to PubMed...
    28. Garcea G, Ong SL, Rajesh A et al. Cystic lesions of the pancreas. A diagnostic and management dilemma. Pancreatology 2008; 8: 236-251. Go to original source... Go to PubMed...
    29. Tipton SG, Smyrk TC, Sarr MC et al. Malignant potential of solid pseudopapillary neoplasm of the pancreas. Br J Surg 2006; 93: 733-737. Go to original source... Go to PubMed...
    30. Roggin KK, Chennat J, Oto A et al. Pancreatic cystic neoplasm. Curr Probl Surg 2010; 47: 459-510. Go to original source... Go to PubMed...
    31. Adsay NV, Andea A, Weawer DC. Centrally necrotic invasive ductal adenocarcinomas of the pancreas presenting clinically as macrocystic leasions. Mod Pathol 2001; 13: 1125A.
    32. Thompson NW, Eckhauser FE, Vinik AI et al. Cystic neuroendocrine neoplasms of the pancreas and liver. Ann Surg 1984; 199: 158-164. Go to original source... Go to PubMed...
    33. Repak R, Rejchrt S, Bartova J et al. Endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration with cyst fluid analysis in pancreatic cystic neoplasms. Hepatogastroenterology 2009; 56: 629-635. Go to PubMed...

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