Cystic Neoplasms and Intraductal Papillary Mucinous Neoplasms of the Pancreas

ABSTRACT

PURPOSE: Cystic neoplasms of the pancreas are rare tumors that occurs in approximately 10~15% of all cystic lesions of the pancreas. A recent trend has been to resect all cystic neoplasms, without any attempt to preoperatively determine the exact histologic subtype. METHODS: We retrospectively reviewed the clinical records of fifteen patients with cystic neoplasms and intraductal papillary mucinous neoplasms of the pancreas who were treated surgically between January, 1991 and May, 2001. RESULTS: Patient ages ranged from 14 to 69 years with a mean of 53.4. Sixty percent of patients were women. There were 4 cases of mucinous cystic neoplasms, 7 solid pseudopapillary tumors, 3 intraductal papillary mucinous neoplasms, and 1 serous cystadenoma. The most prominant symptom was an abdominal mass. Pancreaticoduodenectomy was performed in six cases, distal pancreatectomy in five cases, excision of cyst in three cases and median segmental pancreatectomy in one case. The mortality rate from surgery was 0%, and the overall perioperative complication rate was 40%. The mean follow-up was 24 months (range from 2 months to 63 months). Two patients, both displaying intraductal papillary mucinous neoplasms, died at 9 and 14 months postoperatively. CONCLUSION: We suggest that cystic neoplasms of the pancreas including intraductal papillary mucinous neoplasm should be resected because they are malignant or pre-malignant. Endoscopic retrograde cholangiopancreatography is the imaging modality of choice for the diagnosis of intraductal papillary mucinous neoplasm. We conclude that the prognosis for resected cystic neoplasms of the pancreas is good.