Case Analysis And Literature Review Of Serous Cystadenoma Of Pancreas

Objective:Discuss and elucidate the clinical features, diagnosis and treatment strategies of pancreatic serous neoplasm..Method:The study included a total of 130 cases of pancreatic serous neoplasm confirmed by postoperative pathologic examination and 56 cases of surgery-naive pancreatic cystic neoplasms. Retrospective analysis on pertaining clinical data and relevant literature review was conducted to summarize the findings.Result:The mean age of the neoplasm arm was 53.4±6.5 years old with a female predominance of 71.5%. The diagnosis of all the 130 cases were confirmed by postoperative pathological examination as pancreatic serous neoplasm, excluding dysplasia and malignancy. A majority of these patients denied any clinical symptoms. Among symptomatic patients, abdominal pain was the most common complaint. Most tumors were found in the body and tail of the pancreas, followed by the head of the pancreas, and the neck of pancreas. The presence of clinical symptoms was not significantly different between groups of tumors with a max diameter≥4cm and< 4cm. Among neoplasms of the head of pancreas, those measuring 6cm or more in max diameter are more likely to produce clinical symptoms than those measuring less than 6cm. This difference was not noted in neoplasms in the neck, body and tail of the pancreas.Comparing to open distal pancreatectomy, laparoscopic resection of the body and tail of pancreas was indicative of prolonged operative courses, and shorter hospital stays. Distal pancreatectomy without splenectomy was performed on younger patients, enjoyed lower amount of intraoperative hemorrhage but more suppressed level of platelets after the procedure. In the surgery-naive arm of 56 patients, the median out-patient follow-up time was 36.3 months. During the follow-up, a slight increase in the size of the tumor was found in 14 cases, unchanged lesion size found in 32 cases, and 7 of the patients showed a shrinkage on the tumor size.3 of the patients searched surgical modality due to diffuse anxiety. A total of 0.032mm growth of lesions per month was calculated. In 10 patients with a complete follow-up data over 24 months, more significant growth was noted in previous 24 months than after 24 months (P<0.05), as 7 of these cases remained growth-free after this period. A survey using HAMA showed significant improvement in their anxiety states before and after the follow-up in all patients with and without tumor growth.Conclusion:The pancreatic serous neoplasm occurs predominantly in the middle-aged and elderly female population while a majority of them are benign. We recommend surgical management in symptomatic patients with tumor of the head of the pancreas measuring≥6cm in max diameter, while having a paucity of preoperative evidence of its malignancy profile. Laparoscopic distal pancreatectomy, preferably without splenectomy, proves to be a safe and effective way of operation, which facilitates postoperative recovery and shortens hospital stay. For asymptomatic patients with a clinical picture concerning for pancreatic serous cystadenoma, an at least 24 months close follow-up should be provided, which also serves well in anxiety-relief among patients.