Frequency and characterization of benign lesions in patients undergoing surgery for the suspicion of solid pancreatic neoplasm

Pancreas. 2014 Nov;43(8):1329-33. doi: 10.1097/MPA.0000000000000193.

Abstract

Objectives: A diagnosis of benign lesions (BLs) is reported in 5% to 21% of pancreatoduodenectomies performed for neoplasms; no data for body-tail resections are available. The aims were to investigate the frequency and characterize the BLs mimicking cancer in the head and the body-tail of the pancreas.

Methods: This study is a retrospective review of pancreatic specimenscollected from 2005 to 2011 in the pathology database of Mainz (Germany). Patients with final diagnosis excluding malignancy were analyzed by histology, imaging, and clinical aspects.

Results: Among 373 patients, 33 patients (8.8%) were diagnosed with a benign disease: 25 (8.4%) of 298 in the pancreatic head and 8 (10.7%) of 75 in the body-tail resections. Paraduodenal pancreatitis was diagnosed in 13 (3.5%) of 373 patients; autoimmune pancreatitis (AIP), in 11 (2.9%); "ordinary" chronic pancreatitis, in 6 (1.6%); and accessory spleen, in 3 (0.8%). In pancreatic head resections, the most frequent diagnoses were paraduodenal pancreatitis (13/298, 4.4%) and AIP (9/298, 3%), whereas in the body-tail, the most frequent diagnoses were accessory spleen (3/75, 4%), chronic pancreatitis (3/75, 4%), and AIP (2/75, 2.7%).

Conclusions: Benign lesions are observed with the same frequency inspecimens of the head or the body-tail of the pancreas.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Autoimmune Diseases / epidemiology
  • Autoimmune Diseases / pathology
  • Autoimmune Diseases / surgery
  • Choristoma / epidemiology
  • Choristoma / pathology
  • Choristoma / surgery
  • Diagnosis, Differential
  • Female
  • Germany / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Pancreatectomy / statistics & numerical data
  • Pancreatic Diseases / diagnosis
  • Pancreatic Diseases / epidemiology*
  • Pancreatic Diseases / pathology
  • Pancreatic Diseases / surgery
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / epidemiology
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Pancreatitis / epidemiology
  • Pancreatitis / pathology
  • Pancreatitis / surgery
  • Prevalence
  • Retrospective Studies
  • Spleen / abnormalities
  • Symptom Assessment
  • Unnecessary Procedures
  • Young Adult