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Book ; Online ; E-Book: Cystic tumors of the pancreas

Del Chiaro, Mario A. / Haas, Stephan / Schulick, Richard D.

diagnosis and treatment

2016

Author's details	Marco Del Chiaro, Stephan L. Haas, Richard D. Schulick editors
Keywords	Pankreaszyste
Subject	Bauchspeicheldrüsenzyste
Language	English
Size	1 Online-Ressource (XIII, 181 Seiten), Illustrationen
Publisher	Springer
Publishing place	Cham
Publishing country	Switzerland
Document type	Book ; Online ; E-Book
Remark	Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
HBZ-ID	HT019445687
ISBN	978-3-319-31882-0 ; 9783319318806 ; 3-319-31882-9 ; 3319318802
DOI	10.1007/978-3-319-31882-0
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article: Cystic tumours of the pancreas.

Barreto, George / Shukla, Parul J / Ramadwar, Mukta / Arya, Supreeta / Shrikhande, Shailesh V

HPB : the official journal of the International Hepato Pancreato Biliary Association

2008 Volume 9, Issue 4, Page(s) 259–266

Abstract: ... published data on cystic neoplasms of the pancreas, which though rare, constitute an important subgroup ...

Abstract	Pancreatic carcinoma accounts for the most dismal survival among all malignancies with 5-year survival rates approaching 5%. The reason for this, besides the inherent biologic nature of the disease, is the fact that the patients tend to present late in the disease. We present a review of the current published data on cystic neoplasms of the pancreas, which though rare, constitute an important subgroup of pancreatic neoplasms that have a better prognosis and are potentially curable lesions.
Language	English
Publishing date	2008-03-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2131251-5
ISSN	1365-182X
ISSN	1365-182X
DOI	10.1080/13651820701435287
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Article ; Online: European experts consensus statement on cystic tumours of the pancreas.

Del Chiaro, Marco / Verbeke, Caroline / Salvia, Roberto / Klöppel, Gunter / Werner, Jens / McKay, Colin / Friess, Helmut / Manfredi, Riccardo / Van Cutsem, Eric / Löhr, Matthias / Segersvärd, Ralf

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

2013 Volume 45, Issue 9, Page(s) 703–711

Abstract: Cystic lesions of the pancreas are increasingly recognized. While some lesions show benign ... magnetic resonance imaging are indicated in all patients with cystic lesion of the pancreas. Endoscopic ultrasound ... behaviour (serous cystic neoplasm), others have an unequivocal malignant potential (mucinous cystic neoplasm ...

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.
MeSH term(s)	Adenocarcinoma/diagnosis ; Adenocarcinoma/surgery ; Carcinoma, Pancreatic Ductal ; Carcinoma, Papillary/diagnosis ; Carcinoma, Papillary/surgery ; Cholangiopancreatography, Endoscopic Retrograde ; Cystadenocarcinoma/diagnosis ; Cystadenocarcinoma/surgery ; Cystadenocarcinoma, Mucinous/diagnosis ; Cystadenocarcinoma, Mucinous/surgery ; Cystadenoma/diagnosis ; Cystadenoma/surgery ; Cystadenoma, Mucinous/diagnosis ; Cystadenoma, Mucinous/surgery ; Cystadenoma, Serous/diagnosis ; Cystadenoma, Serous/surgery ; Endosonography ; Europe ; Humans ; Magnetic Resonance Imaging ; Pancreas/diagnostic imaging ; Pancreas/pathology ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/surgery ; Tomography, X-Ray Computed
Language	English
Publishing date	2013-09
Publishing country	Netherlands
Document type	Consensus Development Conference ; Journal Article ; Practice Guideline
ZDB-ID	1459373-7
ISSN	1878-3562 ; 1125-8055
ISSN (online)	1878-3562
ISSN	1125-8055
DOI	10.1016/j.dld.2013.01.010
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Article: Management of cystic tumours of the pancreas.

McKay, Damian / Marron, Conor / Mathew, Sajjan / Diamond, Thomas

ANZ journal of surgery

2004 Volume 74, Issue 8, Page(s) 627–630

Abstract: Background: Cystic tumours of the pancreas account for 5% of pancreatic neoplasms and are ... Methods: This is a retrospective study of all patients diagnosed to have cystic tumours of the pancreas ... all patients were alive and well.: Conclusions: Cystic tumours of the pancreas are uncommon and generally ...

