Pancreatic Cyst Questions Flashcards
What age do serous cystadenomas usually present?
70s
What is the gender preference of serous cyst adenomas?
F (70%) >M
Histology/cytology of serous cyst adenomas
Cuboidal cells, glycogen rich
Distribution of serous cyst adenomas throughout the pancreas
Even
Is there malignant potential of SCAs?
No (<1%)
Genetic mutations that increase risk of SCAs
VHL mutation
Serous cyst adenomas account for what % of neoplastic cysts?
NA
Presentation of SCAs
Usually incidental, may present with mass effect
General fluid characteristics of SCAs
Thin/serous
Amylase level in SCAs
Low
CEA level in SCAs
Low (< 5 ng/mL)
Imaging characteristics of SCAs
Well circumscribed, Micro cysts (60%), Macro/Honey comb (20%), Mixed (15%) cystic. Fibrous central scarring with calcifications are pathognomonic (30%)
On imaging, is there a connection between the cyst and pancreatic duct for SCAs?
No communication
Characteristics in SCAs that are concerning for malignancy
Incidental, slow growing tumor (average growth 0.6 cm/year)
FU imaging for SCAs
< 2cm: yearly
2-5 cm: q6 months
ᄈ 4 cm: q3-6 month
Once stable for ᄈ 2 years, increase time interval
Surgical indications for SCAs
- Symptoms
2. ᄈ 4 cm
Surgical procedure for SCAs
Due to size, formal resection is often required
Prognosis for SCAs
Excellent - benign condition
Give the demographics of MCNs
Age: 50s
Gender: F (98%)»_space; M
Cytology/histology of MCNs
Columnar cells, papillary sheets, ovarian-like stroma, + Mucin
Distribution of MCNs in the pancreas
Body/Tail (95%)
Do MCNs have malignant potential?
Yes
What % of MCNs are malignant?
30%
Genetic mutations that increase risk for MCNs
K-ras, p53 mutations
% of neoplastic cysts that are MCNs
23.40%
MCN presentation
Usually incidental, may present with mass effect
General fluid characteristics of MCNs
Viscous/Mucin
Amylase and CEA level of MCNs
Low amylase, CEA >400
CT characteristics of MCNs
Well circumscribed, macrocystic, peripheral Ca++ highly specific. May have internal septations