Raffaele Pezzilli1, Elisabetta Buscarini2, Tommaso Pollini3, Deborah Bonamini3, Giovanni Marchegiani3, Stefano Crippa4, Giulio Belfiori4, Cosimo Sperti5, Lucia Moletta5, Gioia Pozza5, Germana De Nucci6, Giampiero Manes6, Enzo D Mandelli6, Riccardo Casadei7, Claudio Ricci7, Saverio Alicante2, Claudia Vattiato2, Silvia Carrara8, Milena Di Leo8, Carlo Fabbri9, Silvia Giovanelli10, Luca Barresi11, Matteo Tacelli11, Vincenzo G Mirante12, Rita Conigliaro12, Filippo Antonini13, Giampiero Macarri13, Luca Frulloni14, Giulia De Marchi14, Romano Sassatelli15, Paolo Cecinato15, Giovanna Del Vecchio Blanco16, Andrea Galli17, Angelo Pezzullo18, Alberto Fantin19, Massimo Graffeo20, Mauro Frego21, Domenico Stillittano22, Fabio Monica23, Bastianello Germanà24, Gabriele Capurso25, Mariano Quartini26, Luigi Veneroni27, Renato Cannizzaro28, Massimo Falconi4. 1. Department of Gastroenterology, San Carlo Hospital, Potenza, Italy. Electronic address: raffaele.pezzilli@gmail.com. 2. Gastroenterology and Endoscopy Unit, Maggiore Hospital, Crema, Italy. 3. Pancreas Institute, Verona University, Verona, Italy. 4. Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Centre, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy. 5. Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy. 6. Gastroenterology and Endoscopy Unit, Rhodense Hospital, Milan, Italy. 7. Surgical Department, Polyclinic of Sant'Orsola, University of Bologna, Bologna, Italy. 8. Humanitas Clinical and Research Center, IRCCS, Digestive Endoscopy Unit, Division Of Gastroenterology, Milan, Italy. 9. Unit of Gastroenterology and Digestive Endoscopy, Forlì-Cesena, Italy. 10. Gastroenterology and Interventional Endoscopy Unit, Maggiore Hospital, Bologna, Italy. 11. Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Highly Specialized Therapies), Palermo, Italy. 12. Gastroenterology and Endoscopy Unit, Baggiovara Hospital, University Hospital, Modena, Italy. 13. Gastroenterology and Digestive Endoscopy Unit, Augusto Murri Hospital, Polytechnic University of Marche, Fermo, Italy. 14. Gastroenterology, Department of Medicine, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy. 15. IRCCS Hospital, Reggio Emilia, Italy. 16. Unit of Gastroenterology, Department of Medicine, Tor Vergata University, Rome, Italy. 17. Gastroenterology Research Unit, Department of Experimental and Clinical Biomedical Sciences, Florence, Italy. 18. Department of Anesthesiological, Surgical and Emergency Sciences, University of Naples, Naples, Italy. 19. Gastroenterology Unit, Padua, Italy. 20. Department of Internal Medicine, Gastroenterology and Endoscopy, Poliambulanza Hospital, Brescia, Italy. 21. Surgical Department, Ospedali Riuniti, Padua, Italy. 22. Digestive Endoscopy Unit, Desio Hospital, Milan, Italy. 23. Gastroenterology and Digestive Endoscopy, Cattinara Hospital, Cattinara, Trieste, Italy. 24. Gastroenterology Unit, San Martino Hospital, Belluno, Italy. 25. Digestive and Liver Disease Unit, S. Andrea Hospital, Rome, Italy. 26. Gastroenterology Unit, Santa Maria Hospital, Terni, Italy. 27. Surgical Department, Infermi Hospital, Rimini, Italy. 28. Oncological Center, Aviano-Pordenone, Italy.
Abstract
INTRODUCTION: A prospective survey to evaluate the diagnostic workup of cystic pancreatic neoplasms (CPNs) according to the Italian guidelines. METHODS: An online data sheet was built. RESULTS: Fifteen of the 1385 patients (1.1%) had non cystic neoplastic lesions. Forty percent (518/1295) had at least one 1st degree relative affected by a solid tumor of the digestive and extra-digestive organs. Symptoms/signs associated with the cystic lesion were present in 24.5% of the patients. The cysts were localized in the head of the pancreas in 38.5% of patients. Of the 2370 examinations (1.7 examinations per patient) which were carried out for the diagnosis, magnetic resonance imaging was performed as a single test in 48.4% of patients and in combination with endoscopic ultrasound in 27% of the cases. Of the 1370 patients having CPNs, 89.9% had an intraductal papillary mucinous neoplasm (IPMN) (70.1% a branch duct IPMN, 6.2% a mixed type IPMN and 4.6% a main duct IPMN), 12.7% had a serous cystadenoma, 2.8% a mucinous cystadenoma, 1.5% a non-functioning cystic neuroendocrine neoplasm, 0.7% a solid-pseudopapillary cystic neoplasm, 0.3% a cystic adenocarcinoma, and 1.2% an undetermined cystic neoplasm. Seventy-eight (5.7%) patients were operated upon after the initial work-up. CONCLUSIONS: This prospective study offers a reliable real-life picture of the diagnostic work-up CPN.
INTRODUCTION: A prospective survey to evaluate the diagnostic workup of cystic pancreatic neoplasms (CPNs) according to the Italian guidelines. METHODS: An online data sheet was built. RESULTS: Fifteen of the 1385 patients (1.1%) had non cystic neoplastic lesions. Forty percent (518/1295) had at least one 1st degree relative affected by a solid tumor of the digestive and extra-digestive organs. Symptoms/signs associated with the cystic lesion were present in 24.5% of the patients. The cysts were localized in the head of the pancreas in 38.5% of patients. Of the 2370 examinations (1.7 examinations per patient) which were carried out for the diagnosis, magnetic resonance imaging was performed as a single test in 48.4% of patients and in combination with endoscopic ultrasound in 27% of the cases. Of the 1370 patients having CPNs, 89.9% had an intraductal papillary mucinous neoplasm (IPMN) (70.1% a branch duct IPMN, 6.2% a mixed type IPMN and 4.6% a main duct IPMN), 12.7% had a serous cystadenoma, 2.8% a mucinous cystadenoma, 1.5% a non-functioning cystic neuroendocrine neoplasm, 0.7% a solid-pseudopapillary cystic neoplasm, 0.3% a cystic adenocarcinoma, and 1.2% an undetermined cystic neoplasm. Seventy-eight (5.7%) patients were operated upon after the initial work-up. CONCLUSIONS: This prospective study offers a reliable real-life picture of the diagnostic work-up CPN.
Authors: Adam M Awe; Michael M Vanden Heuvel; Tianyuan Yuan; Victoria R Rendell; Mingren Shen; Agrima Kampani; Shanchao Liang; Dane D Morgan; Emily R Winslow; Meghan G Lubner Journal: Abdom Radiol (NY) Date: 2021-10-12