Abstract	Background: Cystic tumours of the pancreas account for 5% of pancreatic neoplasms and are frequently misdiagnosed as pancreatic pseudocysts. The authors' experience of managing these tumours is presented here, highlighting the clinical presentation, diagnostic difficulties and operative treatment. Methods: This is a retrospective study of all patients diagnosed to have cystic tumours of the pancreas treated at The Mater Hospital, during a 5-year period from 1997 to 2002. Literature was reviewed and guidelines for the management of these tumours have been outlined. Results: Seven patients with cystic pancreatic tumours were treated over this time-period. All patients were women with a median age of 40. Two of these patients were initially diagnosed as having pseudocysts and were treated elsewhere by cystgastrostomy. The tumour was resected in all patients. All but one was benign. At follow up, ranging from 13 to 66 months, all patients were alive and well. Conclusions: Cystic tumours of the pancreas are uncommon and generally slow growing. It is important not to assume that a cystic lesion in the pancreas, especially in middle-aged women, is a pseudocyst. Satisfactory surgical resection may be possible even after previous operative procedures on the pancreas. Prognosis after resection remains good.
MeSH term(s)	Abdominal Pain/etiology ; Adult ; Diagnosis, Differential ; Diarrhea/etiology ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Pancreatic Cyst/complications ; Pancreatic Cyst/diagnosis ; Pancreatic Cyst/surgery ; Pancreatic Pseudocyst/diagnosis ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2004-08
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/j.1445-1433.2004.03108.x
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Article: Cystic tumours of the pancreas: a review.

Falconi, M / Bassi, C / Dervenis, C / Bettini, R / Salvia, R / Carbognin, G / Capelli, P / Pederzoli, P

Chirurgia italiana

2001 Volume 53, Issue 5, Page(s) 595–608

Abstract: The detection of a cystic tumour of the pancreas is a challenge which puts not only the surgeon's ... mucinous adenomas and adenocarcinomas, intraductal papillary mucinous tumours and papillary cystic and ... of the natural history of each of these cystic tumours will help the surgeon formulate the most appropriate treatment ...

Abstract	The detection of a cystic tumour of the pancreas is a challenge which puts not only the surgeon's knowledge and expertise to the test, but also those of the team of radiologists and pathologists with whom he works. The diagnosis of a suspected pancreatic cystic tumour is morphological and is based on modern imaging techniques and, in the case of intraductal papillary mucinous tumours, on endoscopic findings. In the search for the correct preoperative diagnosis, however, it is of fundamental importance to bear in mind the limitations of the various instrumental investigations, and particularly those of fine-needle aspiration cytology. In this light the main morphological and clinicopathological features of serous cystadenomas, mucinous adenomas and adenocarcinomas, intraductal papillary mucinous tumours and papillary cystic and solid tumours are analysed as well as the surgical indications. In fact only the surgeon, on the basis of his knowledge of the patient's medical history and symptoms, will be in a position to determine to which nosological "cystic" entity the morphological findings described belong. A deeper knowledge of the natural history of each of these cystic tumours will help the surgeon formulate the most appropriate treatment indication. Providing the patient's condition fulfills the necessary operability criteria, resection will be mandatory whenever there exists a doubt that the tumour may be malignant or whenever its natural history suggests a malignant potential.
MeSH term(s)	Cysts/classification ; Cysts/diagnosis ; Cysts/therapy ; Humans ; Pancreatic Diseases/classification ; Pancreatic Diseases/diagnosis ; Pancreatic Diseases/therapy ; Pancreatic Neoplasms/classification ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/therapy
Language	English
Publishing date	2001-09
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	603591-7
ISSN	0009-4773
ISSN	0009-4773
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Article ; Online: Role of endosocopic ultrasound in the diagnosis of cystic tumours of the pancreas.

Petrone, M C / Arcidiacono, P G

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

2008 Volume 40, Issue 11, Page(s) 847–853

Abstract: With the increased use of sophisticated imaging, cystic lesions in the pancreas are being ... such as endoscopic ultrasound guided fine needle aspiration of cystic lesion, allows appropriate management. Cystic lesions in the pancreas can be divided ... pathologically into congenital cysts, pseudocysts and cystic neoplasm. At least four different types of cystic ...

