Observation or surgical resection: treatment strategies of pancreatic cystic tumor

With the popularization of the aging population and imaging examination, detection rate of the pancreatic cystic neoplasm are increasing in recent years, which commonly includes intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm (SCN) and solid pesudopapillary tumor (SPT). The differential diagnosis is essential to decide surgical resection or observation. The diagnosis of pancreatic cystic tumor relies primarily on imaging examination. For patients who need to long-term follow-up, the MRI should be recommended. The preoperative precision diagnosis that is performed by traditional imaging, tumor markers, endoscopic ultrasonography and contribute to make the individualized therapy plan. The follow-up strategy is optimal for majority of patients with SCN. According to patients′ condition, the surgical resection or observation will be selected for patients with IPMN or MCN after finding malignant transformation-related high risk factors. SPT has been classified as the malignant tumor, and if patients are suspected to have SPT by imaging examination, surgical resection should be recommended. Key words: Pancreatic cystic neoplasms; Intraductal papillary mucinous neoplasm; Mucinous cystic neoplasm; Serous cystic neoplasms; Solid pesudopapillary tumor; Surgical resection; Conservative observation; Follow-up