Diagnosis and Treatment of 40 Cases of Pancreatic Cystic Neoplasms_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 HUJun ,  HUANGQiang , LINXian-sheng , LIUChen-hai , XIEFang

Department of General Surgery, Affiliated Provincial Hospital of Anhui Medical University, and Hepatobiliarypancreatic Laboratory of Anhui Province, Hefei 230001, Anhui Province, China;

Corresponding?author：

HUANGQiang, Email: hq-sohu@sohu.corn

Keywords：

Pancreatic cystic neoplasm; Diagnosis; Treatment

DOI：

10.7507/1007-9424.20140299

Video：

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Objective To investigate the diagnosis and treatment of pancreatic cystic neoplasm. Methods The clinical data of 40 cases of pancreatic cystic neoplasm from October 2001 to October 2013 in our hospital were retrospec-tively analyzed. Results Patients with pancreatic cystic neoplasm had no specific clinical feature. Ultrasonography and computed tomography displayed a cystic tumor in 57.5%(23/40) and 72.5%(29/40) of all patients, respectively, but could not distinguish the histological types. All of the patients had been operated, among them 2 cases were misdia-gnosed as pseudocysts and internal drainage; another 38 patients were undergoing the distal pancreatectomy. Pathologic examination results after operation showed 23 cases of serous cystadenoma, 9 cases of mucinous cystadenoma, 3 cases of intraductal papillary mucinous adenoma, and 5 cases of mutinous cystadenocarcinoma. Thirty five patients were followed-up. The followed-up time range from 2 months to 8 years, verage(74.2±12.8) months. Among the 3 patients with mucinous cystadenocarcinoma, 1 patient alived with no evidence of recurrence, the other 2 patients died of tumor invasion and metastasis in 4 months and 7months after operation. The others were still alive now with no evidence of recurrence. Conclusion Surgical resection is the most effective treatment for pancreatic cystic tumor, even if the patients with no any symptoms.

Citation： HUJun, HUANGQiang, LINXian-sheng, LIUChen-hai, XIEFang. Diagnosis and Treatment of 40 Cases of Pancreatic Cystic Neoplasms. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(10): 1250-1253. doi: 10.7507/1007-9424.20140299 Copy

