Authors: Brian K P Goh YuMeng Tan YawFui A Chung Pierce K H Chow PengChung Cheow WaiKeong Wong London L P J Ooi
Publish Date: 2006/11/07
Volume: 30, Issue: 12, Pages: 2236-2245
Abstract
Despite formal definitions of mucinous cystic neoplasms MCNs and intraductal papillary neoplasms IPMNs by the World Health Organization WHO and Armed Forces Institute of Pathology AFIP several controversies with regard to MCNs remain The aim of this review was to determine the clinicopathological features of MCNs defined by ovariantype stroma OS as proposed by the WHO and AFIP and to compare them with MCNs defined by less stringent criteriaA MEDLINE search was conducted to identify Englishlanguage articles on pancreatic MCNs from 1996 to 2005 Twentyfive studies were identified The studies were divided into 2 groups group A included 10 studies with 344 patients whereby the presence of OS was a criteria for the diagnosis of MCNs and group B included 15 studies comprising 761 patients whereby the presence of OS was not mandatory for the diagnosis of MCNsPatients in group A MCNs as defined by OS were almost always female 997 with a mean age of 47 range 18–95 years MCNs were located predominantly in the body or tail of the pancreas 946 and had a mean size of 87 cm range 06–35 cm 76 were symptomatic 68 demonstrated ductal communication and 27 were malignant At a mean followup of 575 range 1–264 months and 43 range 2–257 months after surgery 979 of benign and 619 of malignant neoplasms were disease free respectively Patients in group B were older and had a higher proportion of males Neoplasms were more evenly distributed in the pancreas were smaller communicated more frequently with the pancreatic duct and were composed of a higher proportion of malignant tumors compared with group A Their clinicopathological features were intermediate between those of group A and patients with IPMNPancreatic MCNs with OS have unique and distinct clinicopathological features MCNs should be defined by the presence of OS as it is the most reliable way of distinguishing MCNs from IPMN Adoption of “looser” criteria will result in misclassification of some IPMNs as MCNs
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