Old age and no history of pancreatitis, it is cystic neoplasm of pancreas
Most common is SCN followed by MCN and IPMN
OLd patient with dilated duct, cystic neoplasm is IPMN
The most important point of differentiation in cystic neoplasms is whether the epithelium is serous or mucinous.
All mucinous cystic lesions should be resected; lesions < 2 cm remain controversial.
Mucinous neoplasm in middle aged female, body and tail of pancreas
Creeping Resection is for IPMN Intraoperative frozen sectionsin the management of IPMNs. If margins are positive for adenoma or borderline atypia with minimal cytoarchitectural atypia and gastric/foveolar-type epithelium, no further resection is required. If instead they are positive for invasive carcinoma, carcinoma in situ, or borderline atypia exhibiting florid papilla formation, further resection is warranted, if feasible.In such instances, further “creeping” resection toward the head for a tail lesion, or toward the tail for a head or uncinate process lesion, can often be sufficient.
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