Background and study aims: Generally, cystic tumors are divided into two categories: neoplastic cystic tumors
and non-neoplastic cystic (NNC) tumors. Neoplastic cystic tumors include mucinous
cystic neoplasm (MCN), intraductal papillary-mucinous neoplasm (IPMN), and serous
cystic neoplasm (SCN). MCNs and IPMNs have the potential to progress to a malignant
state, whereas SCNs are known for their almost benign behavior. Thus, in order to
make management decisions, it is important to distinguish between potentially malignant
(MCN and IPMN), and benign (SCN and NNC) tumors. The aim of this study was to retrospectively
investigate the value of endoscopic ultrasonography (EUS) for the differential diagnosis
of cystic tumors of the pancreas.
Patients and methods: A total of 76 patients with cystic tumors of the pancreas were preoperatively examined
by EUS. Eight cases were MCNs, 45 were IPMNs, 13 were SCNs, and 10 were NNC tumors.
The EUS findings relevant to distinguishing between potentially malignant and benign
were analyzed statistically.
Results: All patients with MCNs were female and all these tumors were located in the pancreatic
body/tail. IPMN, however, occurred predominantly in men, and in the pancreatic head.
Eight of 11 monolocular cystic tumors were NNC in nature. Eleven of 13 SCNs included
microcystic areas within the tumors. All MCNs were round in appearance, whereas 93 %
of IPMNs were not round in appearance. Mural nodules were present in 25 % of MCN and
38 % of IPMN cases. In univariate analysis, age, tumor size, locularity, the number
of cystic formation, cystic component, and appearance were significant variables.
In multivariate analysis, locularity and cystic component were important for differential
diagnosis of potentially malignant cystic tumors.
Conclusions: The characteristics of cystic tumors of the pancreas revealed by EUS are useful for
their differential diagnosis.
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H. KuboMD
Department of Medicine and Bioregulatory Science
Graduate School of Medical Sciences
Kyushu University
3-1-1, Maidashi
Higashi-ku
Fukuoka 812–8582
Japan
Fax: +81-92-6425287
eMail: canoa@dune.ocn.ne.jp
