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Incidental pancreatic cystic lesions
Senarath Edirimanne1, Saxon J Connor
1Department of Surgery, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand.
World Journal of Surgery
|June 17, 2008
Summary
Incidental pancreatic cystic lesions (IPCL) are increasingly common. A multimodal approach enables nonoperative management for most IPCL, reserving surgery for suspected malignancies.
Area of Science:
- Gastroenterology
- Oncology
- Radiology
Background:
- Incidental pancreatic cystic lesions (IPCL) are a growing clinical concern.
- A significant proportion of IPCL are premalignant or malignant.
Purpose of the Study:
- To review the differential diagnosis, investigation, and management of IPCL.
- To highlight the role of a multimodal diagnostic approach.
Main Methods:
- MEDLINE search for incidental pancreatic cystic lesions.
- Review of diagnostic modalities including imaging and cyst fluid analysis.
Main Results:
- Common IPCL include pancreatic pseudocysts, serous cystic neoplasms, intraductal papillary mucinous neoplasms, and mucinous cystic neoplasms.
- Multidetector computed tomography and magnetic resonance pancreatography aid in characterizing IPCL.
- Specific cyst fluid markers (viscosity, CEA) can indicate mucinous neoplasms.
Conclusions:
- Selective nonoperative management is supported for most IPCL when investigated using a multimodal strategy.
- Surgery remains indicated for IPCL with suspicion of malignancy.
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