Cystic Neoplasms of the Pancreas

ABSTRACT

BACKGROUND: Cystic neoplasms of the pancreas are rare tumors that constitute about 10% of all cystic lesions of the pancreas and less than 1% of all pancreatic neoplasms. This study was conducted to investigate the diagnostic accuracy and postoperative results for these rare tumors. METHODS: The authors reviewed retrospectively 7 patients with cystic neoplasms of the pancreas who had been treated surgically in the period from 1986 through 1998 at the Department of Surgery, Paik Hospital, Seoul. RESULTS: There were 3 serous cystadenomas, 3 mucinous cystadenomas, and 1 papillary and cystic neoplasm. All 7 patients were women. The mean age of the patients was 36.7 years, 45 years for the serous tumors and 37 for the mucinous tumors. Two patient had diabetes mellitus. Major symptoms were abdominal pain (71%) and an abdominal mass (29%). One patient with a mucinous cystadenoma presented with bleeding from gastric varix which developed as a consequence of a splenic vein obstruction by the tumor. The positive rate for CEA was 33.3%, and that for CA 19-9 was 50.0%. No patient showed an abnormally elevated serum amylase level. Computed tomography was helpful in differentiating cystic tumors from pseudocysts or adenocarcinomas of the pancreas. The sites of the lesions were the tail in 3 cases, the body in 2cases, and the head in 2 cases. A distal pancreatectomy was performed in 5 cases, a pylorus-preserving pancreatoduodenectomy in 1 case, and enucleation of the cyst in 1 case. All the patients were alive at 3 to 145 months postoperatively and showed no evidence of disease. CONCLUSION: We conclude that the prognosis for resected cystic neoplasms of the pancreae is good. The correct preoperative differential diagnosis of pancreatic cystic lesions is important for planning the appropriate management, even though the clinical and the radiological features of these lesions are not always reliable.