title: Cystic pancreatic tumors: should we resect all of them?
abstract: OBJECTIVE
  Pancreatic cystic tumors are relatively rare tumors and only 1% of them are malignant. They are often asymptomatic and detected as incidental findings through diagnostic imaging. Currently there are no universal guide lines for the correct clinical approach to pancreatic cystic lesions. Cross-sectional imaging demonstrates some typical morphological features that determine the pre-operative diagnosis of the pancreatic cystic lesions (serous or mucinous cystadenoma, intraductal papillary mucinous neoplasms). In addition, endoscopic ultrasonography permits the collection and analysis of the fluid content. The aim of this paper is to describe our case load in the management of pancreatic cystic neoplasms and propose some criteria for choosing between surgical or conservative approaches.
  
  
  METHODS
  12 patients with pancreatic cystic neoplasms were retrospectively evaluated. They were studied using cross-sectional imaging modalities (computed tomography and magnetic resonance); endoscopic ultrasonography was performed in 7 patients.
  
  
  RESULTS
  In each patient a careful evaluation of several factors (age, comorbidity, imaging features, symptoms, life expectancy) conditioned our clinical decision. Among our 12 patients, surgical resection was performed in 7 cases.
  
  
  CONCLUSIONS
  The treatment of pancreatic cystic lesions is still a dilemma because even in the presence of malignant potential, pancreatic surgery remains very complicated and demolitive. Many factors need to be considered in the management of cystic pancreatic tumors. The most important include histological type, location, size, age and clinical condition of the patient.
  
  
  CONCLUSIONS
  A correct multidisciplinary pre-operative diagnosis is mandatory. Surgery should only be performed in selected cases.
authors.affiliation: Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University Hospital "Policlinico-Vittorio Emanuele", Catania, Italy. dicataldoa@tiscali.it.
authors.forename: A
authors.initials: A
authors.lastname: Di Cataldo
authors.forename: S
authors.initials: S
authors.lastname: Palmucci
authors.forename: R
authors.initials: R
authors.lastname: Latino
authors.forename: C
authors.initials: C
authors.lastname: Trombatore
authors.forename: G
authors.initials: G
authors.lastname: Cappello
authors.forename: A
authors.initials: A
authors.lastname: Amico
authors.forename: G
authors.initials: G
authors.lastname: La Greca
authors.forename: G
authors.initials: G
authors.lastname: Petrillo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018291:Cystadenoma, Mucinous / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010181:Pancreatic Cyst / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed