Cystic lesions of the pancreas are encountered frequently in clinical practice. Cystic neoplasms of the pancreas are much less common. In order to diagnose and most effectively treat these lesions, the surgeon must understand their clinical presentation in order to plan appropriate preoperative evaluation and therapeutic intervention. The following is a descriptive outline of the most common types of cystic neoplasms of the pancreas and a discussion of their preoperative, intraoperative, and postoperative management. The goal of the paper is to provide a functional understanding of cystic neoplasms of the pancreas so that they may be recognized and appropriately treated.
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References
1.
HowardJ. Cystic neoplasm and true cysts of the pancreas. Surg Clin North Am, 1989;69:651–65.
2.
YeoCJ, CameronJL. The Pancreas. In: SabistonDC, LyerlyHK, eds. Textbook of Surgery: the Biologic Basis of Modern Surgical Practice, 15th Ed. Philadelphia: WB Saunders Co, 1997, pp 1168–170, 1175.
3.
WarrenKW, AthanassiadesS, FrederickP, . Surgical treatment of pancreatic cysts: Review of 183 cases. Ann Surg1966;163:886–91.
4.
SpertiC, CappellazzoF, PasqualiC, . Cystic neoplasm of the pancreas: Problems in differential diagnosis. Am Surg1993; 59:740–5.
SennN. The surgical treatment of cysts of the pancreas. Am J Med Sci1885;169:17–49.
14.
MahornerH, MattsonH. The etiology and pathology of cysts of the pancreas. Arch Surg1931;22:1018–33.
15.
BrunschwigA. The surgery of pancreatic tumors. St Louis: CV Mosby Co, 1942, pp 164–82.
16.
BensonR, GordonW. Cystadenoma of the pancreas. Surgery1946;21:353–61.
17.
CullenPK, ReMineWH, DahlinDC. A clinicopathological study of cystadenocarcinoma of the pancreas. Surg Gynecol Obstet1963;117:189–95.
18.
CompagnoJ, OertelJE. Microcystic adenomas of the pancreas (glycogen-rich cystadenomas). Am Soc Clin Pathol1978;69: 289–98.
19.
GeorgeDH, MurphyF, MichalskiR, UlmerBG. Serous cystadenocarcinoma of the pancreas: A new entity?Am J Surg Pathol1989;13:61–6.
20.
YoshimiN, SugeS, TanakaT, . A rare case of serous cystadenocarcinoma of the pancreas. Cancer1962;69:2449–53.
21.
CompagnoJ, OertelJE. Mucinous cystic neoplasms of the pancreas with overt and latent malignancy (cystadenocarcinoma and cystadenoma). Am Soc Clin Pathol1978;69:573–80.
22.
PykeCM, van HeerdenJ A, ColbyTV, . The spectrum of serous cystadenoma of the pancreas: Clinical, pathological and surgical aspects. Ann Surg1992;215:132–9.
23.
YangEK, JoehlRJ, TalamontiMS. Cystic neoplasms of the pancreas. J Am Coll Surg1994;179:747–57.
24.
JohnsonCD, StephensDH, CharboneauJW, . Cystic pancreatic tumors: CT and sonographic assessment. Am J Radiol1988;151:1133–8.
25.
Fernandez del CastilloC, WarshawAL. Cystic tumors of the pancreas. Surg Clin North Am1995;75:1001–15.
26.
BastidC, BernardJP, SarlesH, . Mucinous ductal ectasia of the pancreas: A premalignant disease and a cause of obstructive pancreatitis. Pancreas1991;6:15–22.
27.
ItaiY. Different terms for the same disease: Intraductal mucin-producing tumor versus mucinous tumor of the pancreas. Radiology1996;200:285.
28.
ItaiY, OhhashiK, MagaiH, . “Ductectatic” mucinous cystadenoma and cystadenocarcinoma of the pancreas. Radiology1986;161:697–700.
