Analysis of clinical and pathological features of asymptomatic cystic neoplasms of pancreas

DAI Meng-hua; XU Tao; ZHANG Tai-ping; LIAO Quan; CONG Lin; GUO Jun-chao; HU Ya; CAO Yue; ZHAO Yu-pei; CAI Li-xing

Abstract：Objective To analyze and study clinical and pathological features of incidental cystic neoplasms of pancreas. Methods The clinical data of 126 cases of pancreatic resection performed for cystic neoplasms between January 1984 and June 2008 at Peking Union Medical College Hospital were evaluated retrospectively. Results Among 126 cases of cystic neoplasms of pancreas, 60 cases were asymptomatic including 56 cases of benign and 4 cases of malignant. The benign cases included 28 cases of serous cystic neoplasms, 25 cases of mucinous cystic neoplasms and 3 cases of intraductal papillary mucinous neoplasms. The malignant cases indued 3 cases of mucinous cystic adenocarcinoma and 1 case of invasive intraductal papillary mucinous neoplasm. Univariate and multivariate analysis showed that gender, tumor size and radiological features(solid component and main duct dilation) were significant different between benign and malignant cystic neoplasm of pancreas. Gender was a predictor of malignant pathology, with male cases having a higher incidence of malignancy (3/11, 27.3%) compared with female cases (1/44, 2.27%; P=0.001). The presence of radiographic features (solid component and main pancreatic duct dilation) was associated with malignancy of cystic neoplasms. Tumor size less than 3cm in diameter was more common in benign, asymptomatic cystic neoplasms of pancreas. Conclusion Among asymptomatic cystic neoplasms of pancreas, the incidence of malignant cases is lower. The study suggests that if tumor size in asymptomatic cases is less than 3cm in diameter without malignant radiographic features (solid component and main pancreatic duct dilation) observation and regular folllow-up can be selected.