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How to differentiate congenital pancreatic cysts and cystic pancreatic teratomas?

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Journal of Pediatric Endoscopic Surgery Aims and scope Submit manuscript

Abstract

Purpose

The differential diagnosis of congenital pancreatic cysts and mature cystic pancreatic teratomas is challenging due to the lack of reliable diagnostic tests or pathognomonic imaging findings. This study highlights the differences between these extremely rare entities with few published case reports.

Methods

Based on our recent experience with two cases, we conducted an extensive review of literature including all reported cases of congenital pancreatic cysts and cystic pancreatic teratomas in children.

Results

We report two cases of large cystic abdominal mass detected by prenatal ultrasonography. Both neonates were asymptomatic after birth and were operated on by laparoscopy at the age of 1 year and 3 months, respectively. Histopathology demonstrated a congenital pancreatic cyst in the first case and a mature cystic teratoma in the second case. The post-operative course was uneventful for both children. We describe the clinical and imaging data of the 33 congenital pancreatic cysts and 10 mature cystic teratomas of the pancreas previously reported in the literature, and discuss diagnosis criteria and treatment strategies.

Conclusion

Congenital pancreatic cysts and pancreatic teratomas are rare lesions in children. Clinical presentation is not specific and these lesions are often asymptomatic. Although associated malformations are evocative of congenital pancreatic cyst, the final diagnosis can only be confirmed by histopathological examination. Available treatments include ultrasound-guided puncture, enucleation, distal pancreatectomy, cystogastrostomy, and cysto-jejunostomy by the Roux-en-Y technique. Laparoscopic excision can be performed shortly after birth and is our preferred option.

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Authors and Affiliations

  1. Department of Pediatric Surgery, University Hospital of Saint-Etienne, Saint-Étienne, France

    Nasser Bustangi, François Varlet & Aurelien Scalabre

  2. Department of Pediatric Surgery, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia

    Nasser Bustangi

  3. Department of Gynecology and Obstetrics, University Hospital of Saint-Etienne, Saint-Étienne, France

    Tiphaine Raia-Barjat

  4. Department of Pathology, University Hospital of Saint-Etienne, Saint-Étienne, France

    Mousa Mobarki & Alix Clemenson

  5. Saint-Etienne University, EA SNA EPIS 4607, Saint-Étienne, France

    Aurelien Scalabre

Authors
  1. Nasser Bustangi
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  2. Tiphaine Raia-Barjat
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  3. Mousa Mobarki
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  4. Alix Clemenson
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  5. François Varlet
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  6. Aurelien Scalabre
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Correspondence to Aurelien Scalabre.

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Bustangi, N., Raia-Barjat, T., Mobarki, M. et al. How to differentiate congenital pancreatic cysts and cystic pancreatic teratomas?. J Ped Endosc Surg 1, 23–31 (2019). https://doi.org/10.1007/s42804-019-00007-y

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  • DOI: https://doi.org/10.1007/s42804-019-00007-y

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