Serous Cystic Neoplasms of the Pancreas: Can We Distinguish the So-Called Locally- Aggressive Lesions from the Malignant Lesions? Case Series and Proposal of Unified Term “Serous Cystic Neoplasms of Low Grade Malignant Potential”
Main Article Content
Abstract
Serous cystic neoplasms of the pancreas are uncommon lesions and are generally considered benign. Conservative management is generally advised unless it
is symptomatic, rapidly enlarge mass, or uncertain diagnosis. Malignant serous cystadenocarcinoma has been occasionally reported in the literature. However, controversy remains for the definition, diagnosis, and management of the malignant counterpart. Additional proposal for the so-called locally invasive serous cystic neoplasms also add more confusion to the rare entity.
Keywords:
Serous cystic neoplasms, serous cystadenocarcinoma, locally invasive serous cystic neoplasms
Article Details
How to Cite
ZHU, Hongfa et al.
Serous Cystic Neoplasms of the Pancreas: Can We Distinguish the So-Called Locally- Aggressive Lesions from the Malignant Lesions? Case Series and Proposal of Unified Term “Serous Cystic Neoplasms of Low Grade Malignant Potential”.
Medical Research Archives, [S.l.], v. 6, n. 1, jan. 2018.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/1685>. Date accessed: 21 dec. 2024.
doi: https://doi.org/10.18103/mra.v6i1.1685.
Section
Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Laffan, T.A., et al., Prevalence of unsuspected pancreatic cysts on MDCT. AJR Am J Roentgenol, 2008. 191(3): p. 802-7.
2. de Jong, K., et al., Disappointing interobserver agreement among radiologists for a classifying diagnosis of pancreatic cysts using magnetic resonance imaging. Pancreas, 2012. 41(2): p. 278-82.
3. Horvath, K.D. and J.A. Chabot, An aggressive resectional approach to cystic neoplasms of the pancreas. Am J Surg, 1999. 178(4): p. 269-74.
4. Vege, S.S., et al., American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology, 2015. 148(4): p. 819-22; quize12-3.
5. Antonini, F., et al., Management of serous cystic neoplasms of the pancreas. Expert Rev Gastroenterol Hepatol, 2015. 9(1): p. 115-25.
6. Wargo, J.A., C. Fernandez-del-Castillo, and A.L. Warshaw, Management of pancreatic serous cystadenomas. Adv Surg, 2009. 43: p. 23-34.
7. Strobel, O., et al., Risk of malignancy in serous cystic neoplasms of the pancreas. Digestion, 2003. 68(1): p. 24-33.
8. George, D.H., et al., Serous cystadenocarcinoma of the pancreas: a new entity? Am J Surg Pathol, 1989. 13(1): p. 61-6.
9. Reid, M.D., et al., Serous Neoplasms of the Pancreas: A Clinicopathologic Analysis of 193 Cases and Literature Review With New Insights on Macrocystic and Solid Variants and Critical Reappraisal of So-called "Serous Cystadenocarcinoma". Am J Surg Pathol, 2015. 39(12): p. 1597-610.
10. Khashab, M.A., et al., Tumor size and location correlate with behavior of pancreatic serous cystic neoplasms. Am J Gastroenterol, 2011. 106(8): p. 1521-6.
11. Jais, B., et al., Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas). Gut, 2016. 65(2): p. 305-12.
12. Abe, H., et al., Serous cystadenoma of the pancreas with invasive growth: benign or malignant? Am J Gastroenterol, 1998. 93(10): p. 1963-6.
13. Bosman, F.T., World Health Organization., and International Agency for Research on Cancer., WHO classification of tumours of the digestive system. 4th ed. World Health Organization classification of tumours. 2010, Lyon: International Agency for Research on Cancer. 417 p.
14. Galanis, C., et al., Resected serous cystic neoplasms of the pancreas: a review of 158 patients with recommendations for treatment. J Gastrointest Surg, 2007. 11(7): p. 820-6.
15. Kosmahl, M., et al., Cystic neoplasms of the pancreas and tumor-like lesions with cystic features: a review of 418 cases and a classification proposal. Virchows Arch, 2004. 445(2): p. 168-78.
16. Ohta, T., et al., A case of serous cystadenoma of the pancreas with focal malignant changes. Int J Pancreatol, 1993. 14(3): p. 283-9.
17. Widmaier, U., et al., Serous cystadenocarcinoma of the pancreas. Int J Pancreatol, 1996. 20(2): p. 135-9.
18. Vadala, S., et al., Serous cystadenocarcinoma of the pancreas with portal thrombosis. Clin Ter, 2010. 161(2): p. 149-52.
19. Shintaku, M., A. Arimoto, and N. Sakita, Serous cystadenocarcinoma of the pancreas. Pathol Int, 2005. 55(7): p. 436-9.
