title: Multidisciplinary management strategy for incidental cystic lesions of the pancreas.
abstract: BACKGROUND
  At our institution, incidental pancreatic cysts are frequently identified in asymptomatic patients undergoing routine imaging for staging of nonpancreatic malignancies. Management of these patients is unclear because a small but significant number of incidental pancreatic cysts are malignant.
  
  
  METHODS
  Our institutional database was reviewed for patients with ICD-9 codes for pancreatic cysts from 1980 to 2005. Clinicopathologic factors, including CT and endoscopic ultrasound (EUS) characteristics and management strategies, were analyzed.
  
  
  RESULTS
  Over 25 years, 942 patients were identified with pancreatic cysts. Excluding those with symptoms or pseudocysts, 350 patients remained with incidental pancreatic cysts. Mean overall survival was 41.4 months (mean follow-up 32.7 months). Forty-one patients underwent resection, of whom 38 (92.7%) had premalignant or malignant pathology. Univariate analysis of variables predicting pathologic premalignant or malignant diagnosis identified pancreatic neck or body location as significant factors.
  
  
  CONCLUSIONS
  These data suggest that most incidental pancreatic cysts can be managed nonoperatively using a selective strategy based on detailed review of CT imaging and EUS findings.
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Debashish
authors.initials: D
authors.lastname: Bose
authors.forename: Eric
authors.initials: E
authors.lastname: Tamm
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: Leonardo
authors.initials: L
authors.lastname: Marcal
authors.forename: Aparna
authors.initials: A
authors.lastname: Balachandran
authors.forename: Priya
authors.initials: P
authors.lastname: Bhosale
authors.forename: Jason B
authors.initials: JB
authors.lastname: Fleming
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Lee
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Evans
authors.forename: Rosa F
authors.initials: RF
authors.lastname: Hwang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods*; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010181:Pancreatic Cyst / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011230:Precancerous Conditions; D011379:Prognosis; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult