Pancreatic Cystic Tumors: A Single Institution Series

Introduction: Pancreatic cystic tumors comprise 5–10 % of all exocrine pancreatic tumors. This is a very heterogeneous group of tumors with an extremely diverse clinical behaviour, but characterized by the common feature of a micro- macrocystic pathological pattern. Materials and Methods: From 1999 to 2007 we observed 30 cases of pancreatic cystic tumors. Among them 19 were submitted to surgery while 11 have been introduced to a strict followup schedule. Pathology reports of the resected ones were as follows: 5 CAS, 1 serous cystoadenocarcinoma, 3 CAM, 6 mucinous cystoadenocarcinoma, 3 IPMN and 1 solid pseudopapillary tumor. The majority of them (10) was located in the body-tail of pancreas, 7 cases were in the head and only 2 involved the entire gland. We performed a duodenocephalopancreatectomy in 6 cases, a distal spleno-pancreatectomy in 7, a spleen sparing distal pancreatectomy in 2 and total pancreatectomy in 4 cases. All patients were followed up with a mean time span of 21.1 months (range 6–53). One patient with a mucinous cystoadenoma and a coexistent pancreatic adenocarcinoma died 10 months after surgery. The remaining 18 patients are all presently alive and disease free. Discussion: Pancreatic cystic tumors are not a single clinical entity but share common features which make them different from all the other pancreatic tumors. The main issue regarding their treatment is a correct preoperative diagnosis. Such a proper diagnosis in presently possible only in 20–40% of cases and can guide the surgeon to appropriately select those patients who need an operation.