Pancreatic serous cystadenoma explained

Pancreatic serous cystadenoma
Synonyms:Serous cystadenoma of the pancreas, serous microcystic adenoma
Field:General surgery, gastroenterology
Symptoms:Usually asymptomatic
Onset:50–60 years of age
Risks:Female gender
Treatment:Surgical resection (if symptomatic)
Deaths:0.1%[1]

Pancreatic serous cystadenoma is a benign tumour of the pancreas.[2] It is usually solitary and found in the body or tail of the pancreas, and may be associated with von Hippel–Lindau syndrome.[2]

In contrast to some of the other cyst-forming tumors of the pancreas (such as the intraductal papillary mucinous neoplasm and the pancreatic mucinous cystadenoma), serous cystic neoplasms are almost always entirely benign. There are some exceptions; rare case reports have described isolated malignant serous cystadenocarcinomas.[3] In addition, serous cystic neoplasms slowly grow, and if they grow large enough they can press on adjacent organs and cause symptoms.

Signs and symptoms

In most cases, serous cystadenomas of the pancreas are asymptomatic. However, large cysts may cause symptoms related to their size.

Classification

Pathologists classify serous cystic neoplasms into two broad groups. Those that are benign, that have not spread to other organs, are designated "serous cystadenoma".[4] Serous cystadenomas can be further sub-typed into microcystic, oligocystic (or macrocystic), solid, mixed serous-endocrine neoplasm, and VHL-associated serous cystic neoplasm. This latter classification scheme is useful because it highlights the range of appearances and the clinical associations of these neoplasms. Serous cystic neoplasms that have spread ("metastasized") to another organ are considered malignant and are designated "serous cystadenocarcinoma".

Treatment

These lesions rarely require surgery unless they are symptomatic or the diagnosis is in question. Since these lesions do not have malignant potential, long-term observation with imaging surveillance is unnecessary. Surgery can include the removal of the head of the pancreas (a pancreaticoduodenectomy), removal of the body and tail of the pancreas (a distal pancreatectomy), or rarely removal of the entire pancreas (a total pancreatectomy).[5] In selected cases the surgery can be performed using minimally invasive techniques such as laparoscopy.[6]

Epidemiology

Serous cystadenomas of the pancreas are more common in women. SCAs are usually diagnosed in people 50–60 years of age.[7]

See also

Notes and References

  1. Jais B, Rebours V, Malleo G, Salvia R, Fontana M, Maggino L, Bassi C, Manfredi R, Moran R, Lennon AM, Zaheer A, Wolfgang C, Hruban R, Marchegiani G, Fernández Del Castillo C, Brugge W, Ha Y, Kim MH, Oh D, Hirai I, Kimura W, Jang JY, Kim SW, Jung W, Kang H, Song SY, Kang CM, Lee WJ, Crippa S, Falconi M, Gomatos I, Neoptolemos J, Milanetto AC, Sperti C, Ricci C, Casadei R, Bissolati M, Balzano G, Frigerio I, Girelli R, Delhaye M, Bernier B, Wang H, Jang KT, Song DH, Huggett MT, Oppong KW, Pererva L, Kopchak KV, Del Chiaro M, Segersvard R, Lee LS, Conwell D, Osvaldt A, Campos V, Aguero Garcete G, Napoleon B, Matsumoto I, Shinzeki M, Bolado F, Fernandez JM, Keane MG, Pereira SP, Acuna IA, Vaquero EC, Angiolini MR, Zerbi A, Tang J, Leong RW, Faccinetto A, Morana G, Petrone MC, Arcidiacono PG, Moon JH, Choi HJ, Gill RS, Pavey D, Ouaïssi M, Sastre B, Spandre M, De Angelis CG, Rios-Vives MA, Concepcion-Martin M, Ikeura T, Okazaki K, Frulloni L, Messina O, Lévy P . 6 . Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas) . Gut . 65 . 2 . 305–312 . February 2016 . 26045140 . 10.1136/gutjnl-2015-309638 . free . 11577/3187425 . 206962150 .
  2. Book: WHO Classification of Tumours Editorial Board . Digestive System Tumours . 2019 . 978-92-832-4499-8 . 5th . 1 . Lyon (France) . 303–306. en . 10. Tumours of the pancreas: Pancreatic serous cystadenoma.
  3. Galanis C, Zamani A, Cameron JL, Campbell KA, Lillemoe KD, Caparrelli D, Chang D, Hruban RH, Yeo CJ . 6 . Resected serous cystic neoplasms of the pancreas: a review of 158 patients with recommendations for treatment . Journal of Gastrointestinal Surgery . 11 . 7 . 820–826 . July 2007 . 17440789 . 10.1007/s11605-007-0157-4 . 32023143 .
  4. Web site: Pathology of Neoplasms of the Pancreas . . 25 April 2010.
  5. Web site: Pancreatic Surgery . . 25 April 2010.
  6. Web site: Laproscopic Pancreatic Surgery . . 25 April 2010.
  7. Elta GH, Enestvedt BK, Sauer BG, Lennon AM . ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts . The American Journal of Gastroenterology . 113 . 4 . 464–479 . April 2018 . 29485131 . 10.1038/ajg.2018.14 . 3584079 .

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