Management of Cystic Neoplasms of the Pancreas

2018 ◽  
Author(s):  
Victoria R Rendell ◽  
Walker A Julliard ◽  
Adam M Awe ◽  
Daniel E Abbott ◽  
Emily R Winslow ◽  
...  
Keyword(s):  
Pancreatic Cyst ◽  
Cystic Neoplasm ◽  
Pancreatic Cysts ◽  
Multidisciplinary Teams ◽  
Pancreatic Cystic Neoplasm ◽  
Cross Sectional ◽  
Management Guidelines ◽  
Imaging Characteristics ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

The diagnosis of pancreatic cystic lesions is increasingly common. The majority of pancreatic cysts are now diagnosed incidentally on cross-sectional imaging. Lack of clear evidence-based guidelines and overall poor understanding of the natural history of pancreatic cysts contribute to complexity of managing patients with pancreatic cysts. Pancreatic cystic neoplasm types differ in their presentation, histologic features, imaging characteristics, and predisposition to develop invasive malignancy. The diagnostic strategies to determine cyst type and presence of malignancy—cross-sectional imaging, endoscopic ultrasonography, and analyses of pancreatic cyst fluid aspirates—have improved over time. However, accurate characterization of cysts remains challenging. Several large groups, including the American College of Radiology, the American Gastroenterological Association, the European Study Group on Cystic Tumours of the Pancreas, and the International Association of Pancreatology, have released cyst management guidelines or recommendations that have important differences. In this review, we provide an overview of the most common pancreatic cystic neoplasm, evaluate recent advancements in diagnostic techniques, and compare current management guidelines. This review contains 7 figures, 5 tables, and 77 references. Key Words: intraductal papillary mucinous neoplasm, management guidelines, multidisciplinary teams, mucinous cystic neoplasm, pancreatic cyst, pancreatic cystic neoplasm, serous cystadenoma, solid pseudopapillary neoplasm, surgical oncology 

Incidental Pancreatic Cysts on Cross-Sectional Imaging

2021 ◽  
Vol 59 (4) ◽  
pp. 617-629
Author(s):  
Shannon M. Navarro ◽  
Michael T. Corwin ◽  
Douglas S. Katz ◽  
Ramit Lamba
Keyword(s):  
Pancreatic Cysts ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
Incidental Pancreatic Cysts

Optimal Use of Imaging to Guide Treatment Decisions for Kidney Cancer

2012 ◽  
pp. 284-287
Author(s):  
Walter M. Stadler
Keyword(s):  
Renal Cancer ◽  
Clinical Judgment ◽  
Treatment Decision ◽  
Special Problem ◽  
Continuous Variable ◽  
Metastatic Renal Cancer ◽  
Cross Sectional ◽  
Imaging Characteristics ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Overview: Treatment monitoring for solid tumors in general and for metastatic renal cancer in particular has been dominated by assessment of tumor burden via cross-sectional imaging. This poses a special problem for the mammalian target of rapamycin and vascular endothelial growth factor pathway-directed agents used in this disease. The standard RECIST metrics used to categorize “response” and “progression” are arbitrary and do not adequately capture the effect of these agents. Other approaches, including use of relative RECIST measures as a continuous variable, volumetric measurements, and functional assessments, such as dynamic contrast-enhanced magnetic resonance imaging-based quantitative variables and fluorodeoxyglucose-positron emission tomography, have been proposed as alternatives, but the data do not support their routine clinical use. Even fewer data are available on the use of baseline imaging characteristics to choose a specific therapy. Therefore, until further research on imaging predictive and intermediate biomarkers matures, a combination of standard cross-sectional imaging and clinical judgment is the most pragmatic option for treatment decision making for patients with metastatic renal cancer.

