Pancreatic pseudocysts are the most common cystic lesions of the pancreas and may complicate
acute pancreatitis,
chronic pancreatitis, or pancreatic
trauma. While the majority of acute pseudocysts resolve spontaneously, few may require drainage. On the other hand, pancreatic cystic
tumors, which usually require extirpation, may disguise as pseudocysts. Hence, the distinction between the two entities is crucial for a successful outcome. We conducted this study to highlight the fundamental differences between
pancreatic pseudocysts and cystic
tumors so that relevant management plans can be devised. We reviewed the data of patients with pancreatic cystic lesions that underwent intervention between June 2007 and December 2010 in our hospital. We identified 9 patients (5 males and 4 females) with a median age of 40 years (range, 30-70 years). Five patients had pseudocysts, 2 had cystic
tumors, and 2 had diseases of undetermined pathology.
Pancreatic pseudocysts were treated by pseudocystogastrostomy in 2 cases and percutaneous drainage in 3 cases. One case recurred after percutaneous drainage and required pseudocystogastrostomy. The true
pancreatic cysts were
serous cystadenoma, which was treated by distal
pancreatectomy, and
mucinous cystadenocarcinoma, which was initially treated by drainage, like a pseudocyst, and then by distal
pancreatectomy when its true nature was revealed. We conclude that every effort should be exerted to distinguish between
pancreatic pseudocysts and cystic
tumors of the pancreas to avoid the serious misjudgement of draining rather than extirpating a pancreatic cystic
tumor. Additionally, percutaneous drainage of a
pancreatic pseudocyst is a useful adjunct that may substitute for surgical drainage.