Cystic tumors of the pancreas. Cystadenomas and cystadenocarcinomas. Diagnosis and practical attitude

Los tumores quísticos del páncreas. Cistoadenomas y cistoadenocarcinomas. Diagnóstico y actitud práctica

Valiñas, Roberto - Houry, Sidney - Huguier, Michel

Resumen:

Report of 16 cases of cystic tumors of pancreas(CTP) consisting of 5 serous cystoadeno mas (SC), 6 mucigenous cystoadenomas (MC) and5 cystoadenocarcinomas (CC) pertaining to 11 womenand 5 men.Mean age 63 years (ranging from 44 to 89). Fourof these patients were asymptomatic, 6 of themhad lost between 3 and 20 kilos. One patient with aCC developed Jaundice. CTPs were diagnosed byultrasound or CT scans. CTPs were topographedten times at the leve/ of pancreatic head, twice in itsbody and tour in its tail. At end of preoperative explorationsconducted for the purpose of diagnosis,CTPs went undetected in four cases. The exact diagnosisof tumor nature was made during preoperativein five cases: two SCs, one MC and two CCs.Unequivocal diagnosis was made through thehistologica/ study of surgica/ specimen in elevencases, by the existence of liver metastases in onecase and by citopunture under CT in the remainder.One patient refused to be operated. Thirteenpatientys were operated: in tour a cephalic duodenopancreatectomywas perfomed (1 SC and 3 CCs);in 5, tumor exeresis was performed (1 SC and 4MCs); in 2, a distal pancreatectomy was performed(1 MC and 1 CC); and 2 underwent surgicalpucture (SCs). Asymptomatic SCs may remainunoperated under surveillance, provided diagnosisbe unequivocal. Al/ other cystic tumors have to beresected, either, due to the fact that there is doubtas to their nature or because ít is a symptomaticCS, or an MC or a CC. In the latter case, prognosisis better that in cases of exocrine non metastasicpancreatic cancer.


Los autores reportan 16 casos de tumores quísticosdel páncreas (TQP), 5 cistoadenomas serosos(CS), 6 cistoadenomas mucinosos (CM) y cincocistoadenocarcinomas (CC). Estos se trataronde 11 mujeres y 5 hombres.La edad media fue de 63 años (extremos 44 a89 años). Cuatro enfermos fueron asintomáticos,6 enfermos habían adelgazado de 3 a 10 kg. Unenfermo con un CC tuvo una ictericia. Los TQPfueron diagnosticados por ecografía o tomografíacomputada. Los TQP se topografaron diez vecesa nivel de la cabeza del páncreas, dos veces en elcuerpo y 4 veces en la cola. Al término de las exploracionespreoperatorias el diagnóstico de TQPno fue reconocido en cuatro casos. El diagnósticoexacto de la naturaleza del tumor fue hecho en elpreoperatorio en cinco casos: dos CS, un CM ydos CC. El diagnóstico de certeza fue hecho por el estudio histológico de la pieza quirúrgica en once casos, por punción quirúrgica en dos casos, por la existencia de metástasis hepáticas en un caso,y por la citopunción bajo tomografía en el resto,un enfermo se negó a operarse. Trece enfermosfueron operados: a cuatro se les realizó una duodenopancreatectomíacefálica (un CS y tres CC),a cinco se les realizó una exéresis tumoral (unCS y cuatro CM), a dos se les realizó una pancreatectomíadistal (un CM y un CC) y a dos seles realizó una punción quirúrgica ( dos CS). LosCS asintomáticos pueden ser no operados bajovigilancia si el diagnóstico es certero. Los otrostumores quísticos deben ser resecados, ya seapor que exista duda sobre su naturaleza, ya seaporque se trate de un CS sintomático, o un CM oun CC. En este último caso, el pronóstico es mejorque en los casos de cáncer de páncreas exócrinono metastásico.


Detalles Bibliográficos
2004
páncreas
cistoadenoma
pancreas
cystoadenoma
Español
Sociedad de Cirugía del Uruguay
Revista Cirugía del Uruguay
https://revista.scu.org.uy/index.php/cir_urug/article/view/4522
Acceso abierto
Resumen:
Sumario:Report of 16 cases of cystic tumors of pancreas(CTP) consisting of 5 serous cystoadeno mas (SC), 6 mucigenous cystoadenomas (MC) and5 cystoadenocarcinomas (CC) pertaining to 11 womenand 5 men.Mean age 63 years (ranging from 44 to 89). Fourof these patients were asymptomatic, 6 of themhad lost between 3 and 20 kilos. One patient with aCC developed Jaundice. CTPs were diagnosed byultrasound or CT scans. CTPs were topographedten times at the leve/ of pancreatic head, twice in itsbody and tour in its tail. At end of preoperative explorationsconducted for the purpose of diagnosis,CTPs went undetected in four cases. The exact diagnosisof tumor nature was made during preoperativein five cases: two SCs, one MC and two CCs.Unequivocal diagnosis was made through thehistologica/ study of surgica/ specimen in elevencases, by the existence of liver metastases in onecase and by citopunture under CT in the remainder.One patient refused to be operated. Thirteenpatientys were operated: in tour a cephalic duodenopancreatectomywas perfomed (1 SC and 3 CCs);in 5, tumor exeresis was performed (1 SC and 4MCs); in 2, a distal pancreatectomy was performed(1 MC and 1 CC); and 2 underwent surgicalpucture (SCs). Asymptomatic SCs may remainunoperated under surveillance, provided diagnosisbe unequivocal. Al/ other cystic tumors have to beresected, either, due to the fact that there is doubtas to their nature or because ít is a symptomaticCS, or an MC or a CC. In the latter case, prognosisis better that in cases of exocrine non metastasicpancreatic cancer.