Pancreatic cyst case

1936 ◽  
Vol 32 (8) ◽  
pp. 990-993
Author(s):  
I. A. Ivanov
Keyword(s):  
Pancreatic Cyst ◽  
Pancreatic Cysts

Pancreatic cysts are relatively rare surgical diseases.

scholarly journals Survival in Cystic Neoplasms of the Pancreas

2009 ◽  
Vol 23 (8) ◽  
pp. 537-542 ◽  
Author(s):  
Ali Cadili ◽  
Amy Bazzerelli ◽  
Sipi Garg ◽  
Robert Bailey
Keyword(s):  
Overall Survival ◽  
Pancreatic Cyst ◽  
Patient Survival ◽  
Survival Rates ◽  
Pancreatic Cysts ◽  
Cystic Neoplasms ◽  
Patient Age ◽  
Patient Âgé ◽  
History Of ◽  
Pancreatic Cystic Neoplasms

BACKGROUND: The natural history of pancreatic cystic neoplasms remains poorly understood despite growing evidence on the subject. Pancreatic cysts display a wide spectrum of pathological phenotypes, each associated with a different prognostic implication. Many pancreatic cysts are of undetermined malignant potential at presentation and remain so until surgically resected. While the survival rates of patients with malignant cysts are known to be poor, survival rates in patients with undetermined pancreatic cysts are unknown.OBJECTIVE: To identify the factors associated with survival in a group of patients diagnosed with a pancreatic cyst(s).METHODS: The present study was a retrospective multicentre review of pancreatic cystic neoplasms. All patients with a diagnosis of a neoplastic pancreatic cyst from 1994 to 2003 were identified at five different institutions in Edmonton, Alberta. The data collected included patient age, sex, imaging modality, cyst location, cyst size, number of cysts, comorbid illnesses, history of upper abdominal surgery, previous cancer, previous or concurrent metastases, symptoms (pain, upper gastrointestinal bleeding, signs of biliary obstruction, nausea/vomiting), remarkable radiological features, elevated amylase or lipase, type of pancreatic surgery, final pathology (benign or malignant) and overall survival. Survival models were used to assess whether any covariates were predictors of the survival time. Patient data were plotted using the Kaplan-Meier method. The resulting plot was used to calculate survival in the cohort.RESULTS: In total, 64 patients were identified as having neoplastic pancreatic cysts from 1994 to 2003 at the five institutions. The median overall patient survival time was 86 months. The median age at diagnosis for the patient population was 73 years, with 40 patients being women. Univariate analysis revealed that the risk of death was associated with patient age, sex and history of major comorbid illness. Multivariate models identified increased patient age and male sex as the factors that correlated most strongly with decreased overall survival.CONCLUSION: Overall survival in patients with neoplastic pancreatic cysts is determined by patient factors (ie, age and sex) rather than factors descriptive of the cyst such as size and morphology. No conclusions could be made regarding the relationship between cyst pathology and patient survival.

scholarly journals A multimodality test to guide the management of patients with a pancreatic cyst

2019 ◽  
Vol 11 (501) ◽  
pp. eaav4772 ◽  
Author(s):  
Simeon Springer ◽  
David L. Masica ◽  
Marco Dal Molin ◽  
Christopher Douville ◽  
Christopher J. Thoburn ◽  
...  
Keyword(s):  
Management Practices ◽  
Pancreatic Cyst ◽  
Standard Of Care ◽  
Supervised Machine Learning ◽  
Machine Learning Techniques ◽  
Pancreatic Cysts ◽  
Current Standard ◽  
Imaging Characteristics ◽  
Using Data ◽  
Multimodality Test

Pancreatic cysts are common and often pose a management dilemma, because some cysts are precancerous, whereas others have little risk of developing into invasive cancers. We used supervised machine learning techniques to develop a comprehensive test, CompCyst, to guide the management of patients with pancreatic cysts. The test is based on selected clinical features, imaging characteristics, and cyst fluid genetic and biochemical markers. Using data from 436 patients with pancreatic cysts, we trained CompCyst to classify patients as those who required surgery, those who should be routinely monitored, and those who did not require further surveillance. We then tested CompCyst in an independent cohort of 426 patients, with histopathology used as the gold standard. We found that clinical management informed by the CompCyst test was more accurate than the management dictated by conventional clinical and imaging criteria alone. Application of the CompCyst test would have spared surgery in more than half of the patients who underwent unnecessary resection of their cysts. CompCyst therefore has the potential to reduce the patient morbidity and economic costs associated with current standard-of-care pancreatic cyst management practices.