29.
WarshawAL. Mucinous cystic tumors and mucinous ductal ectasia of the pancreas. Gastrointest Endosc, 1991:37:199–201.
30.
YamadaM, KozukaS, YamaoK, . Mucin-producing tumor of the pancreas. Cancer1991;68:159–68.
31.
ObaraT, MaguchiH, SaitohY, . Mucin-producing tumor of the pancreas: A unique clinical entity. Am J Gastroenterol1991;86:1619–25.
32.
TianF, MylesJ, HowardJM. Mucinous pancreatic ductal ectasia of latent malignancy: An emerging clinicopathologic entity. Surgery1991;111:109–13.
33.
ProcacciC, GrazianiR, BicegoE, . Intraductal mucin-producing tumors of the pancreas: Imaging findings. Radiology1996;198:249–57.
34.
YamaguchiK, TanakaM. Mucin-hypersecreting tumors of the pancreas with mucin extrusion through an enlarged papilla. Am J Gastroenterol1991;86:835–9.
35.
SanfeyH, MendelsohnG, CameronJL. Solid and papillary neoplasm of the pancreas: A potentially curable surgical lesion. Ann Surg1983;197:272–5.
36.
NishiharaK, NagoshiM, TsuneyoshiM, . Papillary cystic tumors of the pancreas: Assessment of their malignant potential. Cancer1993;71:82–92.
37.
SclafaniLM, ReuterVE, CoitDG, BrennanMF. The malignant nature of papillary and cystic neoplasm of the pancreas. Cancer1991;68:153–8.
38.
MaoC, GuvendiM, DomenicoDR, . Papillary cystic and solid tumors of the pancreas: A pancreatic embryonic tumor? Studies of three cases and cumulative review of the world's literature. Surgery1995;118:821–8.
39.
ZinnerMJ. Solid and papillary neoplasm of the pancreas. Surg Clin North Am1995;75:1017–24.
40.
JengLB, ChenMF, TangRP. Solid and papillary neoplasm of the pancreas: Emphasis on surgical treatment. Arch Surg1993; 128:433–6.
41.
ChoiBI, KimKW, HanMC, . Solid and papillary epithelial neoplasm of pancreas: CT findings. Radiology1988; 166:413–6.
42.
TodaniT, ShimadadK, WatanabeY, . Frantz's tumor: A papillary and cystic tumor of the pancreas in girls. J Pediatr Surg1998;23:116–21.
EeklemaEA, StephensDH, WardEM, SheedyPF. CT features of nonfunctioning islet cell carcinoma. Am J Radiol1964; 143:943–8.
45.
BuetowPC, ParrionTV, BuckJL, . Islet cell tumors of the pancreas: Pathologic-imaging correlation among size, necrosis and cysts, calcification, malignant behavior, and functional status. Am J Radiol1995;165:1175–9.
46.
SohaibSAA, ReznekRH, HealyJL, BesserGM. Cystic islet cell tumors of the pancreas. Am J Radiol1998; 170:217.
47.
WarshawAL, RutledgePL. Cystic tumors mistaken for pancreatic pseudocysts. Ann Surg1987;205:393–8.
48.
OhtomoK, FuruiS, OnoueM, . Solid and papillary epithelial neoplasm of the pancreas: MR imaging and pathologic correlation. Radiology1992;184:567–70.
49.
TalaminiMA, PittHA, HrubanRH, . Spectrum of cystic tumors of the pancreas. Am J Surg1992;163:117–24.
50.
LewandrowskiKB, SouthernJF, PinsMR, . Cyst fluid analysis in the differential diagnosis of pancreatic cysts. Ann Surg1993;217:41–7.
51.
RubinD, WarshawAL, SouthernJF, . Expression of CA 15.3 protein in the cyst contents distinguishes benign from malignant pancreatic mucinous cystic neoplasms. Surgery1994; 115:52–5.
