The majority of cystic lesions of the pancreas are paseudocysts, which are collections of pancratic secretions surrounded by fibrous wall having no epithelial lining.
Pseudocysts are of inflammatory or traumatic origin, and occasionally will resolve spontaneously. Excision is not commonly feasible and most are treated by drainage, either internally into the gastrointestinal tract or externally.
About ten percent of pancreatic cysts are neoplastic, benign, r malignant. These cysts always have an epithelial lining and never resorb spontaneously. Neoplastic cysts must be excised. Drainage is inappropriate, inadequate, and injurious.
We report 3 patients with cystic neoplasm of pancreas in whom a misdiagnosis of pseudocyst initially led to improper treatment. We reviewed and analyzed 19 cases of cystic disease of pancreas treated at the Department of Surgery, Pohang St.
Mary's
Hospital during 12 years from January 1980 to December 1992.
1) Age and Sex distribution showed that 57.9% of the cases was occurred in 4th and 5th decade. The male to female ratio was 2.8:1.
2) Neoplastic cysts were found in 3 cases of which 2 cases were found on female and 1 case in male.
3) 84.2% of cases was pseudocysts and 15.8% was neoplastic cysts. The size of the disease was variable but most of the cases was 10 cm below in diameter (69%).
4) The lesions were evenly distributed among the head, body, and tail of the gland. Tumor involved the entire gland in one patients.
5) The main symtpom, present in 73.7% of patients, was mild abdominal pain. A palpablo mass was present in 47.7% of patietns and fatigue occurred in 42.1%.
6) Of common associated disease, peptic ulcer occurred in 36.8% of patients, and cholelithiasis occurred in 36.8%.
7) Internal drainage was performed in 13 patients of pseudocyst and 1 patient of neoplastic disease mistaken for pseudocyst.
8) It is very important that differential diagnosis between pseudocyst and neoplatic cyst should be done by combination of preoperative CT scan, clinical findings operative findings and biopys.
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