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Special Feature
January 19, 2009

Image of the Month—Diagnosis

Arch Surg. 2009;144(1):89-90. doi:10.1001/archsurg.2008.527-b

Cystic neoplasms of the pancreas account for about 1% of all pancreatic tumors. Cystic neoplasms of the pancreas may be classified into 3 categories. True neoplastic cysts, the cystadenomas and cystadenocarcinomas arising from the ductal epithelium, account for 90% of cystic pancreatic tumors.1Intraductal tumors like intraductal pancreatic mucinous neoplasm and intraductal pancreatic endocrine neoplasm (PEN) may demonstrate cystic dilatation of the distal pancreatic ducts. Solid tumors of the pancreas like ductal adenocarcinoma, acinar cell carcinoma, and PEN may very rarely undergo cystic degeneration following central necrosis.2Truly cystic PEN, however, has also been reported.3

Pancreatic endocrine neoplasms account for less than 5% of all cystic pancreatic neoplasms.3The majority of cystic PENs are nonfunctional.4They generally reach a larger size than their solid counterparts.5They most commonly occur in the body and tail of the pancreas in patients between the ages of 50 and 60 years.3They are equally distributed between men and women.