The widespread use of highly sensitive imaging techniques has led to the serendipitous identification of subclinical tumors in some organs [1]. Pancreatic incidentaloma (PI) has been defined as a mass that is incidentally discovered during an image study for symptoms other than the ones of the mass itself or the organ affected. The term “pancreatic incidentaloma” was first described by Ho and Kostiuk [2, 3].
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References
Prinz RA, Brooks MH, Churchill R, et al. Incidental asymptomatic adrenal masses detected by computed tomographic scanning. Is operation required? JAMA. 1982;248:701–4.
Kostiuk TS. Observation of pancreatic incidentaloma. Klin Khir. 2001;9:62–3.
Ho CL, Dehdashti F, Griffeth LK, et al. FDG-PET evaluation of indeterminate pancreatic masses. J Comput Assist Tomogr. 1996;20:363–9.
Strang AM, Lockhart ME, Kenney PJ, et al. Computerized tomographic angiography for renal donor evaluation leads to a higher exclusion rate. J Urol. 2007;177:1826–9.
Ide M, Suzuki Y. Is whole-body FDG-PET valuable for health screening? Eur J Nucl Med Mol Imaging. 2005;32:339–41.
Winter JM, Cameron JL, Lillemoe KD, et al. Periampullary and pancreatic incidentaloma: a single institution’s experience with an increasingly common diagnosis. Ann Surg. 2006;243:673–80.
Tsui KH, Shvarts O, Smith RB, et al. Renal cell carcinoma: prognostic significance of incidentally detected tumors. J Urol. 2000;163:426–30.
Little JM, Richardson A, Tait N. Hepatic dystychoma: a five year experience. HPB Surg. 1991;4:291–7.
Liu CL, Fan ST, Lo CM, et al. Hepatic resection for incidentaloma. J Gastrointest Surg 2004;8:785–93.
Westbrook JI, Braithwaite J, McIntosh JH. The outcomes for patients with incidental lesions: serendipitous or iatrogenic? Am J Roetnol. 1998;171:1193–6.
Herrera MF, Grant CS, van Heerden JA, et al. Incidentally discovered adrenal tumors: an institutional perspective. Surgery. 1991;110:1014–21.
Wolfson D, Barkin JS, Chari ST, et al. Management of pancreatic masses. Pancreas. 2005;31:203–17.
Steer ML, Waxman I, Freedman S. Chronic pancreatitis. N Engl J Med. 1995;332:1482–90.
Finkelberg DL, Sahani D, Deshpande V, Brugge WR. Autoimmune pancreatitis. N Engl J Med. 2006;355:2670–6.
Yadav D, Notahara K, Smyrk TC, et al. Idiopathic tumefactive chronic pancreatitis: clinical profile, histology, and natural history after resection. Clin Gastroenterol Hepatol. 2003;1:129–35.
Hammel P. Tumeurs pancréatiques de découverte fortuite: diagnostic et prise en charge. Gastroenterol Clin Biol. 2002;26:700–8.
Gangi S, Fletcher JG, Nathan MA, et al. Time interval between abnormalities seen on CT and the clinical diagnosis of pancreatic cancer: retrospective review of CT scans obtained before diagnosis. AJR Am J Roentgenol. 2004;182:897–903.
McMahon PM, Halpern EF, Fernandez-del Castillo C, et al. Pancreatic cancer: cost-effectiveness of imaging technologies for assessing resectability. Radiology. 2001;221:93–106.
Nichols MT, Russ PD, Chen YK. Pancreatic imaging: current and emerging technologies. Pancreas. 2006;33:211–20.
Saisho H, Yamaguchi T. Diagnostic imaging for pancreatic cancer: computed tomography, magnetic resonance imaging, and positron emission tomography. Pancreas. 2004;28:273–8.
Choi EK, Park SH, Kim DY, et al. Unusual manifestations of primary pancreatic neoplasia: radiologic-pathologic correlation. J Comput Assist Tomogr. 2006;30:610–7.
Delbeke D, Pinson CW. Pancreatic tumors: role of imaging in the diagnosis, staging, and treatment. J Hepatobiliary Pancreat Surg. 2004;11:4–10.