The Abdominal Wall Lumps and Bumps: Cross-Sectional Imaging Spectrum

2014 ◽  
Vol 65 (1) ◽  
pp. 9-18 ◽  
Author(s):  
Vivek Virmani ◽  
Vineeta Sethi ◽  
Najla Fasih ◽  
John Ryan ◽  
Ania Kielar
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Abdominal Wall ◽  
Effective Management ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Imaging Characteristics ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
Magnetic Resonance Imaging Mri

This article focuses on the cross-sectional imaging spectrum of abnormalities that affect the abdominal wall, with emphasis on magnetic resonance imaging (MRI). Cross-sectional imaging is valuable for diagnosing and evaluating the extent of abdominal-wall masses. With the increasing use of MRI, it is often possible to reach a diagnosis or narrow the differential diagnosis, thereby guiding effective management. Neoplastic and non-neoplastic pathologies will be illustrated, and the distinctive imaging characteristics of these entities will be highlighted.

scholarly journals Cross-Sectional Imaging Characteristics of Pituitary Adenomas, Invasive Adenomas and Adenocarcinomas in Dogs: 33 Cases (1988–2006)

2010 ◽  
Vol 24 (1) ◽  
pp. 160-165 ◽  
Author(s):  
Rachel E. Pollard ◽  
Christopher M. Reilly ◽  
Megan R. Uerling ◽  
Farica D. Wood ◽  
Edward C. Feldman
Keyword(s):  
Pituitary Adenomas ◽  
Cross Sectional ◽  
Imaging Characteristics ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

scholarly journals Pancreatic Cysts: Diagnostic Role of EUS-Guided Microforceps Biopsy and Confocal Laser Endomicroscopy

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Darina Kohoutova ◽  
Sameer Zar ◽  
Rudolf Repak ◽  
Panagiotis Vlavianos ◽  
Jan Bures
Keyword(s):  
Clinical Decision Making ◽  
Diagnostic Yield ◽  
Cyst Fluid ◽  
Confocal Laser Endomicroscopy ◽  
Diagnostic Tools ◽  
Confocal Laser ◽  
Pancreatic Cysts ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Frequent use of high-quality cross-sectional imaging has led to a significant rise in diagnosis of pancreatic cystic lesions (PCLs). Despite the fact that enormous effort has been put into the research of PCLs within the last two decades and multiple guidelines have been developed, our clinical decision-making especially in regard to mucinous lesions remains limited. Currently, clinical assessment, cross-sectional imaging and EUS with fluid analysis (if appropriate) belong to the standard care in patients with PCLs. For differentiation of mucinous from nonmucinous cysts, the sensitivity of cytological investigation and CEA in the cyst fluid is 42% and 52-79%, respectively. Due to the limited accuracy, further diagnostic tools are warranted. Two EUS-guided approaches have been introduced recently. Through-the-(19-gauge EUS) needle Moray microforceps have been developed, and several studies have acknowledged their contribution to the correct diagnosis as they help to overcome limited cellularity of the EUS-guided cyst fluid aspiration and traditional cytology. Confocal laser endomicroscopy offers real-time images and seems to be a promising method for the diagnosis and differential diagnosis of pancreatic PCLs. Example images of the needle-based confocal laser endomicroscopy criteria for the diagnosis of PCLs have been suggested recently. Before both, Moray microforceps and confocal laser endomicroscopy can be widely accepted, further studies are necessary to determine the real diagnostic yield and the clinical efficacy.

scholarly journals Intrapancreatic Accessory Spleen Masquerading as a Pancreatic Mucinous Neoplasm

2020 ◽  
Vol 06 (02) ◽  
pp. e128-e130
Author(s):  
Shiva Poola ◽  
Shachar Laks ◽  
Peter Kragel ◽  
Kara Regan
Keyword(s):  
High Risk ◽  
Pancreatic Cyst ◽  
Imaging Techniques ◽  
Accessory Spleen ◽  
Needle Aspiration ◽  
Pancreatic Cysts ◽  
Cross Sectional ◽  
Intrapancreatic Accessory Spleen ◽  
Cross Sectional Imaging ◽  
Magnetic Resonance Imaging Mri

AbstractIncidentally discovered pancreatic cysts have become more common with increasing use of abdominal cross-sectional imaging. Tools that help us to better risk stratify a pancreatic cyst include advanced imaging techniques, such as pancreatic protocol computed tomography (CT) scan or magnetic resonance imaging (MRI) with cholangiopancreatography. Endoscopic ultrasound (EUS) and fine-needle aspiration (FNA) are invasive measures to better define and sample cysts especially if high-risk features are present. EUS may also yield pancreatic cyst fluid for analysis of carcinoembryonic antigen (CEA) which is elevated in mucinous cysts. This case highlights a rare finding of a mucinous, epidermoid cyst in an intrapancreatic accessory spleen (IPAS) with high-risk features on EUS.

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