Incidental pancreatic cysts: natural history and diagnostic accuracy of a limited serial pancreatic cyst MRI protocol

2014 ◽  
Vol 24 (5) ◽  
pp. 1020-1029 ◽  
Author(s):  
Stephanie Nougaret ◽  
Caroline Reinhold ◽  
Jaron Chong ◽  
Laure Escal ◽  
Gregoire Mercier ◽  
...  
Keyword(s):  
Natural History ◽  
Diagnostic Accuracy ◽  
Pancreatic Cyst ◽  
Pancreatic Cysts ◽  
Mri Protocol ◽  
Incidental Pancreatic Cysts

Su1485 Validation of a 9-microRNA Panel in Pancreatic Cyst Fluid for the Risk Stratification of Pancreatic Cysts in a Prospective Cohort

2015 ◽  
Vol 148 (4) ◽  
pp. S-526
Author(s):  
Wesley K. Utomo ◽  
Leendert Looijenga ◽  
Marco J. Bruno ◽  
Maikel P. Peppelenbosch ◽  
Henri Braat
Keyword(s):  
Risk Stratification ◽  
Prospective Cohort ◽  
Pancreatic Cyst ◽  
Cyst Fluid ◽  
Pancreatic Cysts ◽  
Pancreatic Cyst Fluid

Management of Cystic Neoplasms of the Pancreas

2018 ◽  
Author(s):  
Victoria R Rendell ◽  
Walker A Julliard ◽  
Adam M Awe ◽  
Daniel E Abbott ◽  
Emily R Winslow ◽  
...  
Keyword(s):  
Pancreatic Cyst ◽  
Cystic Neoplasm ◽  
Pancreatic Cysts ◽  
Multidisciplinary Teams ◽  
Pancreatic Cystic Neoplasm ◽  
Cross Sectional ◽  
Management Guidelines ◽  
Imaging Characteristics ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

The diagnosis of pancreatic cystic lesions is increasingly common. The majority of pancreatic cysts are now diagnosed incidentally on cross-sectional imaging. Lack of clear evidence-based guidelines and overall poor understanding of the natural history of pancreatic cysts contribute to complexity of managing patients with pancreatic cysts. Pancreatic cystic neoplasm types differ in their presentation, histologic features, imaging characteristics, and predisposition to develop invasive malignancy. The diagnostic strategies to determine cyst type and presence of malignancy—cross-sectional imaging, endoscopic ultrasonography, and analyses of pancreatic cyst fluid aspirates—have improved over time. However, accurate characterization of cysts remains challenging. Several large groups, including the American College of Radiology, the American Gastroenterological Association, the European Study Group on Cystic Tumours of the Pancreas, and the International Association of Pancreatology, have released cyst management guidelines or recommendations that have important differences. In this review, we provide an overview of the most common pancreatic cystic neoplasm, evaluate recent advancements in diagnostic techniques, and compare current management guidelines. This review contains 7 figures, 5 tables, and 77 references. Key Words: intraductal papillary mucinous neoplasm, management guidelines, multidisciplinary teams, mucinous cystic neoplasm, pancreatic cyst, pancreatic cystic neoplasm, serous cystadenoma, solid pseudopapillary neoplasm, surgical oncology 

scholarly journals A novel approach for selecting combination clinical markers of pathology applied to a large retrospective cohort of surgically resected pancreatic cysts

2016 ◽  
Vol 24 (1) ◽  
pp. 145-152 ◽  
Author(s):  
David L Masica ◽  
Marco Dal Molin ◽  
Christopher L Wolfgang ◽  
Tyler Tomita ◽  
Mohammad R Ostovaneh ◽  
...  
Keyword(s):  
Pancreatic Cyst ◽  
Pancreatic Cysts ◽  
Clinical Markers ◽  
Intraductal Papillary Mucinous Neoplasms ◽  
Cystic Neoplasms ◽  
Mucinous Cystic Neoplasms ◽  
Serous Cystadenomas ◽  
Mucinous Neoplasms ◽  
Independent Cohort ◽  
Solid Pseudopapillary Neoplasms

