Abstract
Background: Most cystic neoplasms of the pancreas (CNPs) are incidentally discovered. Their management continues to be debated and preoperative diagnosis is often inaccurate. Methods: Retrospective review of 330 patients with incidentally discovered CNPs. Preoperative and final histological diagnoses were correlated. Results: 41% (136/330) of patients were operated on at diagnosis. 50 patients underwent resection for a presumed branch-duct (Bd) intraductal papillary mucinous neoplasm (IPMN), which was confirmed in only 64% (32/50); of the remaining patients, 20% had main-duct involvement. Mucinous cystic neoplasm was the preoperative diagnosis in 30/136 patients, histologic examination was confirmatory in only 60% (18/30). Most lesions presumed to be main-duct or combined IPMNs or serous cystadenomas were confirmed as such after resection (15/16 and 11/12, respectively). Multifocality was not only associated with Bd-IPMN, and 5% of all cysts were non-neoplastic. Overall, in only 68% of cases did the preoperative and histological diagnoses match. Conclusions: In an experienced, high-volume center, preoperative diagnosis was incorrect in one-third of incidentally discovered CNPs who underwent resection. Of particular concern, 20% of presumed Bd-IPMN had a main-duct component. Conversely, 5% of resected cysts were not even neoplastic. Clearly, better diagnostic methods are needed to aid in formulating appropriate treatment strategies.
Original language | English (US) |
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Pages (from-to) | 144-150 |
Number of pages | 7 |
Journal | Pancreatology |
Volume | 10 |
Issue number | 2-3 |
DOIs | |
State | Published - Jun 2010 |
Externally published | Yes |
Keywords
- Branch-duct IPMNs
- Cystic neoplasms
- Incidental pancreatic cysts
- Intraductal papillary mucinous neoplasms
- Main-duct IPMNs
- Mucinous cystic neoplasms
- Pancreas, cystic neoplasms
- Pancreatic cysts
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Hepatology
- Gastroenterology