Pancreatic incidentalomas.
Pancreatic incidentalomas are defined as asymptomatic pancreatic lesions, discovered incidentally by imaging for an unrelated indication. They are being discovered with increasing frequency as the use of high quality cross sectional imaging is becoming more widespread. These lesions cover a wide spectrum of pathology from benign simple cysts through potentially malignant lesions such as intraductal papillary mucinous neoplasia, to frankly malignant adenocarcinoma. In this article we outline the incidence, imaging characteristics and natural history of the various incidental lesions with emphasis to neuroendocrine tumors. A diagnostic approach is also suggested, including the rational use of further imaging, serum biochemistry and the utility of ultrasound guided aspiration of cyst fluid if present. We examine several proposed classification systems and discuss the role of surgery, surveillance and prognosis.
Department of Surgery, Instituto Nacional de la Nutrición Salvador Zubirán, Mexico City, Mexico.
Xeily
X
Zárate
Nicholas
N
Williams
Miguel F
MF
Herrera
D000681:Amylases / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis; D049448:Cholangiopancreatography, Magnetic Resonance; D006801:Humans; D018358:Neuroendocrine Tumors / Q000175:diagnosis; D010181:Pancreatic Cyst / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D002272:Carcinoembryonic Antigen; D000681:Amylases