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2.	Hamilton SR, Aaltonen LA, eds. Pathology and genetics of tumours of the digestive system. Vil.2 of World Health Organization classification of tumorous[M]. Lyon, France:IARC Press, 2000:234-240.
3.	Box JC, Douglas HO. Management of cystic neoplasms of the pancreas[J]. Am Surg, 2000, 66(5):495-501.
4.	高德明, 馬慶久, 賴大年, 等.胰腺囊腺瘤和囊腺癌的診治[J].中華普通外科雜志, 2001, 10(4):343-346.
5.	衛紅, 惠希增, 李葉臣, 等.胰腺囊腺癌的臨床診治及其影像學探討[J].肝膽胰外科雜志, 1999, 11(2):142-147.
6.	Fernández-del Castillo C, Targarona J, Thayer SP, et al. Incidental pancreatic cysts:clinicepathologic charaetefistics and comparison with symptomtic patients[J]. Arch Surg, 2003, 138(4):427-434.
7.	葛春林, 郭克建, 羅曉光, 等. 38例胰腺囊性腫瘤的臨床診斷及外科治療[J].中華普通外科雜志, 2006, 21(4):235-238.
8.	Salvia R, Festa L, Butturini G, et al. Pancreatic cystic tumors[J]. Minerva Chir, 2004, 59(2):185-207.
9.	Wu H, Cheng NS, Zhang YG, et al. Improved early diagnosis of cystadenocarcinoma of the pancreas[J]. Hepatobiliary Pancreat Dis Int, 2007, 6(1):87-91.
10.	Brugge WR, Lauwers GY, Sahani D, et al. Cystic neoplasms of the pancreas[J]. N Engl Med, 2004, 351(12):1218-1226.
11.	Kato T, Ikari S, Hirata K, et al. FDG-PET findings of intraductal oncocytic papillary neoplasms of the pancreas:two case reports[J]. Case Rep Gastroenterol, 2012, 6(2):415-424.
12.	Strobel O, Z'graggen K, Schmitz-Winnenthal FH, et al. Risk of malignancy in serous cystic neoplasms of the pancreas[J]. Digestion, 2003, 68(1):24-33.
13.	Siech M, Tripp K, Schmidt-Rohlfing B, et al. Cystic tumours of the pancreas:diagnostic accuracy, pathologic observations and surgical consequences[J]. Langenbecks Arch Surg, 1998, 383(1):56-61.
14.	Sarr MG, Murr M, Smyrk TC, et al. Primary cystic neoplasms of the pancreas.Neoplastic disorders of emerging importance-current state-of-the-art and unanswered questions[J]. J Gastrointest Surg, 2003, 7(3):417-428.
15.	Bassi C, Salvia R, Molinari E, et al. Management of 100 consecutive cases of pancreatic serous cystadenoma:wait for symptoms and see at imaging or vice versa?[J]. World J Surg, 2003, 27(3):319-323.
16.	王單松, 靳大勇, 樓文暉, 等.胰腺黏液性囊性腫瘤診治體會[J].中國臨床醫學, 2006, 13(1):80-81.
17.	Tang LH, Aydin H, Brennan MF, et al. Clinically aggressive solid pseudopapillary tumors of the pancreas:a report of two cases with components of undifferentiated carcinoma and a comparative clinicopathologic analysis of 34 conventional cases[J]. Am J Surg Pathol, 2005, 29(4):512-519.
18.	靳大勇, 樓文暉, 王單松, 等.全胰切除術2l例臨床療效評價[J].中華外科雜志, 2007, 45(1):21-23.
19.	宏滔, 戴福生.胰腺囊腫//呂云福.現代胰腺外科學[M].北京:人民軍醫出版社, 2003:236-246.
20.	McPhee JT, Hill JS, Whalen GF, et al. Perioperative mortality for pancreatectomy:a national perspective[J]. Ann Surg, 2007, 246(2):246-253.
21.	王單松, 樓文暉, 許雪峰, 等.胰腺漿液性囊腺瘤的診斷和治療[J].中華肝膽外科雜志, 2006, 12(8):539-540.
22.	Compagno J, Oertel JE. Microcystic adenomas of the pancreas (glycogen-rich cystadenomas):a clinicopathologic study of 34 cases[J]. Am J Clin Pathol, 1978, 69(3):289-298.
23.	Sahani DV, Kadavigere R, Saokar A, et al. Cystic pancreatic lesions:a simple imaging-based classification system for guiding management[J]. Radiographics, 2005, 25(6):1471-1484.
24.	Gerke H, Jaffe TA, Mitchell RM, et al. Endoscopic ultrasound and computer tomography are inaccurate methods of classifying cystic pancreatic lesions[J]. Dig Liver Dis, 2006, 38(1):39-44.
25.	Neoptolemos JP, Stocken DD, Friess H, et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer[J]. N Engl J Med, 2004, 350(12):1200-1210.

