Pancreatic cystic tumours: when to resect, when to observe.
OBJECTIVE
In recent years there has been an increase in the diagnosis of cystic tumors of the pancreas. In this setting, difficult diagnostic problems and different therapeutic management can be proposed.


METHODS
A review of the literature and authors experience were undertaken.


RESULTS
Cystic tumors of the pancreas include different neoplasms with a different biological behaviour. While most serous cystadenomas (SCAs) can be managed nonoperatively, patients with mucinous cystic neoplasms (MCNs), solid pseudopapillary tumors (SPTs), main-duct intraductal papillary mucinous neoplasms (IPMNs) should undergo surgical resection. Branch-duct IPMNs can be observed with radiological and clinical follow-up when asymptomatic, < 3 cm in size and without radiologic features of malignancy (i.e. nodules).


CONCLUSIONS
Cystic tumors of the pancreas are common. Differential diagnosis among the different tumor-types is of paramount importance for appropriate management. Nonoperative management seems appropriate for most SCAs and for well-selected branch-duct IPMNs.
Salvia
R
R
Department of Surgery, Chirurgia Generale B, Policlinico "GB Rossi", University of Verona, Verona, Italy.
Crippa
S
S
Partelli
S
S
Malleo
G
G
Marcheggiani
G
G
Bacchion
M
M
Butturini
G
G
Bassi
C
C
D000230:Adenocarcinoma / Q000145:classification / Q000473:pathology / Q000601:surgery; D003537:Cystadenoma / Q000145:classification / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000145:classification / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000145:classification / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D011379:Prognosis