Kalra MK, Maher MM, Boland GW, et al. Correlation of positron emission tomography and CT in evaluating pancreatic tumors: technical and clinical implications. AJR Am J Roentgenol. 2003;181:387–93.
Lopez Hänninen E, Amthauer H, Hosten N, et al. Prospective evaluation of pancreatic tumors: accuracy of MR Imaging with MR cholangiopancreatography and MR Angiography. Radiology. 2002;224:34–41.
Tajima Y, Kuroki T, Tsutsumi R, et al. Pancreatic carcinoma coexisting with chronic pancreatitis versus tumor-forming pancreatitis: diagnostic utility of the time-signal intensity curve from dynamic contrast-enhanced MR imaging. World J Gastroenterol. 2007;13:858–65.
Horwhat JD, Gress FG. Defining the diagnostic algorithm in pancreatic cancer. JOP. 2004;5:289–303.
Bhutani MS, Gress FG, Giovannini M, et al. The no endosonographic detection of tumor (NEST) study: a case series of pancreatic cancers missed on endoscopic ultrasonography. Endoscopy. 2004;36:385–9.
DeWitt J, Devereaux B, Chriswell M, et al. Comparison of endoscopic ultrasonography and multidetector computed tomography for detecting and staging pancreatic cancer. Ann Intern Med. 2004;141:753–63.
Borbath I, Van Beers BE, Lonneux M, et al. Preoperative assessment of pancreatic tumors using magnetic resonance imaging, endoscopic ultrasonography, positron emission tomography and laparoscopy. Pancreatology. 2005;5:553–61.
Horwhat JD, Paulson EK, McGrath K, et al. A randomized comparison of EUS-guided FNA versus CT or US-guided FNA for the evaluation of pancreatic mass lesions. Gastrointest Endosc. 2006;63:966–75.
Voss M, Hammel P, Molas G, et al. Value of endoscopic ultrasound guided fine needle aspiration biopsy in the diagnosis of solid pancreatic masses. Gut. 2000;46:244–9.
Varadarajulu S, Tamhane A, Eloubeidi MA. Yield of EUS-guided FNA of pancreatic masses in the presence or the absence of chronic pancreatitis. Gastrointest Endosc. 2005;62:728–36.
Cwik G, Wallner G, Skoczylas T, et al. Cancer antigens 19-9 and 125 in the differential diagnosis of pancreatic mass lesions. Arch Surg. 2006;141:968–74.
Bloomston M, Frankel WL, Petrocca F, et al. MicroRNA expression patterns to differentiate pancreatic adenocarcinoma from normal pancreas and chronic pancreatitis. JAMA. 2007;297:1901–8.
Koopmann J, Zhang Z, White N, et al. Serum diagnosis of pancreatic adenocarcinoma using surface-enhanced laser desorption and ionization mass spectrometry. Clin Cancer Res. 2004;10:860–8.
Buchholz M, Kestler HA, Bauer A, et al. Specialized DNA arrays for the differentiation of pancreatic tumors. Clin Cancer Res. 2005;11:8048–54.
Honda K, Hayashida Y, Umaki T, et al. Possible detection of pancreatic cancer by plasma protein profiling. Cancer Res. 2005;65:10613–22.
Brentjens R, Saltz L. Islet cell tumor of the pancreas: the medical oncologist’s perspective. Surg Clin North Am. 2001;3,527–42.
Horton KM, Hruban RH, Yeo C, Fishman EK. Multi-detector row CT of pancreatic islet cell tumors. Radiographics. 2006;26:453–64.
Kaltsas GA, Besser GM, Grossman AB. The diagnosis and medical management of advanced neuroendocrine tumors. Endocr Rev. 2004;25:458–511.
Debray MP, Geoffroy O, Laissy JP, et al. Imaging appearances of metastases from neuroendocrine tumours of the pancreas. Br J Radiol. 2001;74:1065–70.
Thoeni RF, Mueller-Lisse UG, Chan R, et al. Detection of small, functional islet cell tumors in the pancreas: selection of MR imaging sequences for optimal sensitivity. Radiology. 2000;214:483–90.
