Evaluation of Clinicopathological findings in Resected Serous Cystic Neoplasm

Abstract

Introduction: Serous Cystic Neoplasm (SCN) are relatively rare pancreatic tumors. Close observation is usually recommended. However, surgical resection should be considered with suspicious malignant tumor, and/or with symptom. Method: From October 1994 to October 2018, 12 patients underwent the surgical resection in our institute. We evaluated clinicopathological findings and surgical indications, retrospectively. Result: 1) Patients and tumor characteristics: The mean age was 58.5 years old(34-83y.o), 3 were male, and 9 cases were female. The tumor locations were head of pancreas in 2, body and tail in each 5 cases. The median tumor size was 3.9 cm(1.0-8.0cm) in a diameter. 2) Symptom: Nine cases were asymptomatic, and 3 cases were symptomatic. Asymptomatic cases were all found incidentally. In symptomatic cases, 2 patients had liver dysfunction and one had acid reflex caused by the tumor compression toward the common bile duct, and the stomach. 3) Surgical indications: Surgical indication was the suspicious malignant in 9 cases and 3 cases with symptom, located in head in 2 cases, and in tail in 1 case. In one case, he was diagnosed 16 years ago, tumor gradually increased, finally come down with the liver dysfunction. 4) Surgical procedure: Distal pancreatectomy was performed in 9 cases, and conventional pancreaticoduodenectomy, duodenum preserving pancreatic head resection, segmental pancreatectomy in each 1 case. 5) Histopathological findings: Patients were pathologically diagnosed as macrocystic type in 7, microcystic type in 4 cases, and solid type in 1 case. There was no mixed type in macroscopic. In all cases, final diagnosis was serous cystadenoma and no findings on malignancy. 6) Prognosis: All cases survive with no recurrence (postoperative 2 month-24 years). Conclusion: Surgical indications regarding tumor size and growth rate were still unclear and not established. However, the aggressive surgical resection should be considered in symptomatic patients and rapid tumor growth.