Heera Yoen1, Jung Hoon Kim1,2, Dong Ho Lee2,3, Su Joa Ahn2,3, Jeong Hee Yoon2,3, Joon Koo Han4,5. 1. Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea. 2. Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea. 3. Department of Radiology, Seoul National University Hospital, Seoul, Korea. 4. Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea. hanjk@snu.ac.kr. 5. Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea. hanjk@snu.ac.kr.
Abstract
OBJECTIVE: To describe the natural history of pancreatic cysts after long-term follow-up, with an emphasis on the identifying indicators of indolent lesions. METHODS: We retrospectively sampled 95 patients with 149 cysts <3 cm detected by CT from 2003 to 2004, and followed them for more than five years (mean 117.5 ± 18.8 months). Two radiologists reviewed the initial CT images, then recorded changes after the follow-up. We compared the cysts' initial characteristics between the surgery and non-surgery patient groups, and also between non-benign lesions and benign lesions. RESULTS: Twelve of the 95 patients, who among them had 16 cysts, underwent surgery. Of the 133 cysts in the 83 nonsurgical patients, 57 cysts (42.9 %) enlarged, although only five cysts increased to larger than 3 cm at the end of observation. The initial size of the cyst was significantly larger in the surgery group than non-surgery group. Also, according to cyst-based analysis, ductal communication, dilatation, and shape correlated with those of non-benign cysts and the non-surgical group. No cysts < 15 mm and without p-duct change showed a significant change within three years. CONCLUSION: Small pancreatic cysts, without p-duct change, and without a pleomorphic or clubbed shape, may be followed for a longer interval than current consensus. KEY POINTS: • Almost all small cysts < 3 cm were indolent in long term observation. • No cysts < 15 mm, without p-duct change showed significant change within 3 years. • Cyst size, ductal change and shape can be useful in predicting progress. • Only cysts with IPMN- like features and p-duct change need follow-up with cautions.
OBJECTIVE: To describe the natural history of pancreatic cysts after long-term follow-up, with an emphasis on the identifying indicators of indolent lesions. METHODS: We retrospectively sampled 95 patients with 149 cysts <3 cm detected by CT from 2003 to 2004, and followed them for more than five years (mean 117.5 ± 18.8 months). Two radiologists reviewed the initial CT images, then recorded changes after the follow-up. We compared the cysts' initial characteristics between the surgery and non-surgery patient groups, and also between non-benign lesions and benign lesions. RESULTS: Twelve of the 95 patients, who among them had 16 cysts, underwent surgery. Of the 133 cysts in the 83 nonsurgical patients, 57 cysts (42.9 %) enlarged, although only five cysts increased to larger than 3 cm at the end of observation. The initial size of the cyst was significantly larger in the surgery group than non-surgery group. Also, according to cyst-based analysis, ductal communication, dilatation, and shape correlated with those of non-benign cysts and the non-surgical group. No cysts < 15 mm and without p-duct change showed a significant change within three years. CONCLUSION:Small pancreatic cysts, without p-duct change, and without a pleomorphic or clubbed shape, may be followed for a longer interval than current consensus. KEY POINTS: • Almost all small cysts < 3 cm were indolent in long term observation. • No cysts < 15 mm, without p-duct change showed significant change within 3 years. • Cyst size, ductal change and shape can be useful in predicting progress. • Only cysts with IPMN- like features and p-duct change need follow-up with cautions.
Authors: William R Brugge; Gregory Y Lauwers; Dushyant Sahani; Carlos Fernandez-del Castillo; Andrew L Warshaw Journal: N Engl J Med Date: 2004-09-16 Impact factor: 91.245
Authors: Carlos Fernández-del Castillo; Javier Targarona; Sarah P Thayer; David W Rattner; William R Brugge; Andrew L Warshaw Journal: Arch Surg Date: 2003-04
Authors: Sang Youn Kim; Jeong Min Lee; Se Hyung Kim; Kyung-Sook Shin; Young Jun Kim; Su Kyung An; Chang Jin Han; Joon Koo Han; Byung Ihn Choi Journal: AJR Am J Roentgenol Date: 2006-11 Impact factor: 3.959
Authors: Sang Hyub Lee; Cheol Min Shin; Joo Kyung Park; Sang Myung Woo; Ji Won Yoo; Ji Kon Ryu; Yong Bum Yoon; Yong-Tae Kim Journal: Dig Dis Sci Date: 2007-04-03 Impact factor: 3.199
Authors: Olga R Brook; Peter Beddy; Jay Pahade; Corey Couto; Ian Brennan; Payal Patel; Alexander Brook; Ivan Pedrosa Journal: Radiology Date: 2015-09-04 Impact factor: 11.105
Authors: D Ciprani; M Weniger; M Qadan; T Hank; N K Horick; J M Harrison; G Marchegiani; S Andrianello; P V Pandharipande; C R Ferrone; K D Lillemoe; A L Warshaw; C Bassi; R Salvia; C Fernández-Del Castillo Journal: Pancreatology Date: 2020-08-10 Impact factor: 3.996