Cystic lesions in the pancreas: when to watch, when to resect.
The diagnosis of cystic lesions in the pancreas is becoming more common, largely due to the increases in diagnostic imaging done for other reasons. This review considers pseudocysts, mucinous cystic neoplasms, intraductal papillary mucinous tumors, and serous cystadenomas in some detail. The emphasis is on the fact that, through a careful history, physical examination, radiologic studies, and, often, cyst fluid analysis, a diagnosis can be reached expeditiously. This pursuit is important because two thirds of pancreatic cystic neoplasms are malignant or premalignant and should be resected, whereas pseudocysts and serous cystadenomas are benign, and, depending on the case, may be treated through observation, resection, or, for pseudocysts, by internal drainage.
Balcom IV
J H
JH
Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Fernandez-Del Castillo
C
C
Warshaw
A L
AL
D003937:Diagnosis, Differential; D013505:Digestive System Surgical Procedures / Q000379:methods; D004322:Drainage / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000175:diagnosis*; D010181:Pancreatic Cyst / Q000175:diagnosis* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D010192:Pancreatic Pseudocyst / Q000175:diagnosis; D012737:Sex Factors; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed