title: European experts consensus statement on cystic tumours of the pancreas.
abstract: Cystic lesions of the pancreas are increasingly recognized. While some lesions show benign behaviour (serous cystic neoplasm), others have an unequivocal malignant potential (mucinous cystic neoplasm, branch- and main duct intraductal papillary mucinous neoplasm and solid pseudo-papillary neoplasm). European expert pancreatologists provide updated recommendations: diagnostic computerized tomography and/or magnetic resonance imaging are indicated in all patients with cystic lesion of the pancreas. Endoscopic ultrasound with cyst fluid analysis may be used but there is no evidence to suggest this as a routine diagnostic method. The role of pancreatoscopy remains to be established. Resection should be considered in all symptomatic lesions, in mucinous cystic neoplasm, main duct intraductal papillary mucinous neoplasm and solid pseudo-papillary neoplasm as well as in branch duct intraductal papillary mucinous neoplasm with mural nodules, dilated main pancreatic duct >6mm and possibly if rapidly increasing in size. An oncological partial resection should be performed in main duct intraductal papillary mucinous neoplasm and in lesions with a suspicion of malignancy, otherwise organ preserving procedures may be considered. Frozen section of the transection margin in intraductal papillary mucinous neoplasm is suggested. Follow up after resection is recommended for intraductal papillary mucinous neoplasm, solid pseudo-papillary neoplasm and invasive cancer.
authors: Division of Surgery, CLINTEC, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden. Electronic address: marco.del-chiaro@karolinska.se.
authors: Marco
authors: M
authors: Del Chiaro
authors: Caroline
authors: C
authors: Verbeke
authors: Roberto
authors: R
authors: Salvia
authors: Gunter
authors: G
authors: Klöppel
authors: Jens
authors: J
authors: Werner
authors: Colin
authors: C
authors: McKay
authors: Helmut
authors: H
authors: Friess
authors: Riccardo
authors: R
authors: Manfredi
authors: Eric
authors: E
authors: Van Cutsem
authors: Matthias
authors: M
authors: Löhr
authors: Ralf
authors: R
authors: Segersvärd
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000601:surgery; D021441:Carcinoma, Pancreatic Ductal; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003536:Cystadenocarcinoma / Q000175:diagnosis* / Q000601:surgery; D018282:Cystadenocarcinoma, Mucinous / Q000175:diagnosis / Q000601:surgery; D003537:Cystadenoma / Q000175:diagnosis* / Q000601:surgery; D018291:Cystadenoma, Mucinous / Q000175:diagnosis / Q000601:surgery; D018293:Cystadenoma, Serous / Q000175:diagnosis / Q000601:surgery; D019160:Endosonography; D005060:Europe; D006801:Humans; D008279:Magnetic Resonance Imaging; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Cystic lesions; Guidelines; Pancreas