Cystic Neoplasm of the Pancreas: Its Diagnosis and Treatment

Roh, Hye Rin; Kim, Sun Whe; Suh, Kyung Suk; Park, Yong Hyun; Kim, Yong Tae; Yoon, Yong Bum; Lee, Kuhn Uk

Abstract

BACKGROUND/AIMS: It is important to differentiate cystic neoplasm of the pancreas from pseudocyst and distinguish individual cystic neoplasm for optimal treatment.
METHODS
Clinicopathologic characteristics of sixty-four patients with cystic neoplasms of the pancreas who were treated surgically from March 1984 through February 1998 at Seoul National University Hospital were reviewed.
RESULTS
Their ages ranged from 8 to 78 years with a mean of 42.6. The 78.1% of the patients were women. There were 21 mucinous cystic tumors, 17 serous cystadenomas, 19 solid and papillary epithelial neoplasms, and 7 others. Three patients showed distal metastases. About two thirds were diagnosed accurately by radiological studies. Mucinous cystic tumor tended to have higher levels of amylase, carcinoembrionic antigen, CA 19-9, and CA 125 in the cystic fluid than other cystic tumors. The epithelial cells were found in only half of the cases on cytologic examination. Fifty-eight patients are still alive. Their survival periods are from 3 to 146 months. However, of four patients with mucinous cystic tumor, two patients whose lesions had been considered as benign and not resected, were dead.
CONCLUSIONS
Cystic fluid analysis helps the differential diagnosis in the cystic lesions of the pancreas. Cystic neoplasms of the pancreas should be resected unless the typical small serous cystadenoma is located in the head of the pancreas of the high-risk patients.