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Endoscopic ultrasonography with endoscopic retrograde cholangiopancreatography is useful for differential diagnosis of pancreatic mucinous cystadenocarcinoma



Endoscopic ultrasonography with endoscopic retrograde cholangiopancreatography is useful for differential diagnosis of pancreatic mucinous cystadenocarcinoma



Medical Journal of Kagoshima University 53(4): 59-65



Mucinous cystadenocarcinoma (MCAC) is a relatively rare disease and is often difficult to differentiate from mucinous cystadenoma (MCA) prior to an operation. Endoscopic ultrasonography (EUS) seems to provide an excellent inside pancreatic image to detect small cystic lesions. The aim of this study was to assess the utility of EUS and retrograde cholangiopancreatography (ERCP) for diagnosing pancreatic cysts. Sixty-four patients with pancreatic cystic disease were operated. The lesions included mucinous cystadenocarcinomas, 13; mucinous cystadenomas, 24; serous cystadenomas (SCA), 8; solid pseudopapillary tumors (SPT), 4; retention cysts (RC), 3; pseudo cysts (PC), 12. The diagnosis of cystic tumors by EUS was focused on the presence of nodules and/or septa. The results were as follows: 1) Either or both of them were found in all cases of mucinous cystic tumors. 2) Only septa in 88% of SCA were found. 3) Either nodules or septa in 33% of non-cystic tumors were found. 4) Neither nodules or septa in all SPT were found. The differential diagnosis by EUS, between SPT and non-cystic tumors with no nodules and septa was difficult. The deployment of ERCP, however, made it possible to differentiate them, taking the shape of the cystic wall into consideration. Differentiating by EUS and ERCP between MCAC and MCA was difficult, but in all cases of MCAC, nodules were present. Thus, cystic neoplasms with nodules should be cautiously managed, keeping the possibility of the need to operate in mind.

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Accession: 010585433

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