Clinical Features and Radiological Findings of Cystic Tumor of the Pancreas

ABSTRACT

PURPOSE: Most cystic tumors of the pancreas are composed of serous cystic tumor, mucinous cystic tumor, solid pseudo- papillary epithelial neoplasm (SPEN) and intraductal papillary mucinous tumor (IPMT). With advancements in diagnostic imaging, cystic lesions of the pancreas are being detected with increasing frequency; however, there is still difficulty determining the appropriate diagnostic and therapeutic plan. METHODS: A retrospective review was performed of 15 cases that underwent surgery for pancreatic cystic tumors in our department between July 1995 and August 2005. All 15 cases identified had their records and radiological images reviewed. Radiological findings were characterized and analyzed by one radiologist. RESULTS: The median age was 55.9 years. Six cases were male and nine were female. Common symptoms included: epigastirc pain 6/14 (43%) and palpable mass 2/14 (14%). The accuracy of the preop radiological diagnosis including abdominal CT and US was 12/15 (80%). One case of serous cystic tumor, one of chronic pancreatitis and one SPEN were misdiagnosed; the preoperative diagnosis for these cases was mucinous cystic tumor. Serous cystic tumors were seen with central calcification 2/3 (67%), external lobulation 3/3 (100%); however, the mucinous cystic tumors were seen with peripheral calcification 4/5 (80%), no external lobulation 5/5 (100%) by radiological evaluation. There was no calcification, but external lobulation was common in the IPMT. The SPEN had no specific radiological findings except for peripheral calcification. CONCLUSION: Future multicenter studies with endoscopic sonography and aspiration cytology is needed for improved accuracy of diagnosis.