Skip to main content
Erschienen in: European Surgery 3/2020

17.02.2020 | original article

Misdiagnosis of cystic pancreatic tumors during a 30-year study period

verfasst von: G. Aleksandric, S. Matic, J. Todorovic, Z. Terzic-Supic, V. Aleksic

Erschienen in: European Surgery | Ausgabe 3/2020

Einloggen, um Zugang zu erhalten

Summary

Background

Cystic pancreatic tumors are increasingly found in medical practice. The aim of this study was to examine the prevalence of misdiagnosis of these lesions and the factors associated with preoperative misdiagnosis.

Methods

A retrospective analysis included 66 patients treated in the Clinic for Digestive Surgery, Clinical Center of Serbia, from 1983 to 2013. We included all patients with biopsy-confirmed cystic pancreatic tumors during the study period. We analyzed preoperative parameters, intraoperative and postoperative data of examined patients. Based on the preoperative diagnosis and the biopsy findings, patients were divided into two groups: correct preoperative diagnosis and misdiagnosis.

Results

Prevalence of misdiagnosis was 34.85%. Average age was 45.3 ± 16.9 years, 54 (81.8%) were females. Patients with misdiagnosis had significantly higher odds of being older (Odds ratio [OR]: 1.06, 95% Confidence interval [CI]: 1.01–17.86), to present with symptoms of nausea or vomiting (OR: 5.85, 95% CI: 1.49–23.00), to have a clinically palpable tumor (OR: 4.64, 95% CI: 1.21–17.86), and to have received the diagnosis in the period between 1992 and 2003.