Abstract	With the increased use of sophisticated imaging, cystic lesions in the pancreas are being recognized with greater frequency. Although imaging alone may not provide a specific diagnosis in many cases, a combination of imaging characteristics, clinical presentation, and additional procedures such as endoscopic ultrasound guided fine needle aspiration of cystic lesion, allows appropriate management. Cystic lesions in the pancreas can be divided pathologically into congenital cysts, pseudocysts and cystic neoplasm. At least four different types of cystic neoplasm have been described: mucinous neoplasms, intraductal papillary mucinous neoplasms, serous neoplasms and papillary cystic neoplasms The most important diagnosis is differentiating between mucinous and non-mucinous cystic lesion because of their different potential of malignancy. Endoscopic ultrasound provides the highest resolution of the pancreas and endoscopic ultrasound-fine needle aspiration can supply further diagnostic information on the basis of cytology, fluid viscosity, concentration of tumour glycoproteins, amylase level, molecular analysis that may contribute to the better clinical outcome of these neoplasms.
MeSH term(s)	Biopsy, Fine-Needle/methods ; Cystadenoma, Mucinous/diagnostic imaging ; Cystadenoma, Mucinous/pathology ; Cystadenoma, Serous/diagnostic imaging ; Cystadenoma, Serous/pathology ; Diagnosis, Differential ; Endosonography/methods ; Female ; Humans ; Male ; Pancreatic Cyst/diagnostic imaging ; Pancreatic Cyst/pathology ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/pathology ; Pancreatic Pseudocyst/diagnostic imaging ; Pancreatic Pseudocyst/pathology ; Risk Factors ; Sensitivity and Specificity
Language	English
Publishing date	2008-11
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1459373-7
ISSN	1878-3562 ; 1125-8055
ISSN (online)	1878-3562
ISSN	1125-8055
DOI	10.1016/j.dld.2008.03.019
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Article ; Online: Cystic Tumours of the Pancreas – a Rare and Diverse Type of Tumours

Dag Hoem / Asgaut Viste

Journal of Cancer Therapy, Vol 03, Iss 04, Pp 222-

2012 Volume 229

Abstract: ... up algorithms, surgery and surveillance. We have reviewed our experience with these tumours ... Objective: Increasing incidence of non-inflammatory cystic lesions of the pancreas challenges work ...

Abstract	Objective: Increasing incidence of non-inflammatory cystic lesions of the pancreas challenges work-up algorithms, surgery and surveillance. We have reviewed our experience with these tumours in accordance with International Consensus Guidelines and evaluated the outcome. Patients and Methods: From 1999 to 2009, 34 cases referred to Haukeland University Hospital were operated upon; ten were serous (SCN), twenty-one IPMNs, one MCN, and two solid pseudopapillary neoplasms (SPPN). A thorough medical history was supplemented by CT, MRI, and US before each case were discussed in a MDT to decide on the best subsequent care. Results: All SCN and SPPN patients had benign histopathology, and no deaths were reported. Survival for malignant IPMN was, 2 years: 75%, and 5 years: 67%, where after no deaths were registered in the observation period. Presence of jaundice had the highest impact on survival (p = 0.0009), followed by weight loss (p = 0.005) and dilatation of the common bile duct (p = 0.04). In the IPMN group two had pancreatic juice leakage, and reoperation was performed in one. Conclusions: All SCN turned out benign which justify a high threshold for resection unless unacceptable symptoms dominate. For branch duct IPMNs resections of asymptomatic and smaller lesions (<3 cm) should be avoided but kept under surveillance, whereas symptomatic and lager lesions together with main duct IPMNs lodge a substantial malignant potential and should be resected. Symptomatic or large SPPNs can be, or turn, malignant which require resection.
Keywords	Cystic Pancreatic Tumours ; Incidentalomas ; Clinical Features ; Complications ; Prognostic Factors ; Survival ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Oncology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Subject code	610
Language	English
Publishing date	2012-08-01T00:00:00Z
Publisher	Scientific Research Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Cystic tumours of the pancreas.

Le Borgne, J

The British journal of surgery

1998 Volume 85, Issue 5, Page(s) 577–579

MeSH term(s)	Cystadenocarcinoma, Mucinous/diagnosis ; Cystadenoma, Mucinous/diagnosis ; Humans ; Pancreatic Cyst/diagnosis ; Pancreatic Cyst/surgery ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/surgery ; Pancreatic Pseudocyst/diagnosis
Language	English
Publishing date	1998-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2985-3
ISSN	0007-1323 ; 0263-1202 ; 1355-7688
ISSN	0007-1323 ; 0263-1202 ; 1355-7688
DOI	10.1046/j.1365-2168.1998.00809.x
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Article: Cystic tumours of the pancreas.

Martin, I / Hammond, P / Scott, J / Redhead, D / Carter, D C / Garden, O J

The British journal of surgery

1998 Volume 85, Issue 11, Page(s) 1484–1486

Abstract: Background: Cystic pancreatic tumours may be misdiagnosed as pseudocysts.: Methods: From August ... for a cystic mass in the pancreas with histological confirmation of neoplasia (six serous cystadenoma (SCA ... with cystic degeneration, one cystic islet cell tumour).: Results: While the lesion had been labelled ...

