title: Serous cystic tumors of the pancreas: when to observe and when to operate: a single-center experience.
abstract: BACKGROUND
  Pancreatic serous cystic tumors are considered to have a benign biological and clinical course with only few malignant cases.
  
  
  METHODS
  We retrospectively analyzed data from 26 patients affected by serous cystic tumors consecutively observed in our Pancreas Unit. We explored the different clinical pictures in operated and nonoperated patients.
  
  
  RESULTS
  Eighteen of the 26 patients were female (69%), median age at diagnosis was 61.5 years and 20 patients (77%) underwent surgery. The median diameter of the tumors was greater in patients who underwent surgery than in those who did not (5.5 versus 2.3 cm, p < 0.001). Major pancreatic resections were carried out in 15 of the 20 operated patients (75%). Postoperative morbidity and mortality were 20 and 5%, respectively. During follow-up, there was no observed development of malignancy or any significant increase in the diameter of the lesion among nontreated patients.
  
  
  CONCLUSIONS
  In asymptomatic patients with a clear imaging diagnosis of serous cystic tumor a wait and see management should be recommended, with a careful follow-up. Surgery should be suggested in symptomatic patients or when the preoperative diagnosis is doubtful.
authors.affiliation: Department of Emergency, General and Transplantation Surgery, Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Zanini
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fantini
authors.forename: Riccardo
authors.initials: R
authors.lastname: Casadei
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pezzilli
authors.forename: Donatella
authors.initials: D
authors.lastname: Santini
authors.forename: Lucia
authors.initials: L
authors.lastname: Calculli
authors.forename: Francesco
authors.initials: F
authors.lastname: Minni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D018293:Cystadenoma, Serous / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome