scholarly journals Ciliated Foregut Cyst of the Pancreas Presenting as a Mucinous Cystic Neoplasm

2018 ◽  
Vol 09 (03) ◽  
pp. 125-127
Author(s):  
Nadia Huq ◽  
Wesley Papenfuss ◽  
Nalini M. Guda
Keyword(s):  
Mucinous Cystic Neoplasm ◽  
Needle Aspiration ◽  
Cystic Neoplasm ◽  
Limited Data ◽  
Diagnostic Dilemma ◽  
Posterior Aspect ◽  
Laparoscopic Excision ◽  
Elevated Tumor Marker ◽  
Foregut Cyst ◽  
Current Report

A 53‑year‑old underwent an abdominal computed tomography for hematuria that incidentally discovered a cystic lesion of the pancreas. Endoscopic ultrasound revealed a structure with debris and septations; fine‑needle aspiration with negative cytology but elevated tumor marker suggested a mucinous cystic neoplasm or an intraductal papillary mucinous neoplasm. Laparoscopic excision confirmed a walled‑off cyst detachable from the posterior aspect of the pancreas consistent with a ciliated foregut cyst. There are limited data on ciliated foregut cysts of the pancreas, and the current report highlights the diagnostic dilemma and a review of the current literature.

scholarly journals Laparoscopic excision of a retroperitoneal mucinous cystic neoplasm: A case report

2019 ◽  
Vol 62 ◽  
pp. 27-30
Author(s):  
John Lung ◽  
Allison Gracey ◽  
Abigail Rosales ◽  
Eva Bashover ◽  
Alan Sbar ◽  
...  
Keyword(s):  
Case Report ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Laparoscopic Excision

Mucinous Cystic Neoplasms of the Pancreas: How Much Preoperative Evaluation is Needed?

2010 ◽  
Vol 76 (8) ◽  
pp. 812-817 ◽  
Author(s):  
Tom P. Theruvath ◽  
Katherine A. Morgan ◽  
David B. Adams
Keyword(s):  
Operative Treatment ◽  
Endoscopic Ultrasound ◽  
Preoperative Evaluation ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Cystic Lesions ◽  
Mri Imaging ◽  
Diagnostic Dilemma ◽  
Cystic Neoplasms ◽  
Preoperative Workup

Cystic lesions of the pancreas are identified with increasing frequency by modern imaging. The mucinous cystic neoplasm (MCN) is treated with resection for its malignant potential. How much preoperative evaluation is needed before undertaking operation is frequently a diagnostic dilemma. A retrospective review of 32 patients who underwent resection of a MCN between 1994 and 2007 was performed to define the preoperative evaluation and operative treatment of MCN patients. Thirty-two patients (30 women; mean age 49) had histology-proven MCN. Twenty-seven patients had symptomatic cysts (84%). Five had a history of gallstones and/or acute pancreatitis. All patients were worked up with CT and/or MRI. Endoscopic ultrasound was performed in 14 (44%) and endoscopic retrograde cholangiopancreatography in six (18%). Cytology was obtained in 13 (40%). Pathology revealed 22 benign MCNs (68%), five malignant MCNs (16%), and five MCNs with borderline pathology. Preoperative workup including CT or MRI imaging and cytology suggested MCN as the lesion in 15 patients (46%). CT features by itself predicted MCN in three patients (9%). Cytology revealed another six patients (19%) with possible MCN. In this series, preoperative workup did not identify three of five patients with MCN malignancy. A preoperative diagnosis cannot be made in most patients with MCN. Operative treatment can be based on clinical presentation and CT imaging because endoscopic ultrasound and fine needle aspiration for evaluation may be misleading. Middle-aged women with cystic lesions in the tail of the pancreas without prior gallstone or pancreatitis history most typically fit the profile of the MCN patient.

scholarly journals Cytologic Assessment of Cystic/Intraductal Lesions of the Pancreatobiliary Tract

2021 ◽  
Author(s):  
Michelle D. Reid
Keyword(s):  
Fine Needle Aspiration ◽  
Intraductal Papillary Mucinous Neoplasm ◽  
Imaging Techniques ◽  
Mucinous Cystic Neoplasm ◽  
Needle Aspiration ◽  
Cyst Fluid ◽  
Cystic Neoplasm ◽  
Pancreatic Cysts ◽  
Fine Needle ◽  
Mucinous Neoplasm

Context.— Because of new and improved imaging techniques, cystic/intraductal pancreatobiliary tract lesions are increasingly being discovered, and brushings or endoscopic ultrasound/computed tomography/magnetic resonance imaging–guided fine-needle aspiration biopsies from these lesions have become an integral part of pathologists' daily practice. Because patient management has become increasingly conservative, accurate preoperative diagnosis is critical. Cytologic distinction of low-risk (pseudocysts, serous cystadenoma, lymphoepithelial cysts, and squamoid cysts of the pancreatic duct) from high-risk pancreatic cysts (intraductal papillary mucinous neoplasm and mucinous cystic neoplasm) requires incorporation of clinical, radiologic, and cytologic findings, in conjunction with chemical and molecular analysis of cyst fluid. Cytopathologists must ensure appropriate specimen triage, along with cytologic interpretation, cyst classification, and even grading of some (mucinous) cysts. Epithelial atypia in mucinous cysts (intraductal papillary mucinous neoplasm and mucinous cystic neoplasm) has transitioned from a 3-tiered to a 2-tiered classification system, and intraductal oncocytic papillary neoplasms and intraductal tubulopapillary neoplasms have been separately reclassified because of their distinctive clinicopathologic characteristics. Because these lesions may be sampled on brushing or fine-needle aspiration biopsy, knowledge of their cytomorphology is critical. Objective.— To use an integrated, multidisciplinary approach for the evaluation of cystic/intraductal pancreatobiliary tract lesions (incorporating clinical, radiologic, and cytologic findings with [chemical/molecular] cyst fluid analysis and ancillary stains) for definitive diagnosis and classification. Data Sources.— Review of current literature on the cytopathology of cystic/intraductal pancreatobiliary tract lesions. Conclusions.— Our knowledge/understanding of recent updates in cystic/intraductal pancreatobiliary lesions can ensure that cytopathologists appropriately triage specimens, judiciously use and interpret ancillary studies, and incorporate the studies into reporting.

