Clinico-pathological features of cystic pancreatic endocrine neoplasms and a comparison with their solid counterparts.
OBJECTIVE
Pancreatic endocrine neoplasms (PENs) may occasionally manifest as cystic lesions of the pancreas. The aim of this study is to report our experience with cystic PENs and to compare their clinico-pathological features with their solid counterparts.


METHODS
From 1990 to 2004, 38 patients with PENs were reviewed. Six of these tumours appeared on radiological imaging as a cystic lesion of the pancreas.


RESULTS
Of the 38 patients with a PEN, 21 of the patients were female and with a median age of 54.5 (range, 33-83) years. Sixteen patients had functional endocrine tumours of which insulinoma was the most common. The six patients with cystic PEN had a median age of 55.5 (range, 41-70) years and half were female. Cystic PENs were significantly larger [48 (range, 25-170) mm vs 19 (range, 3-120) mm, P = 0.013] and were less likely to be benign (0 vs 50%, P = 0.017) compared to their solid counterparts. There was no difference between cystic and solid PENs in terms of age, sex, presence of symptoms, proportion of functioning tumours and location of tumours within the pancreas.


CONCLUSIONS
Cystic PENs share many clinico-pathological features with solid PENs. These differ only in the cystic appearance and tend to be of a larger size. Hence, these findings suggest that cystic and solid PENs are unlikely to be distinct pathological entities but are likely to be morphological variants of the same entity.
Department of Surgery, Singapore General Hospital, Singapore.
B K P
BK
Goh
L L P J
LL
Ooi
Y M
YM
Tan
P C
PC
Cheow
Y F A
YF
Chung
P K H
PK
Chow
W K
WK
Wong
D015746:Abdominal Pain / Q000175:diagnosis; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D015408:Gastrinoma / Q000473:pathology; D006801:Humans; D007340:Insulinoma / Q000473:pathology; D008297:Male; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000473:pathology; D009378:Neoplasms, Multiple Primary / Q000473:pathology; D010180:Pancreatectomy; D010181:Pancreatic Cyst / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000473:pathology; D014057:Tomography, X-Ray Computed; D003969:Vipoma / Q000473:pathology; D015431:Weight Loss