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Difficulties in the preoperative assessment of pancreatic cystic lesions: a case report

Serventi, Fernando and Marrosu, Antonio and Deriu, Michela and Sassu, Maria Angela and Paliogiannis, Panagiotis and Trignano, Mario (2009) Difficulties in the preoperative assessment of pancreatic cystic lesions: a case report. European Surgical Research, Vol. 43 (2), p. 101. ISSN 0014-312X. Article.

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DOI: 10.1159/000223651

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Abstract

Introduction: Conventional diagnostic instruments encounter great difficulties in the preoperative assessment of pancreatic lesions. Also preoperative histological diagnosis is not trustworthy as there is a high rate of false negatives and differential diagnosis can often fail.
Case Report: We report a case of a young woman with instrumental diagnosis of a suspect malignant pancreatic cystic lesion. The patient underwent distal splenopancreasectomy and histological examination of the specimen revealed an Intraductal Papillary Mucinous Neoplasm (IPMN) associated to a Mucinous Cystic Neoplasm (MCN) and an unexpected small neuroendocrine tumor in the pancreatic tail.
Discussion: Not all pancreatic neoplasms need a radical surgical treatment which is associated to high morbidity and mortality rates. Nevertheless it is indicated in all cases of MCN with signs of malignant transformation, in main- and branch duct IPMN and in case of pancreatic neuroendocrine tumors if they are singular and in M0 stage. So a certain preoperative histological diagnosis would be desirable.
Conclusions: A preoperative definite histological diagnosis, in case of cystic and neuroendocrine neoplasms of the pancreas, is often not feasible. So many patients undergo surgery with the suspect of pancreatic neoplasm as the certain histological diagnosis can only be made on the specimen.

Item Type:Article
ID Code:9335
Status:Published
Refereed:Yes
Uncontrolled Keywords:Pancreas, cancer, cystic lesions
Subjects:Area 06 - Scienze mediche > MED/18 Chirurgia generale
Divisions:001 Università di Sassari > 03 Istituti > Patologia chirurgica
Publisher:S. Karger AG.
ISSN:0014-312X
Additional Information:Paper presented at the 22. National Congress of the Italian Society of Young Surgeon (SPIGC) and the 1. Congress of the European Society of Young Surgeons (ESYS), June 18–20, 2009, Rome.
Deposited On:25 Nov 2013 12:07

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