Cystadenoma and cystadenocarcinoma of the pancreas: Surgical treatment and prognosis

During the period 1987 to 1994, 14 patients with cystic neoplasms of the pancreas were surgically treated. The resection rate for cystadenoma was 71% (5/7). Pathologically, two patients (29%) had serous, and five (71%) mucinous, cystadenoma. All patients are alive for 18 to 81 months after surgery. The resection rate of cystadenocarcinoma was 100% (7/7). Cystic neoplasm had been suspected from the results of abdominal ultrasonography and computed tomography in 71% (5/7) of the patients. In two patients (29%), the preoperative diagnosis of pseudocyst associated with chronic pancreatitis was made. Six patients (86%) died of recurrent or metastatic carcinoma in 6 to 28 months after surgery, and only one patient (14%) was alive without disease in 84 months. Mean tumor size was 7.3 cm in cystadenoma and 8.6 cm in cystadenocarcinoma. Both operative mortality rates were 0%. It remains difficult to differentiate preoperatively between benign and malignant cystic neoplasms of the pancreas. Because the tumor is often found at an advanced stage, the results of resection of cystadenocarcinoma are not satisfactory. In most patients, radical resection of a cystic lesion suspected to be neoplastic is favored.