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Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment Tseng JF; Warshaw AL; Sahani DV; Lauwers GY; Rattner DW; Fernandez-del Castillo CAnn Surg 2005[Sep]; 242 (3): 413-9; discussion 419-21OBJECTIVE: To define the natural history and optimal management of serous cystadenoma of the pancreas. SUMMARY BACKGROUND DATA: Serous cystadenoma of the pancreas is the most common benign pancreatic neoplasm. Diagnostic criteria, potential for growth or malignancy, and outcomes are not well defined. As a result, management for patients with serous cystadenomas varies widely in current practice. METHODS: A total of 106 patients presenting with serous cystadenoma of the pancreas from 1976-2004 were identified. Hospital records were evaluated for patient and tumor characteristics, diagnostic workup, treatment, and outcome. Twenty-four patients with serial radiographic imaging were identified, and tumor growth curves calculated. RESULTS: Mean age at presentation was 61.5 years and 75% of patients were female. The most common symptoms were abdominal pain (25%), fullness/mass (10%), and jaundice (7%); 47% were asymptomatic. Mean tumor diameter was 4.9 +/- 3.1 cm, which did not vary by location. Tumors <4 cm were less likely to be symptomatic than were tumors > or =4 cm (22% vs. 72%, P < 0.001). The median growth rate in the patients who had serial radiography was 0.60 cm/y. For tumors <4 cm at presentation (n = 15), the rate was 0.12 cm/y, whereas for tumors > or =4 cm (n = 9), the rate was 1.98 cm/y (P = 0.0002). Overall, 86 patients underwent surgery, with one perioperative death. CONCLUSIONS: Large (>4 cm) serous cystadenomas are more likely to be symptomatic. Although the median growth rate for this neoplasm is only 0.6 cm/y, it is significantly greater in large tumors. Whereas expectant management is reasonable in small asymptomatic tumors, we recommend resection for large serous cystadenomas regardless of the presence or absence of symptoms.|Aged[MESH]|Aged, 80 and over[MESH]|Cystadenoma, Serous/*diagnosis/*physiopathology/therapy[MESH]|Disease Progression[MESH]|Female[MESH]|Health Planning Guidelines[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Pancreatic Neoplasms/*diagnosis/*physiopathology/therapy[MESH]|Tomography, X-Ray Computed[MESH] |