Abstract	Background: Cystic pancreatic tumours may be misdiagnosed as pseudocysts. Methods: From August 1990 to January 1998, 21 patients (16 women) with a median age of 60 years underwent operation for a cystic mass in the pancreas with histological confirmation of neoplasia (six serous cystadenoma (SCA), three mucinous cystic adenoma (MCA), ten mucinous cystadenocarcinoma (MCAC), one ductal adenocarcinoma with cystic degeneration, one cystic islet cell tumour). Results: While the lesion had been labelled as a pseudocyst in eight patients, only one patient (MCA in the pancreatic head) had had acute pancreatitis previously. In seven patients the computed tomogram (CT) lacked suspicious neoplastic features, while endoscopic retrograde cholangiopancreatography, angiography and percutaneous cyst fluid analysis were unhelpful or misleading in 16 of 18 investigations with respect to differentiating tumour from pseudocyst. Attempted operation for cure was performed in 18 patients despite diagnostic delays of up to 6 years and initial treatment with cystenterostomy in two cases. Conclusion: Retrospective review revealed that all 21 cystic neoplasms could be diagnosed before operation by a history excluding previous pancreatitis (20 of 21 patients) or a CT suspicious for neoplasia (14 of 21). The diagnosis relies more on absence of previous pancreatitis and a suspicious clinician who errs on the side of resecting a pseudocyst rather than watching or draining a cystic neoplasm.
MeSH term(s)	Adenoma/diagnostic imaging ; Adenoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Cystadenocarcinoma, Mucinous/diagnostic imaging ; Cystadenocarcinoma, Mucinous/surgery ; Cystadenocarcinoma, Serous/diagnostic imaging ; Cystadenocarcinoma, Serous/surgery ; Cystadenoma/diagnostic imaging ; Cystadenoma/surgery ; Cystadenoma, Serous/diagnostic imaging ; Cystadenoma, Serous/surgery ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Cyst/diagnostic imaging ; Pancreatic Cyst/surgery ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome ; Ultrasonography
Language	English
Publishing date	1998-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2985-3
ISSN	0007-1323 ; 0263-1202 ; 1355-7688
ISSN	0007-1323 ; 0263-1202 ; 1355-7688
DOI	10.1046/j.1365-2168.1998.00870.x
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Article ; Online: Benign cystic neoplasm and endocrine tumours of the pancreas--when and how to operate--an overview.

Beger, H G / Poch, B / Vasilescu, C

International journal of surgery (London, England)

2014 Volume 12, Issue 6, Page(s) 606–614

Abstract: ... enucleation is recommended for all symptomatic neuro-endocrine tumours with size up to 2-3 cm and non ... adherence to pancreatic main-ducts. EN has been applied predominantly in neuro-endocrine tumours and less ... neoplasm and in one third for neuro-endocrine tumours. The high level of 33% pancreatic fistula and severe ...

Abstract	Background: The recent evolution of limited local operative procedures for benign pancreatic lesions shifted surgical treatment options to the application of local techniques, although major resections of pancreatic head and left resection are still the standard. Objectives: To evaluate the level of evidence of tumour enucleation (EN), pancreatic middle segment resection (PMSR) and duodenum preserving total/subtotal pancreatic head resection (DPPHRt/s), we focus based on present knowledge on indication to surgical treatment evaluating the questions, when and how to operate. Results: Tumour enucleation is recommended for all symptomatic neuro-endocrine tumours with size up to 2-3 cm and non-adherence to pancreatic main-ducts. EN has been applied predominantly in neuro-endocrine tumours and less frequently in cystic neoplasms. 20% of enucleation are performed as minimal invasive laparascopic procedure. Surgery related severe post-operative complications with the need of re-intervention are observed in about 11%, pancreatic fistula in 33%. The major advantage of EN are low procedure related early post-operative morbidity and a very low hospital mortality. PMSR is applied in two thirds for symptomatic cystic neoplasm and in one third for neuro-endocrine tumours. The high level of 33% pancreatic fistula and severe post-operative complications of 18% is related to management of proximal pancreatic stump. DPPHRt/s is used in 70% for symptomatic cystic neoplasms, for lesions with risk for malignancy and in less than 10% for neuro-endocrine tumours. DPPHRt with segment resection of peripapillary duodenum and intra-pancreatic common bile duct has been applied in one third of patients and in two thirds by complete preservation of duodenum and common bile duct. The level of evidence for EN and PMSR is low because of retrospective data evaluation and absence of RCT results. For DPPHR, 7 prospective, controlled studies underline the advantages compared to partial pancreaticoduodenectomy. Conclusion: The application of tumour enucleation, pancreatic middle segment resection and duodenum preserving subtotal or total pancreatic head resection are associated with low level surgery related early post-operative complications and a very low hospital mortality. The major advantage of the limited procedures is preservation of exo- and endocrine pancreatic functions.
MeSH term(s)	Carcinoma, Neuroendocrine/surgery ; Humans ; Neoplasms, Cystic, Mucinous, and Serous/surgery ; Pancreatectomy/adverse effects ; Pancreatectomy/methods ; Pancreatic Neoplasms/surgery ; Prospective Studies ; Retrospective Studies
Language	English
Publishing date	2014
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1016/j.ijsu.2014.03.020
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