Endoscopy 2021; 53(S 01): S224
DOI: 10.1055/s-0041-1724882
Abstracts | ESGE Days
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Long-Term Malignancy in Small Pancreatic Cystic Lesions Without Worrisome Features or High Stigmata

M Lindo Ricce
1   Hospital Virgen De La Salud, Gastroenterology, Toledo, Spain
,
A Guardiola-Arévalo
2   Hospital Universitario de Fuenlabrada, Gastroenterology, Madrid, Spain
,
Ortega A Repiso
1   Hospital Virgen De La Salud, Gastroenterology, Toledo, Spain
,
R Gómez-Rodriguez
1   Hospital Virgen De La Salud, Gastroenterology, Toledo, Spain
› Author Affiliations
 

Aims The malignancy risk of small pancreatic cystic lesions (PCLs) without worrisome features or high-risk stigmata remains unclear for that reason the aim of this study is to elucidate their natural history.

Methods We conducted a retrospective cohort study of 71 patients. We enroll all the patients with pancreatic cysts without worrisome features or high stigmata with size less than 15 mm who underwent endoscopic ultrasound (EUS) from 2005 through 2013. We analyzed this patients until November 2020. We included all patients with more than 12 months of follow up. We excluded patients with pancreatic pseudocysts. Follow up included endoscopic ultrasound, computed tomography or magnetic resonance imaging. Serial morphological changes and pancreatic cancer(PC) incidence, including malignant progression of PCLs, were evaluated.

Results A total of 71 patients (64,8 % women and median age 65,6 ± 11,7 years) were followed for a median of 7,3 years (Range 1,0 – 15,1 years). The cystic size was 8,9 ± 3,4 mm. Morphologically, 65 cases (91,5 %) were unilocular, 6 (8,5 %) multilocular and 24 (33,8 %) involved multifocal lesions. The initial EUS presumptive diagnosis of the cysts included: 30 (42,2 %) branch-duct intraductal papillary mucinous neoplasms, 30 (42,2 %) indeterminate cyst, 7 (9,8 %) serous cystic neoplasm and 4 (5,6 %) mucinous cystic neoplasm. In the follow up 20 (28 %) pancreatic cysts grew or developed new lesions. Three patients (4,22 %) (62, 52 and 67 years old) developed pancreatic ductal adenocarcinoma during follow up; from these, two were resectable and one unresectable. The median time to develop PC was 9,6 years (Range 8,9 -10,5 years).

Conclusions The incidence of malignant progression of PCLs less than 15 mm without worrisome features or elevated stigmata is not irrelevant and occurs late. For this reason, stopping follow-up early should not be considered in these patients.

Citation Lindo Ricce M, Guardiola-Arévalo A, Repiso Ortega A et al. eP391 LONG-TERM MALIGNANCY IN SMALL PANCREATIC CYSTIC LESIONS WITHOUT WORRISOME FEATURES OR HIGH STIGMATA. Endoscopy 2021; 53: S224.



Publication History

Article published online:
19 March 2021

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