Semelka RC, Custodio CM, Cem-Balci N, Woosley JT. Neuroendocrine tumors of the pancreas: spectrum of appearances on MRI. J Magn Reson Imaging. 2000;11:141–8.
Rösch T, Lightdale CJ, Botet JF, et al. Localization of pancreatic endocrine tumors by endoscopic ultrasonography. N Engl J Med. 1992;326:1721–6.
Anderson MA, Carpenter S, Thompson NW, et al. Endoscopic ultrasound is highly accurate and directs management in patients with neuroendocrine tumors of the pancreas. Am J Gastroenterol. 2000:95:2271–7.
Kaltsas GA, Mukherjee JJ, Grossman AB. The value of radiolabelled MIBG and octreotide in the diagnosis and management of neuroendocrine tumours. Ann Oncol. 2001;12(Suppl 2):S47–50.
Wiedenmann B, Jensen RT, Mignon M, et al. Preoperative diagnosis and surgical management of neuroendocrine gastroenteropancreatic tumors: general recommendations by a consensus workshop. World J Surg. 1998;22:309–18.
Orlefors H, Sundin A, Garske U, et al. Whole-body (11)C-5-hydroxytryptophan positron emission tomography as a universal imaging technique for neuroendocrine tumors: comparison with somatostatin receptor scintigraphy and computed tomography. J Clin Endocrinol Metab. 2005;90:3392–400.
Merkle EM, Boaz T, Kolokythas O, et al. Metastases to the pancreas. Br J Radiol. 1998;71:1208–14.
Scatarige JC, Horton KM, Sheth S, Fishman EK. Pancreatic parenchymal metastases: observations on helical CT. AJR Am J Roentgenol. 2001;176:695–9.
Palazzo L, Borotto E, Cellier C, et al. Endosonographic features of pancreatic metastases. Gastrointest Endosc. 1996;44:433–6.
Ghavamian R, Klein KA, Stephens DH, et al. Renal cell carcinoma metastatic to the pancreas: clinical and radiological features. Mayo Clin Proced. 2000;75:581–5.
Kim T, Murakami T, Takamura M, et al. Pancreatic mass due to chronic pancreatitis: correlation of CT and MR imaging features with pathologic findings. AJR Am J Roentgenol. 2001;177:367–71.
Kwon RS, Brugge WR. New advances in pancreatic imaging. Curr Opin Gastroenterol. 2005;21:561–7.
Imdahl A. Nitzsche E, Krautmann F, et al. Evaluation of positron emission tomography with 2-[(18) F] fluoro-2-deoxy-D-glucose for the differentiation of chronic pancreatitis and pancreatic cancer. Br J Surg. 1999;86:194–9.
Okazaki K, Kawa S, Kamisawa T, et al. Clinical diagnostic criteria of autoimmune pancreatitis: revised proposal. J Gastroenterol. 2006;41:626–31.
Fernández-del Castillo C, Targarona J, Thayer SP, et al. Incidental pancreatic cysts: clinicopathologic characteristics and comparison with symptomatic patients. Arch Surg. 2003;138:427–34.
Allen PJ, Jaques DP, D’Angelica M, et al. Cystic lesions of the pancreas: selection criteria for operative and nonoperative management in 209 patients. J Gastrointest Surg. 2003;7:970–7.
Allen PJ, D'Angelica M, Gonen M, et al. A selective approach to the resection of cystic lesions of the pancreas: results from 539 consecutive patients. Ann Surg. 2006;244:572–82.
Sheehan MK, Beck K, Pickleman J, Aranha GV. Spectrum of cystic neoplasms of the pancreas and their surgical management. Arch Surg. 2003;138:657–62.
Sahani DV, Kadavigere R, Saokar A, et al. Cystic pancreatic lesions: a simple imaging-based classification system for guiding management. Radiographics. 2005;25:1471–84.
Holzheimer RG, Mannick JA (eds). Surgical treatment: evidence-based and problem-oriented. Munich, Germany: Zuckschwerdt, 2001.
