Pancreatic incidentalomas: clinical and pathologic spectrum

Incidental abnormalities are increasingly being detected. The pathology and clinical outcome of patients with pancreatic incidentalomas have not been well characterized.

We reviewed the records of 356 patients with pancreatic abnormalities from August 2001 to June 2007. Clinical and pathologic data were collected for a cohort of patients who had incidental pancreatic lesions detected by imaging modalities.

Fifty-seven pancreatic incidentalomas were identified. Ninety percent of them were detected by computed axial tomography (CT). The most frequent indications for imaging were genitourinary symptoms and cancer surveillance. Sixty percent of the lesions were solid, and 40% were cystic. Surgical resection was performed in 33 patients. Locally advanced disease was found in six patients, and metastatic disease was found in 9 patients. The most frequent diagnoses were ductal adenocarcinoma, neuroendocrine tumors, and serous cystadenoma.

Patients with pancreatic incidentalomas account for a significant patient subgroup. Incidental pancreatic lesions occur frequently and require prompt surgical evaluation.