Macrocystic pancreatic cystadenoma: the role of EUS and cyst fluid analysis in distinguishing mucinous and serous lesions

• Published in: Gastrointestinal endoscopy 2004-06, Vol.59 (7), p.823-829
• Main Authors: O'Toole, Dermot, Palazzo, Laurent, Hammel, Pascal, Yaghlene, Lamia Ben, Couvelard, Anne, Felce-Dachez, Michèle, Fabre, Monique, Dancour, Alain, Aubert, Alain, Sauvanet, Alain, Maire, Frédérique, Lévy, Philippe, Ruszniewski, Philippe
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antigens, Tumor-Associated, Carbohydrate - analysis; Biological and medical sciences; Biomarkers, Tumor - analysis; Biopsy, Fine-Needle; CA-19-9 Antigen - analysis; Carcinoembryonic Antigen - analysis; Cyst Fluid - chemistry; Cystadenoma, Mucinous - diagnosis; Cystadenoma, Mucinous - diagnostic imaging; Cystadenoma, Mucinous - pathology; Cystadenoma, Serous - diagnosis; Cystadenoma, Serous - diagnostic imaging; Cystadenoma, Serous - pathology; Diagnosis, Differential; Endosonography; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Male; Medical sciences; Middle Aged; Mucin-1 - analysis; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - pathology; Predictive Value of Tests; Sensitivity and Specificity
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/S0016-5107(04)00346-3

Benign pancreatic serous cystadenoma usually is morphologically distinguishable from mucinous cystadenomas, which require resection because of their malignant potential. A macrocystic variant of serous cystadenoma recently has been described, rendering this important distinction more difficult. The aim of this study was to determine the EUS and tumor marker characteristics of mucinous cystadenoma compared with macrocystic serous cystadenomas. Medical records for consecutive patients seen between 1995 and 2002, with a histopathologic diagnosis of mucinous cystadenoma or macrocystic serous cystadenoma after surgery, who had undergone a detailed EUS examination, including EUS-guided FNA, were retrospectively reviewed. A resection specimen was available for 32 mucinous cystadenomas and 9 macrocystic serous cystadenomas. No significant differences were observed with regard to clinical data (age, gender, presence of symptoms), lesion size, and location within the pancreas. All mucinous cystadenomas had a discernible cyst wall (thickened, 66%; focal parietal nodules, 25%) compared with 56% of macrocystic serous cystadenomas ( p