Cohen-Scali F, Vilgrain V, Brancatelli G, et al. Discrimination of unilocular macrocystic serous cystadenoma from pancreatic pseudocyst and mucinous cystadenoma with CT: initial observations. Radiology. 2003;228:727–33.
Sarr MG, Murr M, Smyrk TC, et al. Primary cystic neoplasms of the pancreas. Neoplastic disorders of emerging importance-current state-of-the-art and unanswered questions. J Gastrointest Surg. 2003;7:417–28.
Curry CA, Eng J, Horton KM, et al. CT of primary cystic pancreatic neoplasms: can CT be used for patient triage and treatment? AJR Am J Roentgenol. 2000;175:99–103.
Fernandez-del Castillo C, Warshaw AL. Current management of cystic neoplasms of the pancreas. Adv Surg. 2000;34:237–48.
Procacci C, Biasiutti C, Carbognin G, et al. Characterization of cystic tumors of the pancreas: CT accuracy. J Comput Assist Tomogr. 1999;23:906–12.
Procacci C, Graziani R, Bicego E, et al. Serous cystadenoma of the pancreas: report of 30 cases with emphasis on imaging findings. J Comput Assist Tomogr. 1997;21:373–82.
Warshaw AL, Compton CC, Lewandrowski K, et al. Cystic tumors of the pancreas. New clinical, radiologic, and pathologic observations in 67 patients. Ann Surg. 1990;212:432–43.
Sahani D, Prasad S, Saini S, Mueller P. Cystic pancreatic neoplasms evaluation by CT and magnetic resonance cholangiopancreatography. Gastrointest Endosc Clin N Am. 2002;12:657–72.
Mathieu D, Guigui B, Valette PJ, et al. Pancreatic cystic neoplasms. Radiol Clin North Am. 1989;27:163–76.
Horvath KD, Chabot JA. An aggressive resectional approach to cystic neoplasms of the pancreas. Am J Surg. 1999;178:269–74.
McNulty NJ, Francis IR, Platt JF, et al. Multi–detector row helical CT of the pancreas: effect of contrast-enhanced multiphasic imaging on enhancement of the pancreas, peripancreatic vasculature, and pancreatic adenocarcinoma. Radiology. 2001;220:97–102.
Siech M, Tripp K, Schmidt-Rohlfing B, et al. Intraductal papillary mucinous tumor of the pancreas. Am J Surg. 1999;177:117–20.
Taouli B, Vilgrain V, Vullierme MP, et al. Intraductal papillary mucinous tumors of the pancreas: helical CT with histopathologic correlation. Radiology. 2000;217:757–64.
Kloppel G, Kosmahl M. Cystic lesions and neoplasms of the pancreas: the features are becoming clearer. Pancreatology. 2001;1:648–55.
Mallery S, Quirk D, Lewandrowski K, et al. EUS-guided FNA with cyst fluid analysis in pancreatic cystic lesions (abstr). Gastrointest Endosc. 1998;47:AB149.
Brugge WR. Evaluation of pancreatic cystic lesions with EUS. Gastrointest Endosc. 2004;59:698–707.
Sedlack R, Affi A, Vazquez-Sequeiros E, et al. Utility of EUS in the evaluation of cystic pancreatic lesions. Gastrointest Endosc. 2002;56:543–7.
Brugge WR, Lauwers GY, Sahani D, et al. Cystic neoplasms of the pancreas. N Engl J Med. 2004;351(12):1218–26.
Sakorafas GH, Sarr MG. Cystic neoplasms of the pancreas: what a clinician should know. Cancer Treat Rev. 2005;31:507–35.
Tseng JF, Warshaw AL, Sahani DV, et al. Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment. Ann Surg. 2005;242:413–19.
Walsh RM, Vogt DP, Henderson JM, et al. Natural history of indeterminate pancreatic cysts. Surgery. 2005;138:665–71.
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Herrera, M.F., Pantoja, J.P., Salazar, M.S., Velázquez-Fernández, D. (2009). Pancreatic Incidentaloma. In: Hubbard, J., Inabnet, W., Lo, CY. (eds) Endocrine Surgery. Springer Specialist Surgery Series. Springer, London. https://doi.org/10.1007/978-1-84628-881-4_41
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