Cystic neoplasms of the pancreas
S. G. ReMine, D. Frey, R. L. Rossi, J. L. Munson and J. W. Braasch
From 1963 to 1983, 26 patients with cystic neoplasms of the pancreas were
treated at the Lahey Clinic, Burlington, Mass. Cystadenoma (15 patients)
was more common than cystadenocarcinoma (11 patients). Preoperative
symptoms, such as abdominal pain, were present for as long as 18 years
before diagnosis. The mean size of cysts was 7 cm. Distal pancreatectomy,
the most common operation, was performed in ten patients. Eight of the 11
patients with cystadenocarcinoma had metastatic disease at the time of
surgical exploration. There was one postoperative death (3.8%). Patients
with cystadenocarcinoma had an adjusted median survival time after
operation of 6.0 months. The long prodrome in many of the cancer patients
suggests that benign cystadenomas, particularly of the mucinous type, may
undergo malignant degeneration. Benign cystadenoma seems unlikely to recur
after adequate resection. Whenever possible, complete excision of
cystadenoma and cystadenocarcinoma is the procedure of choice.