20. Matsumoto, T., et al., Malignant serous cystic neoplasm of the pancreas: report of a case and review of the literature. J Clin Gastroenterol, 2005. 39(3): p. 253-6.
21. King, J.C., et al., Pancreatic serous cystadenocarcinoma: a case report and review of the literature. J Gastrointest Surg, 2009. 13(10): p. 1864-8.
22. Friebe, V., et al., Serous cystadenocarcinoma of the pancreas: management of a rare entity. Pancreas, 2005. 31(2): p. 182-7.
23. Cho, W., et al., Pancreatic serous cystadenocarcinoma with invasive growth into the colon and spleen. J Korean Surg Soc, 2011. 81(3): p. 221-4.
24. Kimura, W. and M. Makuuchi, Operative indications for cystic lesions of the pancreas with malignant potential--our experience. Hepatogastroenterology, 1999. 46(25): p. 483-91.
25. Eriguchi, N., et al., Serous cystadenocarcinoma of the pancreas with liver metastases. J Hepatobiliary Pancreat Surg, 1998. 5(4): p. 467-70.
26. Wasel, B.A., et al., Histological percutaneous diagnosis of stage IV microcystic serous cystadenocarcinoma of the pancreas. BMJ Case Rep, 2013. 2013.
27. Wu, J., et al., Whole-exome sequencing of neoplastic cysts of the pancreas reveals recurrent mutations in components of ubiquitin-dependent pathways. Proc Natl Acad Sci U S A, 2011. 108(52): p. 21188-93.
28. Van Dyke, T.J., et al., Serous Cystadenocarcinoma of the Pancreas: Clinical Features and Management of a Rare Tumor. Dig Surg, 2016. 33(3): p. 240-8.
29. Franko, J., et al., Serous cystadenocarcinoma of the pancreas with metachronous hepatic metastasis. Am J Clin Oncol, 2008. 31(6): p. 624-5.
30. Bano, S., et al., Imaging of pancreatic serous cystadenocarcinoma. Jpn J Radiol, 2011. 29(10): p. 730-4.
31. Zhu, H., et al., Carcinoma ex microcystic adenoma of the pancreas: a report of a novel form of malignancy in serous neoplasms. Am J Surg Pathol, 2012. 36(2): p. 305-10.
32. Bramis, K., et al., Serous cystadenocarcinoma of the pancreas: report of a case and management reflections. World J Surg Oncol, 2012. 10: p. 51.
33. Wu, C.M., et al., Serous cystic neoplasm involving the pancreas and liver: an unusual clinical entity. Abdom Imaging, 1999. 24(1): p. 75-7.
34. Huh, J., et al., Malignant pancreatic serous cystic neoplasms: systematic review with a new case. BMC Gastroenterol, 2016. 16(1): p. 97.
35. Klimstra, D.S., et al., The pathologic classification of neuroendocrine tumors: a review of nomenclature, grading, and staging systems. Pancreas, 2010. 39(6): p. 707-12.
36. Tseng, J.F., et al., Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment. Ann Surg, 2005. 242(3): p. 413-9; discussion 419-21.
37. Tseng, J.F., Management of serous cystadenoma of the pancreas. J Gastrointest Surg, 2008. 12(3): p. 408-10.
38. Springer, S., et al., A combination of molecular markers and clinical features improve the classification of pancreatic cysts. Gastroenterology, 2015. 149(6): p. 1501-10.
39. Reid, M.D., et al., Serous cystic neoplasms of the pancreas: clinicopathologic and molecular characteristics. Semin Diagn Pathol, 2014. 31(6): p. 475-83.
40. Wood, L.D. and R.H. Hruban, Pathology and molecular genetics of pancreatic neoplasms. Cancer J, 2012. 18(6): p. 492-501.
41. Theisen, B.K., A.I. Wald, and A.D. Singhi, Molecular Diagnostics in the Evaluation of Pancreatic Cysts. Surg Pathol Clin, 2016. 9(3): p. 441-56.
42. Rathore, M.U., A. Arif, and B. Umair, Serous cystadenocarcinoma of pancreas. J Coll Physicians Surg Pak, 2013. 23(6): p. 430-1.
43. Kosmahl, M., et al., Serous cystic neoplasms of the pancreas: an immunohistochemical analysis revealing alpha-inhibin, neuron-specific enolase, and MUC6 as new markers. Am J Surg Pathol, 2004. 28(3): p. 339-46.
44. Kamei, K., et al., Multifocal pancreatic serous cystadenoma with atypical cells and focal perineural invasion. Int J Pancreatol, 1991. 10(2): p. 161-72.
45. Machado, M.C., et al., Synchronous resection of pancreatic serous cystadenocarcinoma and liver metastasis: First reported case and review of literature. Pancreatology, 2015. 15(6): p. 708-12.
