Approach pancreatic incidentaloma

Adrenal myelolipoma is considered a benign neoplasm that accounts for 6% to 16% of adrenal incidentalomas, and it is the second most common incidental adrenal tumor after adrenal adenomas. They are usually asymptomatic; however, in the presence of symptoms, significant growth, or complications, open surgical resection is indicated. We present the case of a 46-year-old woman with obesity and diabetes who experienced five years of left hemiabdominal pain, which was unsuccessfully treated symptomatically...

INTRODUCTION: The widespread use of imaging methods has led to an increased identification of asymptomatic Pancreatic Cystic Lymphangiomas (PCL), a rare entity for which available information is very limited. PRESENTATION OF CASE: We present the case of an asymptomatic 61-year-old male, submitted to elective enucleation of a pancreatic head PCL at our institution. After four years of follow-up the patient is doing well and has no clinical or imaging signs of recurrence...

Summary: A 61-year-old man went to the Emergency Department with left upper abdominal quadrant pain and low-grade fever, as well as a loss of weight (3 kg in 6 weeks). A solid-cystic lesion in the left adrenal lodge was discovered by abdominal ultrasonography. A slight increase in the serum amylase with normal lipase was observed, but there were no signs or symptoms of pancreatitis. A contrast-enhanced CT revealed a tumor that was suspected of adrenocortical cancer. Therefore, he was referred to the endocrine unit...

BACKGROUND: Serial imaging in patients with aortic aneurysms may identify non-vascular disease. However, the prevalence and clinical history of pancreatic incidentalomas in this population is unknown. METHODS: Retrospective cross-sectional study of adults who underwent computed tomography angiography (CTA) surveillance imaging for abdominal or thoracoabdominal aortic aneurysm at a single academic institution between 2015 and 2020. Descriptive statistics were used for patients with pancreatic lesions...

PURPOSE: Pancreatic cancer is among the most aggressive malignancies and is rarely discovered early. However, pancreatic "incidentalomas," particularly cysts, are frequently identified in asymptomatic patients through anatomic imaging for unrelated causes. Accurate determination of the malignant potential of cystic lesions could lead to life-saving surgery or spare patients with indolent disease undue risk. Current risk assessment of pancreatic cysts requires invasive sampling, with attendant morbidity and sampling errors...

BACKGROUND: The diffusion of cross-sectional imaging has recently permitted the detection of an increasing number of incidentalomas localized in the distal pancreas. Currently, there are no studies in the literature exploring the laparoscopic approach as treatment for left-sided pancreatic incidentalomas. METHODS AND RESULTS: We report a series of 20 incidentalomas localized in the body and tail of the pancreas treated with laparoscopic surgery over the period 2010-2014...

Periampullary region encircles a radius of 2 cm around the ampulla of Vater; accordingly, four distinct neoplasias with overlapping imaging features originate in the region. Each of these lesions has a different long-term prognosis; hence, imaging evaluation to characterize the lesion is important. Further certain specific features pertaining to the vascular invasion and systemic spread may decide about the treatment as well as surgical approach. An understanding of the advances in imaging and image processing technology as well as in the methods of image acquisition, for the purpose, is quite relevant towards etching out a rational pre-treatment evaluation protocol...

Incidentally discovered pancreatic lesions that are asymptomatic have become much more common in recent years. It is important to characterize these lesions and to determine which patients can be safely observed and which should undergo an operation, as a substantial proportion of them might be malignant or premalignant. This review focus on the diagnostic approach and management of the different types of cystic and solid incidental pancreatic lesions based on appropriate clinical input, imaging screening and histological criteria...

INTRODUCTION: Asymptomatic lesions of the pancreas, referred to as 'incidentalomas', have appeared with increased frequency in recent years. Giant incidentalomas have rarely been reported in the literature. PRESENTATION OF CASE: We report herein a rare case of a giant cystic pancreatic incidentaloma measuring 12.7cm×8cm, which was found in an otherwise healthy male patient during a routine genitourinary imaging work-up. The patient underwent a distal pancreatectomy and splenectomy; the pathology report demonstrated a giant serous cystadenoma of the body and tail of the pancreas...

Pancreatic incidentalomas are defined as asymptomatic pancreatic lesions, discovered incidentally by imaging for an unrelated indication. They are being discovered with increasing frequency as the use of high quality cross sectional imaging is becoming more widespread. These lesions cover a wide spectrum of pathology from benign simple cysts through potentially malignant lesions such as intraductal papillary mucinous neoplasia, to frankly malignant adenocarcinoma. In this article we outline the incidence, imaging characteristics and natural history of the various incidental lesions with emphasis to neuroendocrine tumors...

Patients with extra-adrenal malignancies are diagnosed increasingly with benign adrenal tumors, as well as non-oncology subjects. We aimed to demonstrate the natural course of adrenal adenomas in terms of mass size and hormonal status in oncology and non-oncology subjects. We also compared the characteristics and behavior of adrenal adenomas with adrenal malignancies. In our registry of adrenal tumors (n = 335), we prospectively evaluated 29 oncology subjects (EAM+) and age, gender, and follow-up duration matched 110 non-oncology subjects (EAM-) with adrenal adenomas...

The aim of this study was to present our experience with laparoscopic adrenalectomy. Over the period from January 2000 to January 2007, 60 patients (40 M, 20 F; mean age: 52.5 years; range: 16-77 years) underwent adrenalectomy in our department. Five patients were submitted to bilateral adrenalectomy, thus making a total of 65 cases. The indications were the following: non-secreting masses in 21 cases and secreting masses in 44; 29% were incidentalomas. The operation was performed with a transperitoneal lateral approach...

INTRODUCTION: We report our results of laparoscopic anterior transperitoneal adrenalectomy. PATIENTS: Between 4/1996 to 05/2001, a laparoscopic adrenalectomy was performed in 34 patients (median age 48 years). The adrenalectomy was performed transperitoneally (31 unilateral; 3 bilateral). The adrenaline level was measured in 7 patients with a pheochromocytoma. RESULTS: All tumors (mean size 3.5 cm; 0.4 to 8.0 cm) could be extirpated by laparoscopy...