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Pancreatic cystadenoma and cystadenocarcinoma: diagnostic value of preoperative morphological investigations.

OBJECTIVE
To find out whether preoperative morphological investigations differentiated between serous cystadenoma, mucinous cystadenoma, and cystadenocarcinoma of the pancreas.


DESIGN
Multicentre retrospective study of casenotes.


SETTING
24 Adult gastroenterology units (1 private, 8 non-university teaching hospitals, and 15 university teaching hospitals) in France.


SUBJECTS
71 Patients with 74 tumours diagnosed between January 1978 and January 1988.


MAIN OUTCOME MEASURES
Correlation between histological diagnosis and results of ultrasonography, computed tomography, angiography, and magnetic resonance imaging.


RESULTS
6 of 59 ultrasound scans (10%), 7 of 52 computed tomograms (13%), 0 of 18 angiograms, 1 of 12 pancreatograms (8%), and the single magnetic resonance scan correctly diagnosed the type of pancreatic tumour. Ultrasonography or computed tomography, or both, diagnosed cystadenoma (but not the type) in 26 cases (37%). "Pseudocyst" was diagnosed in 14 cases (20%).


CONCLUSIONS
In contrast to other studies, our results indicate that preoperative morphological investigations are of limited value in diagnosing cystadenomas of the pancreas. In particular, their ability to differentiate between different types of cystadenoma is poor.