46. Yoshimi, N., et al., A rare case of serous cystadenocarcinoma of the pancreas. Cancer, 1992. 69(10): p. 2449-53.
47. Rossidis, G., et al., Malignant transformation of a pancreatic serous cystadenoma. Am Surg, 2012. 78(2): p. 260-3.
48. Okada, T., et al., [Hepatic metastasis of serous cystadenocarcinoma resected 4 years after operation of primary tumors--a case report]. Nihon Shokakibyo Gakkai Zasshi, 1991. 88(10): p. 2719-23.
49. Ishikawa, T., et al., Immunohistochemical and molecular biological studies of serous cystadenoma of the pancreas. Pancreas, 1998. 16(1): p. 40-4.
2. de Jong, K., et al., Disappointing interobserver agreement among radiologists for a classifying diagnosis of pancreatic cysts using magnetic resonance imaging. Pancreas, 2012. 41(2): p. 278-82.
3. Horvath, K.D. and J.A. Chabot, An aggressive resectional approach to cystic neoplasms of the pancreas. Am J Surg, 1999. 178(4): p. 269-74.
4. Vege, S.S., et al., American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology, 2015. 148(4): p. 819-22; quize12-3.
5. Antonini, F., et al., Management of serous cystic neoplasms of the pancreas. Expert Rev Gastroenterol Hepatol, 2015. 9(1): p. 115-25.
6. Wargo, J.A., C. Fernandez-del-Castillo, and A.L. Warshaw, Management of pancreatic serous cystadenomas. Adv Surg, 2009. 43: p. 23-34.
7. Strobel, O., et al., Risk of malignancy in serous cystic neoplasms of the pancreas. Digestion, 2003. 68(1): p. 24-33.
8. George, D.H., et al., Serous cystadenocarcinoma of the pancreas: a new entity? Am J Surg Pathol, 1989. 13(1): p. 61-6.
9. Reid, M.D., et al., Serous Neoplasms of the Pancreas: A Clinicopathologic Analysis of 193 Cases and Literature Review With New Insights on Macrocystic and Solid Variants and Critical Reappraisal of So-called "Serous Cystadenocarcinoma". Am J Surg Pathol, 2015. 39(12): p. 1597-610.
10. Khashab, M.A., et al., Tumor size and location correlate with behavior of pancreatic serous cystic neoplasms. Am J Gastroenterol, 2011. 106(8): p. 1521-6.
11. Jais, B., et al., Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas). Gut, 2016. 65(2): p. 305-12.
12. Abe, H., et al., Serous cystadenoma of the pancreas with invasive growth: benign or malignant? Am J Gastroenterol, 1998. 93(10): p. 1963-6.
13. Bosman, F.T., World Health Organization., and International Agency for Research on Cancer., WHO classification of tumours of the digestive system. 4th ed. World Health Organization classification of tumours. 2010, Lyon: International Agency for Research on Cancer. 417 p.
14. Galanis, C., et al., Resected serous cystic neoplasms of the pancreas: a review of 158 patients with recommendations for treatment. J Gastrointest Surg, 2007. 11(7): p. 820-6.
15. Kosmahl, M., et al., Cystic neoplasms of the pancreas and tumor-like lesions with cystic features: a review of 418 cases and a classification proposal. Virchows Arch, 2004. 445(2): p. 168-78.
16. Ohta, T., et al., A case of serous cystadenoma of the pancreas with focal malignant changes. Int J Pancreatol, 1993. 14(3): p. 283-9.
17. Widmaier, U., et al., Serous cystadenocarcinoma of the pancreas. Int J Pancreatol, 1996. 20(2): p. 135-9.
18. Vadala, S., et al., Serous cystadenocarcinoma of the pancreas with portal thrombosis. Clin Ter, 2010. 161(2): p. 149-52.
19. Shintaku, M., A. Arimoto, and N. Sakita, Serous cystadenocarcinoma of the pancreas. Pathol Int, 2005. 55(7): p. 436-9.
20. Matsumoto, T., et al., Malignant serous cystic neoplasm of the pancreas: report of a case and review of the literature. J Clin Gastroenterol, 2005. 39(3): p. 253-6.
21. King, J.C., et al., Pancreatic serous cystadenocarcinoma: a case report and review of the literature. J Gastrointest Surg, 2009. 13(10): p. 1864-8.
22. Friebe, V., et al., Serous cystadenocarcinoma of the pancreas: management of a rare entity. Pancreas, 2005. 31(2): p. 182-7.
23. Cho, W., et al., Pancreatic serous cystadenocarcinoma with invasive growth into the colon and spleen. J Korean Surg Soc, 2011. 81(3): p. 221-4.
