[Cystadenoma and cystadenocarcinoma of the pancreas]

Abstract

In the past 28 years 298 pancreatic tumors have been observed, out of which 2% (6 cases) were cystadenomas and 1.3% (4 cases) were cystadenocarcinomas. Cystadenomas appear around the 6th decade of life, what constitutes an argument against its congenital origin. They are more frequent in woman (2 to 1). The histopathologic differentiation of the mucinous cystic neoplasma often forming papillae of the serous cystadenoma is useful because those are likely to become malignant. Association of pancreatic cystadenomas with different pathologies (biliary lithiasis, cancer of a different location, cysts in other organs, diabetes) has been observed, but these would be mere coincidences. Cystadenomas are frequently operative findings (3 cases) in patients who had been operated on for different reasons, but they may have different symptoms, mainly pain and a abdominal mass. Visual method of diagnosis are useful in preoperative diagnosis. In cystic formations of the pancreas with surgical possibilities, operative biopsy a must be preferred to that one obtained by means of pre-operating needle puncture. Surgical resection is the method to be chosen, either enucleation (1 case) or pancreatectomy (3 cases), being more important in mucinous cystadenoma because they may become malignant. Cystadenocarcinomas are not so frequent and seem to originate in benign cystadenomas. Palpable tumors, compression signs and pain are the late clinical manifestations. The resection is the treatment to be chosen although the most cases are unresectable. An external drainage is not a satisfactory operation but it sometimes helps to lessen the symptoms, and sometimes its posterior resection was possible.