Cystic tumors of the pancreas. Cystadenomas and cystadenocarcinomas. Diagnosis and practical attitude

Abstract

Report of 16 cases of cystic tumors of pancreas
(CTP) consisting of 5 serous cystoadeno mas (SC), 6 mucigenous cystoadenomas (MC) and
5 cystoadenocarcinomas (CC) pertaining to 11 women
and 5 men.
Mean age 63 years (ranging from 44 to 89). Four
of these patients were asymptomatic, 6 of them
had lost between 3 and 20 kilos. One patient with a
CC developed Jaundice. CTPs were diagnosed by
ultrasound or CT scans. CTPs were topographed
ten times at the leve/ of pancreatic head, twice in its
body and tour in its tail. At end of preoperative explorations
conducted for the purpose of diagnosis,
CTPs went undetected in four cases. The exact diagnosis
of tumor nature was made during preoperative
in five cases: two SCs, one MC and two CCs.
Unequivocal diagnosis was made through the
histologica/ study of surgica/ specimen in eleven
cases, by the existence of liver metastases in one
case and by citopunture under CT in the remainder.
One patient refused to be operated. Thirteen
patientys were operated: in tour a cephalic duodenopancreatectomy
was perfomed (1 SC and 3 CCs);
in 5, tumor exeresis was performed (1 SC and 4
MCs); in 2, a distal pancreatectomy was performed
(1 MC and 1 CC); and 2 underwent surgical
pucture (SCs). Asymptomatic SCs may remain
unoperated under surveillance, provided diagnosis
be unequivocal. Al/ other cystic tumors have to be
resected, either, due to the fact that there is doubt
as to their nature or because ít is a symptomatic
CS, or an MC or a CC. In the latter case, prognosis
is better that in cases of exocrine non metastasic
pancreatic cancer.