Cystic neoplasms of the pancreas

Ten cystadenomas and cystadenocarcinomas of the pancreas are presented. We believe that the strong recommendations of the pathologists who feel that all cystic neoplasms of this type have malignant potential or contain malignant elements emphasizes the need for total excision if at all possible in these patients. It is conceivable that the reason for the high incidence of cystadenocarcinomas in our small series may be the meticulous searching of the cellular elements for evidence of malignancy. It strongly militates against anything less than total excision as treatment for these curable lesions. The correct preoperative diagnosis is mandatory for a logical plan for surgical intervention. All cysts, whether deemed benign or malignant, should be aggressively attacked surgically unless there is distant metastasis. The very high rate of malignant potential of benign cystadenomas coupled with the relatively indolent growth pattern of malignant cystadenocarcinomas combine to give a high rate of surgical cure.