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DOI: 10.1055/s-0040-1705027
PANCREATIC CYSTIC LESIONS: DOCTOR, DO I HAVE PANCREATIC CANCER!?
Publikationsverlauf
Publikationsdatum:
23. April 2020 (online)
Aims The prevalence of pancreatic cystic lesions (PCLs), both benign and malignant, has significantly increased in the past few years. We carried out a study aiming to evaluate the frequency of Endoscopic Ultrasound (EUS) based diagnosis of PCLs, with or without fine needle aspiration (FNA), in a tertiary emergency care center.
Methods We conducted a retrospective study assessing a total of 1155 EUS performed by a single operator between 2016 and 2019. Only the EUS findings that were relevant for PCLs were selected and divided into four groups, epithelial neoplastic (EN), epithelial non-neoplastic (ENN), non-epithelial non-neoplastic lesions (NENN) and non-epithelial neoplastic (NEN).
Results Among 1155 EUS performed, 103 (8.92%) met the criteria to be identified as PCLs. From this total, 62 were epithelial neoplastic lesions (60.19%), 26 were epithelial non-neoplastic lesions (25.24%) and 15 were non-epithelial non-neoplastic lesion (14.56%). In every group we assessed the percentage of each type of lesion. In the EN group we added 14 serous cystadenomas (13.59%), 11 serous cystadenocarcinomas (10.68%), 2 mucinous cystadenocarcinomas (1.94%), 12 main duct intraductal papillary mucinous neoplasia (MD-IPMN) (11.65%), 23 branch duct intraductal papillary mucinous neoplasia (BD-IPMN) (22.33%). In the ENN group we added 26 retention
cysts (25.24%), while in the NENN group there were 15 pancreatitis-associated pseudocysts (14.57%).FNA was performed in 30 cases (29.12%) with high suspicion for malignancies, with a confirmed positive diagnosis in 10 cases (9.71%) and were later referred to the surgery and oncological department. Further monitorization was recommended in all cases with low malignancy risk.
Conclusions Given their malignant potential and scarce evidence regarding their true prevalence,
PCLs have been in the medical world spotlight for some years. EUS with or without FNA has proven to be the go-to tool in the diagnosis and monitorization of PCLs with emerging evidence of their increasing frequency.