PMID- 32418758
OWN - NLM
STAT- MEDLINE
DCOM- 20210709
LR  - 20210709
IS  - 1424-3911 (Electronic)
IS  - 1424-3903 (Linking)
VI  - 20
IP  - 5
DP  - 2020 Jul
TI  - Multifocal/diffuse pancreatic serous cystic neoplasms: Systematic review with a 
      new case.
PG  - 902-909
LID - S1424-3903(20)30144-7 [pii]
LID - 10.1016/j.pan.2020.04.015 [doi]
AB  - BACKGROUND/OBJECTIVES: Pancreatic cystic neoplasms (PCNs) are common, among which 
      13%-23% are serous cystic neoplasms (SCNs). However, diffuse and multifocal 
      variants of SCNs are extremely rare. The differential diagnosis of SCNs from 
      other PCNs is important as the former entities are benign and do not become 
      invasive. OBJECTIVE: This study analyzes the clinical characteristics of 
      multifocal/diffuse SCN through a systematic review of the literature and a case 
      report. METHODS: A comprehensive literature search was executed in the Ovid 
      MEDLINE, Embase, and Google Scholar databases. The search strategy was designed 
      to capture the concept of multifocal/diffuse SCN cases with sufficient clinical 
      information for detailed analysis. Using the final included articles, we analyzed 
      tumor characteristics, diagnostic modalities used, initial management and 
      indications, and patient outcomes. RESULTS: A review of 262 articles yielded 19 
      publications with 22 cases that had detailed clinical information. We presented 
      an additional case from our institution database. The systematic review of 23 
      cases revealed that the diffuse variant is more common than the multifocal 
      variant (15 vs 8 cases, respectively). Patients were managed with surgical 
      intervention, conservative treatment, or conservative treatment followed by 
      surgical intervention. Indications for surgery following conservative management 
      mainly included new onset or worsening of symptoms. Only one case reported 
      significant tumor growth after attempting an observational approach. No articles 
      reported recurrence of SCN after pancreatectomy, and no articles reported 
      mortality related to multifocal/diffuse SCNs. CONCLUSION: Despite their 
      expansive-growing and space-occupying characteristics, multifocal/diffuse SCNs 
      should be treated similarly to their more common unifocal counterpart.
CI  - Copyright (c) 2020 IAP and EPC. Published by Elsevier B.V. All rights reserved.
FAU - Wu, Y H Andrew
AU  - Wu YHA
AD  - Division of Surgical Oncology, Department of Surgery, University of Colorado, 
      Anschutz Medical Campus, Aurora, CO, USA.
FAU - Samuels, Jason M
AU  - Samuels JM
AD  - Division of Surgical Oncology, Department of Surgery, University of Colorado, 
      Anschutz Medical Campus, Aurora, CO, USA.
FAU - Harnke, Ben
AU  - Harnke B
AD  - Strauss Health Sciences Library, University of Colorado, Anschutz Medical Campus, 
      Aurora, CO, USA.
FAU - Negrini, Daniel
AU  - Negrini D
AD  - Division of Surgical Oncology, Department of Surgery, University of Colorado, 
      Anschutz Medical Campus, Aurora, CO, USA; Department of Anesthesiology, Federal 
      University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
FAU - Al-Musawi, Mohammed H
AU  - Al-Musawi MH
AD  - Clinical Trials Office, Department of Surgery, University of Colorado, Anschutz 
      Medical Campus, Aurora, CO, USA.
FAU - Meguid, Cheryl
AU  - Meguid C
AD  - Division of Surgical Oncology, Department of Surgery, University of Colorado, 
      Anschutz Medical Campus, Aurora, CO, USA.
FAU - Ahrendt, Steven
AU  - Ahrendt S
AD  - Division of Surgical Oncology, Department of Surgery, University of Colorado, 
      Anschutz Medical Campus, Aurora, CO, USA; University of Colorado Cancer Center, 
      Aurora, CO, USA.
FAU - Schulick, Richard D
AU  - Schulick RD
AD  - Division of Surgical Oncology, Department of Surgery, University of Colorado, 
      Anschutz Medical Campus, Aurora, CO, USA; University of Colorado Cancer Center, 
      Aurora, CO, USA.
FAU - Del Chiaro, Marco
AU  - Del Chiaro M
AD  - Division of Surgical Oncology, Department of Surgery, University of Colorado, 
      Anschutz Medical Campus, Aurora, CO, USA; University of Colorado Cancer Center, 
      Aurora, CO, USA. Electronic address: marco.delchiaro@cuanschutz.edu.
FAU - Oba, Atsushi
AU  - Oba A
AD  - Division of Surgical Oncology, Department of Surgery, University of Colorado, 
      Anschutz Medical Campus, Aurora, CO, USA; Department of Hepatobiliary and 
      Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer 
      Research, Tokyo, Japan.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20200505
PL  - Switzerland
TA  - Pancreatology
JT  - Pancreatology : official journal of the International Association of 
      Pancreatology (IAP) ... [et al.]
JID - 100966936
SB  - IM
MH  - Adenoma/*epidemiology/pathology/therapy
MH  - Cystadenocarcinoma, Serous/*epidemiology/pathology/therapy
MH  - Cystadenoma, Serous/*epidemiology/pathology/therapy
MH  - Humans
MH  - Pancreatic Neoplasms/*epidemiology/pathology/therapy
OTO - NOTNLM
OT  - Diffuse
OT  - Microcystic adenoma
OT  - Multifocal
OT  - Pancreas
OT  - Serous cystadenoma
OT  - Serous cystic neoplasm
COIS- Declaration of competing interest The authors have no conflict of interests.
EDAT- 2020/05/19 06:00
MHDA- 2021/07/10 06:00
CRDT- 2020/05/19 06:00
PHST- 2020/02/04 00:00 [received]
PHST- 2020/04/14 00:00 [revised]
PHST- 2020/04/20 00:00 [accepted]
PHST- 2020/05/19 06:00 [pubmed]
PHST- 2021/07/10 06:00 [medline]
PHST- 2020/05/19 06:00 [entrez]
AID - S1424-3903(20)30144-7 [pii]
AID - 10.1016/j.pan.2020.04.015 [doi]
PST - ppublish
SO  - Pancreatology. 2020 Jul;20(5):902-909. doi: 10.1016/j.pan.2020.04.015. Epub 2020 
      May 5.