Clinicopathological And Surgical Review Of Pancreatic Cystic Lesions:Review Of Three-years Period

Context Cystic lesions of the pancreas represent an important subgroup of pancreatic tumors. The characterization of these lesions has evolved in recent years, and will continue to change according to the increasing number of biopsies and resections performed.Design Patients diagnosed with cytic lesions were collected, Pancreatectomy specimens containing cystic lesions collected over a three-year period were reviewed.Main outcome measures Demographic and pathologic features were recorded together with surgical procedures.Setting Cases were subclassified in diagnostic categories and were grouped according to the nature of the lesion (non-neoplastic vs. neoplastic).Results Of264pancreatic lesions,42cysts corresponding to42patients were studied. The patients mean age was58years. Twenty five cysts (59.5) occurred in women.Among the42cysts, two (4.76%) were non-neoplastic and40(95.24%) were neoplastic (33.33%benign,21.43%borderline,40.48%malignant). Intraductal papillary mucinous neoplasm was the most common diagnosis (n=21;50%) followed by mucinous cystic neoplasm (n=7;16.67%) and serous cystic neoplasm (n=6;14.28%). Frequency of female gender was higher and age was lower in the borderline lesions (P=0.049and P=0.047, respectively). Tumor size was significantly lower in malignant lesions (P=0.547). Incidental identification was more frequent in benign lesions (n=5,P=0.032), whereas malignant lesions were more frequently Symptomatic presenting with abdominal pain (n=10, P=0.001). Pancreatic duodenectomy(PD) was the most common used surgical approach for malignant lesions (n=11;57.89%) followed by resection of pancreatic head, body and spleen (DP) for benign neplastic (n=9;56.25%)Conclusion:Among the pancreatic cystic lesions heterogeneous group, malignant neoplasms predominate, particularly those with invasive papillary mucinous neoplasm, followed by benign neoplasms. Age at presentation, gender, location and tumor size are highly variable, with the exception of solid pseudopapillary tumor occurs exclusively in young female patients.