Introduction
Cystic pancreatic tumors are rare tumours that are increasingly being discovered incidentally due in part to the improved performance of pancreatic imaging modalities (ultrasound, multidetector CT scan, MRI) and advancements in knowledge regarding the characteristics of these lesions. They are represented by serous cystadenomas (SC), mucinous cystadenomas (MC), intraductal papillary mucinous neoplasms (IPMN), and solid pseudopapillary tumors of the pancreas (SPTP). The aim is to study the epidemiological, clinical, biological, and etiological aspects of these pancreatic tumors.
Aims & Methods
This single-centre study was carried out from September 2015 to August 2023 and included all patients with cystic tumours of the pancreas. False pancreatic cysts were excluded from the study. Epidemiological, clinical, biological and echo-endoscopic data were collected from endoscopic-ultrasounds registers. All endoscopic-ultrasounds were performed under Propofol sedation using a Pentax-type radial and/or linear video echo-endoscope, and cytoponctions were performed using 19 G echotip needles for biochemical analysis of the cystic fluid and/or anatomopathological study.
Results
Out of a total of 649 biliopancreatic endoscopic ultrasounds performed, 53 patients were included, representing a prevalence of 8.16%. The mean age was 62.3 years (29-82 years) with a clear female predominance (Sex Ratio = 0.65). Discovery circumstances were incidental findings in 21 cases (39%), epigastric pain in 17 cases (32%), acute pancreatitis in 6 cases (11.3%), jaundice in 6 cases (11.3%), and abdominal pain in 3 cases (5.6%). Biochemically, cholestasis was found in 12 cases (22.6%), cytolysis in 5 cases (9.4%), and elevated Ca19-9 in 6 cases (11.3%). Endoscopic ultrasound revealed the location, number, and size of the tumor: 21 cases (39.6%) were located in the pancreatic head, 13 cases (24.5%) in the body, 9 cases (17%) in the tail, and 10 cases (18.9%) were multifocal, with an average tumor size of 28.5 mm (1.9-76 mm). Communication with pancreatic ducts was observed in 35 cases (66%), and Wirsung duct dilation in 16 cases (30.1%). Cytology was performed in 27 cases (51%). The endoscopic ultrasound appearance combined with cystic fluid analysis favored IPMN in 42 cases (79.2%), mucinous cystadenoma in 5 cases (9.4%), serous cystadenoma in 3 cases (5.7%), and SPTP in 3 cases (5.7%).
Conclusion
Cystic pancreatic tumors are rare neoplasms predominantly affecting women in their sixties, often discovered incidentally. They predominantly occur in the pancreatic head and are mainly comprised of IPMN followed by mucinous cystadenomas, with serous cystadenomas and SPTPs being less common.
Disclosure
no links of interest