MEDS12002 Lecture Notes - Lecture 1: Calcification, Cirrhosis, Aorta
Cystic Pancreatic Neoplasms
Two types of cystic neoplasm:
•
Microcystic Adenoma
(serous cystadenoma)
•
Macrocystic Adenoma
(mucinous cystadenoma/cystadenocarcinoma)
• Cystic neoplasms of the pancreas account for less than 10% to 15% of all pancreatic cysts and less
than 1% of all pancreatic malignancies.
Cystic Pancreatic Neoplasms
Microcystic Adenoma (serous cystadenoma):
• Rare, benign disease is found more often in older women.
• Tumour is well circumscribed and usually consists of a large mass with multiple tiny cysts.
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Macrocystic Adenoma
(Mucinous cystadenoma/cystadenocarcinoma):
• May be either malignant or benign
with a malignant potential.
• Occurs predominantly in women.
• Usually occurs in the body or tail.
• Well-defined cysts contain thick
mucinous fluid, internal septations, or
mural nodules.
Clinically nonspecific abdominal symptoms, weight
loss, abdominal mass, or jaundice are presenting
symptoms
Endocrine Pancreatic Neoplasms
Insulinomas
• Most are small, well-encapsulated, with good vascular supply.
• Often occur in patients with hyperinsulinism and
hypoglycemia.
Gastrinomas
• Most are malignant.
• Are frequently multiple and extrapancreatic.
• Are difficult to locate.
May be isolated or associated with the Multiple Endocrine
Neoplasia syndrome type 1 (MEN 1)
(MEN 1 is characterized by the triad of parathyroid, pituitary,
and pancreatic lesions. Lesions may be solitary, multiple, or diffuse.)
Pancreatic cystadenoma found in the body of the pancreas in this 53-year-
old woman.
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Parapancreatic Neoplasms
Other Retroperitoneal neoplasms or DDx:
• Lymphangiomas
• Lymphomas
• Paragangliomas
• Cystic teratomas
• Metastases
Lymphangiomas
• Most often thin-walled,
homogeneous, small cysts
• Also, have been seen with septa,
thick walls, calcification, and
internal debris
Cystic teratomas
• Found more frequently in children and young adults.
• Their appearance is a mixed sonographic pattern of cystic, solid, fat, and calcifications.
Metastatic Disease to the Pancreas
• Generally, metastasis to the pancreas is uncommon; reported in 10% of patients with cancer.
• Primary tumors that can metastasize to the pancreas include melanomas, breast, gastrointestinal,
and lung tumours.
Pancreatic Ultrasonic Appearance
• Retroperitoneal organ
Patient with lymphoma who has epigastric pain. Multiple
nodes
(calipers)
are seen in the peripancreatic area.
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Document Summary
Two types of cystic neoplasm: microcystic adenoma (serous cystadenoma, macrocystic adenoma (mucinous cystadenoma/cystadenocarcinoma, cystic neoplasms of the pancreas account for less than 10% to 15% of all pancreatic cysts and less than 1% of all pancreatic malignancies. Microcystic adenoma (serous cystadenoma): rare, benign disease is found more often in older women, tumour is well circumscribed and usually consists of a large mass with multiple tiny cysts. Macrocystic adenoma (mucinous cystadenoma/cystadenocarcinoma): may be either malignant or benign with a malignant potential, occurs predominantly in women, usually occurs in the body or tail, well-defined cysts contain thick mucinous fluid, internal septations, or mural nodules. Clinically nonspecific abdominal symptoms, weight loss, abdominal mass, or jaundice are presenting symptoms. Pancreatic cystadenoma found in the body of the pancreas in this 53-year- old woman. Insulinomas: most are small, well-encapsulated, with good vascular supply, often occur in patients with hyperinsulinism and hypoglycemia. Gastrinomas: most are malignant, are frequently multiple and extrapancreatic, are difficult to locate.
