PMID- 34237168
OWN - NLM
STAT- MEDLINE
DCOM- 20220221
LR  - 20220221
IS  - 1365-2796 (Electronic)
IS  - 0954-6820 (Linking)
VI  - 290
IP  - 5
DP  - 2021 Nov
TI  - Pancreatic incidentalomas: Investigation and management.
PG  - 969-979
LID - 10.1111/joim.13359 [doi]
AB  - The incidence of pancreatic incidentalomas (PIs) detected in otherwise 
      asymptomatic patients is growing with the increasing quality and use of advanced 
      imaging techniques. PI can present as isolated main pancreatic duct dilation or 
      as a solid or cystic lesion. Although historically thought to be relatively rare, 
      PIs are rather common, particularly cystic lesions of the pancreas, which can be 
      detected in up to 49% of the general population. With the poor prognosis of 
      pancreatic cancer, PIs are an opportunity for prevention and early diagnosis, but 
      when managed poorly, they can also lead to overtreatment and unnecessary 
      morbidity. The management of PI should begin with a dedicated pancreas protocol 
      computed tomography (CT) scan or magnetic resonance imaging (MRI) to accurately 
      characterize duct size, lesion characteristics and establish an accurate baseline 
      for subsequent follow up. Diagnosis and subsequent management depends on the 
      extent of main duct dilation and solid versus cystic appearance. Solid lesions 
      are highly concerning for malignancy. Cystic lesions can be further categorized 
      as intraductal papillary mucinous neoplasms of the pancreas (IPMNs) or mucinous 
      cystic neoplasms (MCNs), both of which harbour malignant potential, or as serous 
      cystic neoplasms (SCNs) that are benign. In this paper, we summarize the major 
      challenges related to PI and present pragmatic suggestions for management.
CI  - (c) 2021 The Association for the Publication of the Journal of Internal Medicine.
FAU - Del Chiaro, Marco
AU  - Del Chiaro M
AD  - Division of Surgical Oncology, Department of Surgery, University of Colorado 
      Anschutz Medical Campus, Aurora, Colorado, USA.
FAU - Torphy, Robert J
AU  - Torphy RJ
AUID- ORCID: 0000-0003-3941-0886
AD  - Division of Surgical Oncology, Department of Surgery, University of Colorado 
      Anschutz Medical Campus, Aurora, Colorado, USA.
FAU - Schulick, Richard D
AU  - Schulick RD
AD  - Division of Surgical Oncology, Department of Surgery, University of Colorado 
      Anschutz Medical Campus, Aurora, Colorado, USA.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - J Intern Med
JT  - Journal of internal medicine
JID - 8904841
SB  - IM
MH  - Humans
MH  - Incidental Findings
MH  - Magnetic Resonance Imaging
MH  - Pancreas
MH  - *Pancreatic Neoplasms/diagnosis/therapy
MH  - Tomography, X-Ray Computed
OTO - NOTNLM
OT  - intraductal papillary mucinous neoplasms
OT  - mucinous cystic neoplasms (MCNs)
OT  - pancreatic cancer
OT  - pancreatic cystic neoplasms
OT  - pancreatic incidentalomas
EDAT- 2021/07/09 06:00
MHDA- 2022/02/22 06:00
CRDT- 2021/07/08 17:49
PHST- 2021/07/09 06:00 [pubmed]
PHST- 2022/02/22 06:00 [medline]
PHST- 2021/07/08 17:49 [entrez]
AID - 10.1111/joim.13359 [doi]
PST - ppublish
SO  - J Intern Med. 2021 Nov;290(5):969-979. doi: 10.1111/joim.13359.