1. Hutchins GF, Draganov PV. Cystic neoplasm of the pancreas:a diagnostic challenge[J]. World J Gastroenterology, 2009, 15(1):48-54.
2. Hamilton SR, Aaltonen LA, eds. Pathology and genetics of tumours of the digestive system. Vil.2 of World Health Organization classification of tumorous[M]. Lyon, France:IARC Press, 2000:234-240.
3. Box JC, Douglas HO. Management of cystic neoplasms of the pancreas[J]. Am Surg, 2000, 66(5):495-501.
4. 高德明, 馬慶久, 賴大年, 等.胰腺囊腺瘤和囊腺癌的診治[J].中華普通外科雜志, 2001, 10(4):343-346.
5. 衛紅, 惠希增, 李葉臣, 等.胰腺囊腺癌的臨床診治及其影像學探討[J].肝膽胰外科雜志, 1999, 11(2):142-147.
6. Fernández-del Castillo C, Targarona J, Thayer SP, et al. Incidental pancreatic cysts:clinicepathologic charaetefistics and comparison with symptomtic patients[J]. Arch Surg, 2003, 138(4):427-434.
7. 葛春林, 郭克建, 羅曉光, 等. 38例胰腺囊性腫瘤的臨床診斷及外科治療[J].中華普通外科雜志, 2006, 21(4):235-238.
8. Salvia R, Festa L, Butturini G, et al. Pancreatic cystic tumors[J]. Minerva Chir, 2004, 59(2):185-207.
9. Wu H, Cheng NS, Zhang YG, et al. Improved early diagnosis of cystadenocarcinoma of the pancreas[J]. Hepatobiliary Pancreat Dis Int, 2007, 6(1):87-91.
10. Brugge WR, Lauwers GY, Sahani D, et al. Cystic neoplasms of the pancreas[J]. N Engl Med, 2004, 351(12):1218-1226.
11. Kato T, Ikari S, Hirata K, et al. FDG-PET findings of intraductal oncocytic papillary neoplasms of the pancreas:two case reports[J]. Case Rep Gastroenterol, 2012, 6(2):415-424.
12. Strobel O, Z'graggen K, Schmitz-Winnenthal FH, et al. Risk of malignancy in serous cystic neoplasms of the pancreas[J]. Digestion, 2003, 68(1):24-33.
13. Siech M, Tripp K, Schmidt-Rohlfing B, et al. Cystic tumours of the pancreas:diagnostic accuracy, pathologic observations and surgical consequences[J]. Langenbecks Arch Surg, 1998, 383(1):56-61.
14. Sarr MG, Murr M, Smyrk TC, et al. Primary cystic neoplasms of the pancreas.Neoplastic disorders of emerging importance-current state-of-the-art and unanswered questions[J]. J Gastrointest Surg, 2003, 7(3):417-428.
15. Bassi C, Salvia R, Molinari E, et al. Management of 100 consecutive cases of pancreatic serous cystadenoma:wait for symptoms and see at imaging or vice versa?[J]. World J Surg, 2003, 27(3):319-323.
16. 王單松, 靳大勇, 樓文暉, 等.胰腺黏液性囊性腫瘤診治體會[J].中國臨床醫學, 2006, 13(1):80-81.
17. Tang LH, Aydin H, Brennan MF, et al. Clinically aggressive solid pseudopapillary tumors of the pancreas:a report of two cases with components of undifferentiated carcinoma and a comparative clinicopathologic analysis of 34 conventional cases[J]. Am J Surg Pathol, 2005, 29(4):512-519.
18. 靳大勇, 樓文暉, 王單松, 等.全胰切除術2l例臨床療效評價[J].中華外科雜志, 2007, 45(1):21-23.
19. 宏滔, 戴福生.胰腺囊腫//呂云福.現代胰腺外科學[M].北京:人民軍醫出版社, 2003:236-246.
20. McPhee JT, Hill JS, Whalen GF, et al. Perioperative mortality for pancreatectomy:a national perspective[J]. Ann Surg, 2007, 246(2):246-253.
21. 王單松, 樓文暉, 許雪峰, 等.胰腺漿液性囊腺瘤的診斷和治療[J].中華肝膽外科雜志, 2006, 12(8):539-540.
22. Compagno J, Oertel JE. Microcystic adenomas of the pancreas (glycogen-rich cystadenomas):a clinicopathologic study of 34 cases[J]. Am J Clin Pathol, 1978, 69(3):289-298.
23. Sahani DV, Kadavigere R, Saokar A, et al. Cystic pancreatic lesions:a simple imaging-based classification system for guiding management[J]. Radiographics, 2005, 25(6):1471-1484.
24. Gerke H, Jaffe TA, Mitchell RM, et al. Endoscopic ultrasound and computer tomography are inaccurate methods of classifying cystic pancreatic lesions[J]. Dig Liver Dis, 2006, 38(1):39-44.
25. Neoptolemos JP, Stocken DD, Friess H, et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer[J]. N Engl J Med, 2004, 350(12):1200-1210.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Treatment of 40 Cases of Pancreatic Cystic Neoplasms

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