Conclusion

During the 30-year study period, more than one third of the patients in our study had a misdiagnosis preoperatively. The likelihood of misdiagnosis was higher among older patients, patients with symptoms of nausea or vomiting, patients with a clinically palpable tumor, and patients treated during the period between 1992 and 2003. The decline in the prevalence of misdiagnoses should be expected, due to advances in imaging methods and their availability, which are increasing significantly.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Chandwani R, Allen PJ. Cystic neoplasms of the pancreas. 2015. pp. 1–13. Chandwani R, Allen PJ. Cystic neoplasms of the pancreas. 2015. pp. 1–13.
2.
Zurück zum Zitat Al-Haddad M, Schmidt MC, Sandrasegaran K, Dewitt J. Diagnosis and treatment of cystic pancreatic tumors. Clin Gastroenterol Hepatol. 2011;9(8):635–48.CrossRef Al-Haddad M, Schmidt MC, Sandrasegaran K, Dewitt J. Diagnosis and treatment of cystic pancreatic tumors. Clin Gastroenterol Hepatol. 2011;9(8):635–48.CrossRef
3.
Zurück zum Zitat Di Cataldo A, et al. Cystic pancreatic tumors: should we resect all of them. Eur Rev Med Pharmacol Sci. 2014;18(2):16–23.PubMed Di Cataldo A, et al. Cystic pancreatic tumors: should we resect all of them. Eur Rev Med Pharmacol Sci. 2014;18(2):16–23.PubMed
4.
Zurück zum Zitat Salvia R, et al. Pancreatic resections for cystic neoplasms: From the surgeon’s presumption to the pathologist’s reality. Surgery. 2012;152(3 Suppl):S135–S42.CrossRef Salvia R, et al. Pancreatic resections for cystic neoplasms: From the surgeon’s presumption to the pathologist’s reality. Surgery. 2012;152(3 Suppl):S135–S42.CrossRef
5.
Zurück zum Zitat Del Chiaro M, Segersvad R, Pozzi Mucelli R, Rangelova E, Lohr M, Verbeke C. Comparison of preoperative conference-based diagnosis with histology of cystic tumors of the pancreas. Ann Surg Oncol. 2014;21:1539–44.CrossRef Del Chiaro M, Segersvad R, Pozzi Mucelli R, Rangelova E, Lohr M, Verbeke C. Comparison of preoperative conference-based diagnosis with histology of cystic tumors of the pancreas. Ann Surg Oncol. 2014;21:1539–44.CrossRef
6.
Zurück zum Zitat Palmucci S, et al. Cystic pancreatic neoplasms: diagnosis and management emphasizing their imaging features. Eur Rev Med Pharmacol Sci. 2014;18(8):1259–68.PubMed Palmucci S, et al. Cystic pancreatic neoplasms: diagnosis and management emphasizing their imaging features. Eur Rev Med Pharmacol Sci. 2014;18(8):1259–68.PubMed
7.
Zurück zum Zitat Del M, Verbeke C, Salvia R, Klöppel G, Werner J. European experts consensus statement on cystic tumours of the pancreas. Dig Liver Dis. 2013;45:703–11.CrossRef Del M, Verbeke C, Salvia R, Klöppel G, Werner J. European experts consensus statement on cystic tumours of the pancreas. Dig Liver Dis. 2013;45:703–11.CrossRef
8.
Zurück zum Zitat Birnbaum DJ, et al. Surgery for pancreatic neoplasms: How accurate are our surgical indications ? Surgery. 2017;162(1):112–9.CrossRef Birnbaum DJ, et al. Surgery for pancreatic neoplasms: How accurate are our surgical indications ? Surgery. 2017;162(1):112–9.CrossRef
9.
Zurück zum Zitat Di Cataldo A, et al. Cystic pancreatic tumors: Should we resect all of them? Eur Rev Med Pharmacol Sci. 2014;18(Suppl 2):16–23.PubMed Di Cataldo A, et al. Cystic pancreatic tumors: Should we resect all of them? Eur Rev Med Pharmacol Sci. 2014;18(Suppl 2):16–23.PubMed
10.
Zurück zum Zitat Salvia R, et al. Branch-duct intraductal papillary mucinous neoplasms of the pancreas: to operate or not to operate? Gut. 2007;56(8):1086–90.CrossRef Salvia R, et al. Branch-duct intraductal papillary mucinous neoplasms of the pancreas: to operate or not to operate? Gut. 2007;56(8):1086–90.CrossRef
11.
Zurück zum Zitat Warshaw AL, Compton CC, Lewandrowski K, Cardenosa G, Mueller PR. Cystic tumors of the pancreas. New clinical, radiologic, and pathologic observations in 67 patients. Ann Surg. 1990;212(4):432.CrossRef Warshaw AL, Compton CC, Lewandrowski K, Cardenosa G, Mueller PR. Cystic tumors of the pancreas. New clinical, radiologic, and pathologic observations in 67 patients. Ann Surg. 1990;212(4):432.CrossRef
12.
Zurück zum Zitat Compagno J, Oertel JE. Mucinous cystic neoplasms of the pancreas with overt and latent malignancy (cystadenocarcinoma and cystadenoma): a clinicopathologic study of 41 cases. Am J Clin Pathol. 1978;69(6):573–80.CrossRef Compagno J, Oertel JE. Mucinous cystic neoplasms of the pancreas with overt and latent malignancy (cystadenocarcinoma and cystadenoma): a clinicopathologic study of 41 cases. Am J Clin Pathol. 1978;69(6):573–80.CrossRef
13.
Zurück zum Zitat Gomez D, Rahman SH, Wong LF, Verbeke CS, Menon KV. Predictors of malignant potential of cystic lesions of the pancreas. Eur J Surg Oncol. 2008;34(8):876–82.CrossRef Gomez D, Rahman SH, Wong LF, Verbeke CS, Menon KV. Predictors of malignant potential of cystic lesions of the pancreas. Eur J Surg Oncol. 2008;34(8):876–82.CrossRef
14.
Zurück zum Zitat Ooi L, Ho GH, Chew SP, Low CH, Soo KC. Cystic tumours of the pancreas: a diagnostic dilemma. Aust N Z J Surg. 1998;68(12):844–6.CrossRef Ooi L, Ho GH, Chew SP, Low CH, Soo KC. Cystic tumours of the pancreas: a diagnostic dilemma. Aust N Z J Surg. 1998;68(12):844–6.CrossRef
15.
Zurück zum Zitat Goh BK‑P, Tan Y‑M, Chung Y‑FA. Utility of fusion CT-PET in the diagnosis of small pancreatic carcinoma. World J Gastroenterol. 2005;11(24):3800.CrossRef Goh BK‑P, Tan Y‑M, Chung Y‑FA. Utility of fusion CT-PET in the diagnosis of small pancreatic carcinoma. World J Gastroenterol. 2005;11(24):3800.CrossRef
Metadaten
Titel
Misdiagnosis of cystic pancreatic tumors during a 30-year study period
verfasst von
G. Aleksandric
S. Matic
J. Todorovic
Z. Terzic-Supic
V. Aleksic
Publikationsdatum
17.02.2020
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 3/2020
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-020-00628-1

Weitere Artikel der Ausgabe 3/2020

European Surgery 3/2020 Zur Ausgabe