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[Cystic tumors of the pancreas. Cystadenomas and cystadenocarcinomas. Diagnosis and management].

Thirteen cases of cystic tumours of the pancreas were studied: serous cystadenomas (CS) = 4, mucinous cystadenomas (MC) = 4 and cystadenocarcinomas (CC) = 5. There were 9 females and 4 males, mean age 60 years (range 44 to 89 years). Two patients had no clinical manifestations, six (2 MC and 4 CC) had a weight loss (3-10 kg). One patient with CC had jaundice. Tumours of the pancreas were diagnosed with sonographic or CT-scan examinations. Eight were localized in the head of the pancreas, two in the body and three in the tail. The cystic tumour remained unknown after preoperative explorations in three cases. The exact nature of the tumour was identified preoperatively in four cases (SC, MC and two CC). Final diagnosis was obtained after histological examination of the surgical specimen in nine cases, by surgical puncture in one case and due to the presence of liver metastases in one case and ultrasound guided needle biopsy in one other. One patient refused all surgery. Ten patients were operated: four had duodenopancreatectomy (SC and three CC), three had tumour exeresis (SC and two MC), two had caudal splenopancreatectomy (MC and CC) and one had surgical puncture (SC). Clinical surveillance is justified in cases with asymptomatic. SC if certain diagnosis has been obtained. Other cystic tumours of the pancreas should be removed, either because there is doubt as to the exact nature of the tumour; because of symptoms induced by SC or because a MC or CC has been identified. In this latter case, the prognosis appears to be better than for non-metastasis exocrine cancer of the pancreas.