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Zystische Tumoren des Pankreas

Cystic tumors of the pancreas

Zusammenfassung

Zystische Pankreastumoren umfassen ein breites Spektrum gutartiger, prämaligner und maligner Veränderungen, die primär zystisch sind oder durch eine zystische Degeneration solider Tumoren entstehen. Wegen des breiten Einsatzes von Schnittbildtechniken werden sie zunehmend bei asymptomatischen Patienten und bei Patienten mit Bauchschmerzen, Pankreatitis und Ikterus entdeckt. Unter diesen Tumoren stellen die intraduktalen papillären muzinösen Neoplasien, die serösen zystischen Neoplasien und die muzinös zystischen Neoplasien den Hauptanteil. Mit zunehmender Erfahrung mit diesen Tumoren hat sich ein tieferes Verständnis für die Morphologie und den natürlichen Verlauf entwickelt. Es wird zunehmend gefordert, diese Tumoren zu differenzieren und ihre Dignität einzuschätzen, sodass eine genaue Kenntnis der morphologischen Zeichen in der CT und MRT wichtig ist. Da die Morphologie sehr vielgestaltig ist und sich die Phänomene überlappen können, sind zusätzliche Kriterien wie klinisches Bild, Lokalisation, Alter und Geschlecht mit in Betracht zu ziehen. Bei adäquater Therapie können die meisten Tumoren durch eine chirurgische Entfernung beseitigt werden. Das Management zystischer Tumoren ist bei asymptomatischen Patienten noch nicht standardisiert.

Abstract

Cystic lesions of the pancreas encompass a broad spectrum of benign, premalignant, and malignant tumors which are primarily cystic or result from cystic necroses of solid neoplasms. Because of the wide use of cross-sectional imaging techniques they are increasingly being identified in asymptomatic patients as well as in patients presenting with abdominal pain, jaundice or pancreatitis. Among these lesions, intraductal papillary mucinous neoplasms, serous cystic neoplasms and mucinous cystic neoplasms represent the majority of cases. With increasing experience with these tumors, a refinement of our understanding of their morphology and of their natural course has emerged. It is important to be familiar with the CT and MR imaging features of these lesions to differentiate these tumors and to orient the diagnosis towards benign or malignant forms. Because characterization of cystic tumors of the pancreas can sometimes be difficult due to overlapping imaging features, additional criteria such as clinical symptoms, localization, age and gender have to be taken into account. If appropriately treated, these tumors can usually be cured by resection and the decreasing risk of pancreatic surgery has led to an increasing number of resections of pancreatic tumors. The management of cystic tumors of the pancreas has not yet been standardized and the correct evaluation and subsequent management of the disease in asymptomatic patients have not been fully defined.

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Brambs, HJ., Juchems, M. Zystische Tumoren des Pankreas. Radiologe 48, 740 (2008). https://doi.org/10.1007/s00117-008-1671-4

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Schlüsselwörter

  • Zystische Pankreastumoren
  • Computertomographie (CT)
  • Magnetresonanztomographie (MRT)
  • Differenzierung der unterschiedlichen Typen
  • Unterscheidung gutartiger und maligner Formen
  • Therapie und Management

Keywords

  • Cystic pancreatic tumors
  • Computed tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Differentiation of various types
  • Differentiation of benign and malignant forms
  • Therapy and management