Role of Endoscopic Ultrasonography in the Management of Benign Biliopancreatic Diseases

Abstract

Pancreatic cystic disease consists of about 2.5% in individuals without history of symptoms of pancreatic disease [1, 2]. Cystic pancreatic lesions encompass a varied group of pancreatic abnormalities, including inflammatory (pseudocysts), benign (serous cystadenomas), precancerous (mucinous cystic neoplasms [MCNs], intraductal papillary mucinous neoplasms [IPMNs], and solid and pseudopapillary epithelium neoplasm), and other entities (cystic degeneration of ductal origin pancreatic cancer or neuroendocrine carcinomas) [3–7]. The serous cystadenomas (SCAs) often reveal a microcystic or honeycomb appearance on imaging with the pathognomonic central scar or sunburst calcification occurring in up to 20% of these lesions (Fig. 1). SCAs consist of cuboidal epithelial cells that stain positive for glycogen and more importantly only very rarely carry malignant potential [8]. The mucinous cystic neoplasm (MCN) of the pancreas is a relatively uncommon tumor that comprises about a quarter of all resected cystic neoplasms of the pancreas in large surgical series [9]. This tumor (Fig. 2) is predominantly seen in women (>95%) and in the distal pancreas (>95%) and, unlike branch duct IPMNs, is always a single lesion [10–12].