Solitary True Cyst of Pancreas: Report of a Case and Review of Literature
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REVIEW ARTICLE
Solitary True Cyst of Pancreas: Report of a Case and Review of Literature Mohammad Atif Khan & G. R. Verma
Published online: 6 April 2010 # Springer Science+Business Media, LLC 2010
Abstract Context Solitary true cysts of the pancreas in adults are extremely rare, and only few cases have been reported in the literature. The etiology and natural history of these lesions remain unknown, and treatment is not standardized. We describe an additional resected case. Case reports A 55-year-old female who presented to us with a history of heaviness and pain in right upper abdomen for 1 year. CT scan of abdomen showed a large unilocular cyst in the region of the head of the pancreas. The patient underwent pancreatico-duodenectomy with binding pancreaticojejunostomy. The histology of cyst revealed true unilocular pancreatic cyst lined by cuboidal epithelium. She is well after 3 years of follow-up. Conclusions A preoperative work-up alone does not always allow an accurate diagnosis, but it is useful in determining lesion characteristics and guiding therapeutic decisionmaking. When surgery is indicated, a limited resection is warranted in most cases. Keywords true cyst . pancreas . unilocular
M. A. Khan : G. R. Verma Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India M. A. Khan (*) Kabir Colony, Anoopshahr Road, Aligarh 202002 Uttar Pradesh, India e-mail: [email protected]
Introduction Solitary true cyst of pancreas is an extremely rare condition, especially in adults [1–7]. These cysts are unilocular and are lined by true epithelium. To date, only 13 cases of true cyst have been reported in English literature. We describe a case of true cyst of the head of pancreas treated surgically and review the literature. The incidental true pancreatic cysts are reported to be rapidly increasing with the routine use of cross-sectional imaging [8–10]. Endoscopic ultrasound guided fine needle aspiration cytology (EUS-FNA), with its low complication rate and improving accuracy, is now fast becoming an indispensable tool in the diagnosis of cystic lesions of the pancreas. Recently, positron emission tomography (PET) has been found to be accurate in detecting small pancreatic cancers [34], and its application has been extended into discriminating benign from malignant pancreatic cystic lesions [35]. Despite near-unanimous agreement among investigators that a significant proportion of small pancreatic cysts are potentially or frankly malignant, many [22, 25, 27] still recommend observation of these cysts with various imaging modalities such as computerized axial tomography (CAT), magnetic resonance imaging (MRI), or endoscopic ultrasound (EUS). The management of pancreatic cystic lesions remains controversial. Whereas an aggressive resectional approach is advocated by some [19], an increasing number of clinicians are now questioning the practicality of this policy with the dramatic increase in the number of pancreatic cysts detected incidentally on radiolog
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