Cystic Neoplams of Pancreas Important points

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Important points on cystic neoplasms of pancreas From NEET Questions and discussions 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.