Objective: Our objective was to develop an approach for selecting combinatorial markers of pathology from diverse clinical data types. We demonstrate this approach on the problem of pancreatic cyst classification. Materials and Methods: We analyzed 1026 patients with surgically resected pancreatic cysts, comprising 584 intraductal papillary mucinous neoplasms, 332 serous cystadenomas, 78 mucinous cystic neoplasms, and 42 solid-pseudopapillary neoplasms. To derive optimal markers for cyst classification from the preoperative clinical and radiological data, we developed a statistical approach for combining any number of categorical, dichotomous, or continuous-valued clinical parameters into individual predictors of pathology. The approach is unbiased and statistically rigorous. Millions of feature combinations were tested using 10-fold cross-validation, and the most informative features were validated in an independent cohort of 130 patients with surgically resected pancreatic cysts. Results: We identified combinatorial clinical markers that classified serous cystadenomas with 95% sensitivity and 83% specificity; solid-pseudopapillary neoplasms with 89% sensitivity and 86% specificity; mucinous cystic neoplasms with 91% sensitivity and 83% specificity; and intraductal papillary mucinous neoplasms with 94% sensitivity and 90% specificity. No individual features were as accurate as the combination markers. We further validated these combinatorial markers on an independent cohort of 130 pancreatic cysts, and achieved high and well-balanced accuracies. Overall sensitivity and specificity for identifying patients requiring surgical resection was 84% and 81%, respectively. Conclusions: Our approach identified combinatorial markers for pancreatic cyst classification that had improved performance relative to the individual features they comprise. In principle, this approach can be applied to any clinical dataset comprising dichotomous, categorical, and continuous-valued parameters.

Pancreatic cyst fluid DNA analysis in evaluating pancreatic cysts: a report of the PANDA study

2009 ◽  
Vol 69 (6) ◽  
pp. 1095-1102 ◽  
Author(s):  
Asif Khalid ◽  
Maliha Zahid ◽  
Sydney D. Finkelstein ◽  
Julia K. LeBlanc ◽  
Neeraj Kaushik ◽  
...  
Keyword(s):  
Dna Analysis ◽  
Pancreatic Cyst ◽  
Cyst Fluid ◽  
Pancreatic Cysts ◽  
Pancreatic Cyst Fluid

Pancreatic Cyst Cytopathology: Is It Still Worthwhile to Do It?

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S93-S93
Author(s):  
Xiaofeng Zhao ◽  
Aileen Grace Arriola
Keyword(s):  
Minimally Invasive ◽  
Pancreatic Cyst ◽  
Invasive Procedure ◽  
Cost Effective ◽  
Diagnostic Value ◽  
University Hospital ◽  
Pancreatic Cysts ◽  
Molecular Testing ◽  
Cystic Lesions ◽  
Patient Demographics

Abstract Objectives Cystic lesions are relatively common in the pancreas, with pseudocysts accounting for 75% to 90% among other etiologies. In contrast to cysts in other organs, cysts in the pancreas are more likely to be neoplastic rather than benign or insignificant. EUS-guided FNA has served as a minimally invasive and fast diagnosis methodology. However, the efficacy of FNA on pancreatic lesions is controversial. Methods A 10-year retrospective study of upper EUS-guided FNA specimens on all cystic lesions in pancreas was conducted at the pathology department of a university hospital. Diagnoses and patient demographics were obtained. The frequency of diagnosis was investigated. When available, the endoscopic findings and CEA levels were obtained for analysis. Results A total of 188 pancreatic cyst FNA cases were collected. Approximately 80% of the specimens were satisfactory for cytology evaluation, and the diagnosis of “negative for dysplasia/malignancy” accounted for the majority of the cases (77.6%). The presence of communication with the pancreatic duct or elevated CEA level (>192 ng/mL) does not change the frequency of negative diagnosis significantly (P = .25). Among the 29 cases with a benign impression on EUS, only 1 case was upgraded to a higher lesion on cytology (3.5%) and this cyst measured >3 cm. Among 86 cysts ≤3 cm, only 1 case was diagnosed as an IPMN and high-grade dysplasia was not identified. All 41 cases with unsatisfactory cytology were due to insufficient cellularity, including 14 cases with an impression of a questionable lesion on EUS. Conclusion In our patient population, EUS-guided FNA of pancreatic cysts does not add significant diagnostic value to EUS findings of benign-appearing pancreatic cysts ≤3 cm and may not be cost-effective overall. Additional molecular testing on cyst fluid obtained by EUS-FNA, especially on cases with insufficient cellularity, may enhance the value of this minimally invasive procedure and improve its diagnostic performance.

Sign in / Sign up

Export Citation Format

Share Document