title: Pancreatic neoplasms in pregnancy: diagnosis, complications, and management.
abstract: BACKGROUND
  Neoplasms of the pancreas during pregnancy are rare, with less than 25 cases of benign and malignant tumors reported in the literature.
  
  
  METHODS
  We present three unique cases of pancreatic tumors occurring during pregnancy--one mucinous cystic neoplasm and two adenocarcinomas. We review the literature regarding pancreatic neoplasms during pregnancy and discuss the diagnosis, complications, and management of these tumors.
  
  
  RESULTS
  Magnetic resonance imaging and ultrasound are the imaging modalities of choice in pregnancy. In patients with benign or premalignant tumors, surgical resection may be postponed until the second trimester. In symptomatic patients, or if there is a concern for intrauterine growth restriction, urgent surgical intervention should be performed. With malignant tumors, the benefit of delaying surgery must be balanced with the risk of maternal disease progression. Termination of the pregnancy should be discussed when a malignant tumor is diagnosed during the first trimester. Pancreatic tumors diagnosed during the third trimester may be resected after delivery. If malignant, early delivery of the fetus and subsequent maternal operation can be considered at appropriate fetal maturity.
  
  
  CONCLUSIONS
  When these tumors occur during pregnancy, they present a diagnostic and treatment dilemma, with variation in treatment based on gestational age and patient preference.
authors.affiliation: Department of Surgery, University of Texas Medical Branch, 301 University Boulevard, JSA 6.312, Galveston, TX 77555-0542, USA. caboyd@utmb.edu
authors.forename: Casey A
authors.initials: CA
authors.lastname: Boyd
authors.forename: Jaime
authors.initials: J
authors.lastname: Benarroch-Gampel
authors.forename: Gokhan
authors.initials: G
authors.lastname: Kilic
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Kruse
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Weber
authors.forename: Taylor S
authors.initials: TS
authors.lastname: Riall
mesh_terms: D000328:Adult; D019160:Endosonography / Q000379:methods; D017809:Fatal Outcome; D005260:Female; D005865:Gestational Age; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D011183:Postoperative Complications / Q000503:physiopathology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D011256:Pregnancy Outcome; D016216:Ultrasonography, Prenatal / Q000379:methods; D055815:Young Adult