Summary
Background
Cystic pancreatic tumors are increasingly found in medical practice. The aim of this study was to examine the prevalence of misdiagnosis of these lesions and the factors associated with preoperative misdiagnosis.
Methods
A retrospective analysis included 66 patients treated in the Clinic for Digestive Surgery, Clinical Center of Serbia, from 1983 to 2013. We included all patients with biopsy-confirmed cystic pancreatic tumors during the study period. We analyzed preoperative parameters, intraoperative and postoperative data of examined patients. Based on the preoperative diagnosis and the biopsy findings, patients were divided into two groups: correct preoperative diagnosis and misdiagnosis.
Results
Prevalence of misdiagnosis was 34.85%. Average age was 45.3 ± 16.9 years, 54 (81.8%) were females. Patients with misdiagnosis had significantly higher odds of being older (Odds ratio [OR]: 1.06, 95% Confidence interval [CI]: 1.01–17.86), to present with symptoms of nausea or vomiting (OR: 5.85, 95% CI: 1.49–23.00), to have a clinically palpable tumor (OR: 4.64, 95% CI: 1.21–17.86), and to have received the diagnosis in the period between 1992 and 2003.
Conclusion
During the 30-year study period, more than one third of the patients in our study had a misdiagnosis preoperatively. The likelihood of misdiagnosis was higher among older patients, patients with symptoms of nausea or vomiting, patients with a clinically palpable tumor, and patients treated during the period between 1992 and 2003. The decline in the prevalence of misdiagnoses should be expected, due to advances in imaging methods and their availability, which are increasing significantly.
Similar content being viewed by others
References
Chandwani R, Allen PJ. Cystic neoplasms of the pancreas. 2015. pp. 1–13.
Al-Haddad M, Schmidt MC, Sandrasegaran K, Dewitt J. Diagnosis and treatment of cystic pancreatic tumors. Clin Gastroenterol Hepatol. 2011;9(8):635–48.
Di Cataldo A, et al. Cystic pancreatic tumors: should we resect all of them. Eur Rev Med Pharmacol Sci. 2014;18(2):16–23.
Salvia R, et al. Pancreatic resections for cystic neoplasms: From the surgeon’s presumption to the pathologist’s reality. Surgery. 2012;152(3 Suppl):S135–S42.
Del Chiaro M, Segersvad R, Pozzi Mucelli R, Rangelova E, Lohr M, Verbeke C. Comparison of preoperative conference-based diagnosis with histology of cystic tumors of the pancreas. Ann Surg Oncol. 2014;21:1539–44.
Palmucci S, et al. Cystic pancreatic neoplasms: diagnosis and management emphasizing their imaging features. Eur Rev Med Pharmacol Sci. 2014;18(8):1259–68.
Del M, Verbeke C, Salvia R, Klöppel G, Werner J. European experts consensus statement on cystic tumours of the pancreas. Dig Liver Dis. 2013;45:703–11.
Birnbaum DJ, et al. Surgery for pancreatic neoplasms: How accurate are our surgical indications ? Surgery. 2017;162(1):112–9.
Di Cataldo A, et al. Cystic pancreatic tumors: Should we resect all of them? Eur Rev Med Pharmacol Sci. 2014;18(Suppl 2):16–23.
Salvia R, et al. Branch-duct intraductal papillary mucinous neoplasms of the pancreas: to operate or not to operate? Gut. 2007;56(8):1086–90.
Warshaw AL, Compton CC, Lewandrowski K, Cardenosa G, Mueller PR. Cystic tumors of the pancreas. New clinical, radiologic, and pathologic observations in 67 patients. Ann Surg. 1990;212(4):432.
Compagno J, Oertel JE. Mucinous cystic neoplasms of the pancreas with overt and latent malignancy (cystadenocarcinoma and cystadenoma): a clinicopathologic study of 41 cases. Am J Clin Pathol. 1978;69(6):573–80.
Gomez D, Rahman SH, Wong LF, Verbeke CS, Menon KV. Predictors of malignant potential of cystic lesions of the pancreas. Eur J Surg Oncol. 2008;34(8):876–82.
Ooi L, Ho GH, Chew SP, Low CH, Soo KC. Cystic tumours of the pancreas: a diagnostic dilemma. Aust N Z J Surg. 1998;68(12):844–6.
Goh BK‑P, Tan Y‑M, Chung Y‑FA. Utility of fusion CT-PET in the diagnosis of small pancreatic carcinoma. World J Gastroenterol. 2005;11(24):3800.
Funding
This work is supported by the Ministry of Education, Science, and Technological Development of the Republic of Serbia, grant no. 41004, contract no. 175042 (2011–2014), and grant no. 175046.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
G. Aleksandric, S. Matic, J. Todorovic, Z. Terzic-Supic, and V. Aleksic declare that they have no competing interests.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Aleksandric, G., Matic, S., Todorovic, J. et al. Misdiagnosis of cystic pancreatic tumors during a 30-year study period. Eur Surg 52, 127–131 (2020). https://doi.org/10.1007/s10353-020-00628-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10353-020-00628-1