scholarly journals EUS Morphology Is Reliable in Selecting Patients with Mucinous Pancreatic Cyst(s) Most Likely to Benefit from Surgical Resection

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Siddharth Javia ◽  
Satish Munigala ◽  
Sushovan Guha ◽  
Banke Agarwal
Keyword(s):  
Surgical Resection ◽  
Pancreatic Cyst ◽  
Mucinous Cystic Neoplasm ◽  
Needle Aspiration ◽  
Surgical Pathology ◽  
Mesenteric Cyst ◽  
Cystic Neoplasm ◽  
Pancreatic Cysts ◽  
Wall Thickening ◽  
Cyst Size

Background and Study Aims. Endoscopic ultrasound (EUS) surveillance of patients with mucinous pancreatic cysts relies on the assessment of morphologic features suggestive of malignant transformation. These criteria were derived from the evaluation of surgical pathology in patients with pancreatic cysts who underwent surgery. Reliability of these criteria when evaluated by EUS in identifying lesions which require surgery has still not been established. Patients and Methods. This retrospective cohort study included seventy-eight patients who underwent surgical resection of pancreatic cysts based on EUS-FNA (fine-needle aspiration) findings suggestive of mucinous pancreatic cysts with concern for malignancy. Results. Final surgical pathology diagnoses of patients were the following: adenocarcinoma (19), intraductal papillary mucinous neoplasm (IPMN) (39), mucinous cystic neoplasm (MCN) (13), serous cystadenoma (2), pseudocyst (3), mucinous solid-cystic lesion of indeterminate type (1), and mesenteric cyst (1). Cysts with focal wall thickening ≥ 3 mm (p=0.0008), dilation of pancreatic duct (PD) (p=0.0067), and cyst size ≥ 3 cm (p=0.016) had significantly higher risk of adenocarcinoma. None of the patients without any of these morphologic features had cancer. Conclusions. In patients with mucinous pancreatic cyst(s), focal wall thickening, cyst size ≥ 3 cm, and PD dilation as assessed by EUS can help identify advanced mucinous cysts which require surgery and should routinely be evaluated during EUS surveillance.

scholarly journals Endoscopic ultrasound for differential diagnosis of malignant pancreatic cystic lesions: case report and review of literature

Oncoreview ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 103-107
Author(s):  
Jacek Janiszewski ◽  
Joanna Woźniak ◽  
Iwona Kot-Gromuł ◽  
Maciej Michalak ◽  
Zygmunt Kozielec ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Cystic Lesion ◽  
Histopathological Examination ◽  
Final Diagnosis ◽  
Mucinous Cystic Neoplasm ◽  
Needle Aspiration ◽  
Cystic Neoplasm ◽  
Review Of Literature ◽  
Potentially Malignant ◽  
Tomography Scan

A 63-year-old female patient was admitted to the hospital for an in-depth diagnosis of accidentally found pancreatic cystic lesion. The lesion was detected by computed tomography scan and magnetic resonance imaging of the abdomen and identified as potentially malignant mucinous cystic neoplasm (MCN). Endoscopic ultrasound-guided fine-needle aspiration biopsy with the analysis of the fluid from the cyst was performed as well and it confirmed the malignancy of the cystic lesion. The patient was qualified for surgery and the final diagnosis based on histopathological examination of the surgical material confirmed MCN with the accompanying invasive pancreatic adenocarcinoma.

scholarly journals A Mucinous Cystic Neoplasm of the Mesocolon Showing Features of Malignancy

2012 ◽  
Vol 2012 ◽  
pp. 1-2
Author(s):  
Kiki Mistry ◽  
Marta Penna ◽  
Shiva Dindyal ◽  
Hasan Mukhtar
Keyword(s):  
Incidental Finding ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Cystic Neoplasms ◽  
Complete Excision ◽  
Palpable Mass ◽  
Rare Tumours ◽  
Laparoscopic Excision ◽  
Mucinous Tumours ◽  
Mucinous Tumour

Mucinous cystic neoplasms are rare tumours of uncertain histogenesis. They arise from the ovaries, pancreas, and other intra-abdominal sites but more unusually from the mesocolon. They can present with abdominal pain, distension, or a palpable mass but are commonly an incidental finding. We describe the case of a 48-year-old woman who was found to have an incidental left pelvic cyst on computed tomography. Subsequent laparoscopic excision and histological analysis demonstrated the cyst to be a borderline malignant mucinous tumour arising from the mesocolon. Mucinous tumours should be considered in the differential diagnosis of all intra-abdominal cysts and treatment should be by surgical complete excision.

A case of pancreatic mucinous cystic neoplasm: long-term follow-up with ultrasonography

Choonpa Igaku ◽  
2011 ◽  
Vol 38 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Junko FUKUDA ◽  
Sachiko TANAKA ◽  
Miho NAKAO ◽  
Eri UEDA ◽  
Reiko SUZUKI ◽  
...  
Keyword(s):  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Long Term Follow Up
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