Presentation and Management of Cystic Neoplasms of the Pancreas in the Gastroenterology and Hepatology Teaching Hospital
Iraqi Postgraduate Medical Journal,
2012, Volume 11, Issue 3, Pages 353-362
Pancreatic cystic neoplasms are relatively uncommon, and constitute about 1-2% of all primary pancreatic tumors and are thought to account for approximately 10-15% of all pancreatic cystic lesions. These tumors are composed of a variety of neoplasms with a wide range of malignant potential
To define the clinical differences among different pathologic groups of cystic neoplasm of the pancreas, distinguish these neoplasms from pancreatic pseudocysts, and benign from malignant or premalignant varieties.
PATIENTS AND METHODS:
Retrospective study of 49 patients with clinical, laboratory and imaging features suggestive of cystic neoplasms of the pancreas who were managed at the Gastroenterology and Hepatology teaching Hospital over the period from September 2004 to January 2011. All the patients underwent CT scanning and EUS. ERCP was performed for 16 patients.
The mean age was 46 years, 31 patients' females and 18 males. (73%) were symptomatic, 32 lesions (65.3 %) were located in the pancreatic body and tail whereas 13 lesions (26.5 %) were located in the pancreatic head, neck and uncinate process. The mean of maximum tumor diameter was 8.76 cm. An attempted curative resection was undertaken for 21 patients. CT gave accurate result in 9 out of 16 patients in SCN,16 out of 19 in MCN and 5 out of 6 in IPMN ,EUS including EUS guided FNA gave accurate diagnosis in all patients.
The role of imaging in detecting the cystic neoplasms of the pancreas and confirming their locations and proximity to surrounding structures is well recognized and CT or MRI is the best for this purpose. EUS including EUS-guided FNA for cytology and fluid studies has proven to be a useful addition to the diagnostic armamentarium of the clinicians
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