24. Kimura, W. and M. Makuuchi, Operative indications for cystic lesions of the pancreas with malignant potential--our experience. Hepatogastroenterology, 1999. 46(25): p. 483-91.
25. Eriguchi, N., et al., Serous cystadenocarcinoma of the pancreas with liver metastases. J Hepatobiliary Pancreat Surg, 1998. 5(4): p. 467-70.
26. Wasel, B.A., et al., Histological percutaneous diagnosis of stage IV microcystic serous cystadenocarcinoma of the pancreas. BMJ Case Rep, 2013. 2013.
27. Wu, J., et al., Whole-exome sequencing of neoplastic cysts of the pancreas reveals recurrent mutations in components of ubiquitin-dependent pathways. Proc Natl Acad Sci U S A, 2011. 108(52): p. 21188-93.
28. Van Dyke, T.J., et al., Serous Cystadenocarcinoma of the Pancreas: Clinical Features and Management of a Rare Tumor. Dig Surg, 2016. 33(3): p. 240-8.
29. Franko, J., et al., Serous cystadenocarcinoma of the pancreas with metachronous hepatic metastasis. Am J Clin Oncol, 2008. 31(6): p. 624-5.
30. Bano, S., et al., Imaging of pancreatic serous cystadenocarcinoma. Jpn J Radiol, 2011. 29(10): p. 730-4.
31. Zhu, H., et al., Carcinoma ex microcystic adenoma of the pancreas: a report of a novel form of malignancy in serous neoplasms. Am J Surg Pathol, 2012. 36(2): p. 305-10.
32. Bramis, K., et al., Serous cystadenocarcinoma of the pancreas: report of a case and management reflections. World J Surg Oncol, 2012. 10: p. 51.
33. Wu, C.M., et al., Serous cystic neoplasm involving the pancreas and liver: an unusual clinical entity. Abdom Imaging, 1999. 24(1): p. 75-7.
34. Huh, J., et al., Malignant pancreatic serous cystic neoplasms: systematic review with a new case. BMC Gastroenterol, 2016. 16(1): p. 97.
35. Klimstra, D.S., et al., The pathologic classification of neuroendocrine tumors: a review of nomenclature, grading, and staging systems. Pancreas, 2010. 39(6): p. 707-12.
36. Tseng, J.F., et al., Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment. Ann Surg, 2005. 242(3): p. 413-9; discussion 419-21.
37. Tseng, J.F., Management of serous cystadenoma of the pancreas. J Gastrointest Surg, 2008. 12(3): p. 408-10.
38. Springer, S., et al., A combination of molecular markers and clinical features improve the classification of pancreatic cysts. Gastroenterology, 2015. 149(6): p. 1501-10.
39. Reid, M.D., et al., Serous cystic neoplasms of the pancreas: clinicopathologic and molecular characteristics. Semin Diagn Pathol, 2014. 31(6): p. 475-83.
40. Wood, L.D. and R.H. Hruban, Pathology and molecular genetics of pancreatic neoplasms. Cancer J, 2012. 18(6): p. 492-501.
41. Theisen, B.K., A.I. Wald, and A.D. Singhi, Molecular Diagnostics in the Evaluation of Pancreatic Cysts. Surg Pathol Clin, 2016. 9(3): p. 441-56.
42. Rathore, M.U., A. Arif, and B. Umair, Serous cystadenocarcinoma of pancreas. J Coll Physicians Surg Pak, 2013. 23(6): p. 430-1.
43. Kosmahl, M., et al., Serous cystic neoplasms of the pancreas: an immunohistochemical analysis revealing alpha-inhibin, neuron-specific enolase, and MUC6 as new markers. Am J Surg Pathol, 2004. 28(3): p. 339-46.
44. Kamei, K., et al., Multifocal pancreatic serous cystadenoma with atypical cells and focal perineural invasion. Int J Pancreatol, 1991. 10(2): p. 161-72.
45. Machado, M.C., et al., Synchronous resection of pancreatic serous cystadenocarcinoma and liver metastasis: First reported case and review of literature. Pancreatology, 2015. 15(6): p. 708-12.
46. Yoshimi, N., et al., A rare case of serous cystadenocarcinoma of the pancreas. Cancer, 1992. 69(10): p. 2449-53.
47. Rossidis, G., et al., Malignant transformation of a pancreatic serous cystadenoma. Am Surg, 2012. 78(2): p. 260-3.
48. Okada, T., et al., [Hepatic metastasis of serous cystadenocarcinoma resected 4 years after operation of primary tumors--a case report]. Nihon Shokakibyo Gakkai Zasshi, 1991. 88(10): p. 2719-23.
49. Ishikawa, T., et al., Immunohistochemical and molecular biological studies of serous cystadenoma of the pancreas. Pancreas, 1998. 16(1): p. 40-4.