If there is any doubt as to the nature of the cystic lesion at operation as in this case, it should be excised. It is better to excise a pseudocyst or mesenteric cyst than leave behind or drain a cystic neoplasm2,3. Because invasive carcinoma can be focal the entire specimen must be extensively examined histologically21. When the final pathology reveals invasion or positive margin for high-grade dysplasia undetected on frozen sections, a reoperation should be performed in surgically fit patients4. These benign pancreatic cystic lesions have a very high cure rate unless malignant change supervenes when a 50%, 5-year survival after resection of mucinous cystadenocarcinoma is attained5. Usually, benign MCN do not recur and therefore surveillance is not necessary4. Surveillance after resection of benign IPMNs is currently under debate as the prognosis of invasive IPMN is better than that of pancreatic ductal adenocarcinoma (PDAC). However, in cases of stage II/III invasive IPMN, the prognosis is similar to that of PDAC22–24 and the follow-up strategy should be similar to that for PDAC4.
The need for ethics approval and consent to participate was waived.
E.P.W.: was the main author and surgeon; D.E.: contributed to the literature search; T.C.N.: contributed in literature search; M.N.N.: contribute ideas. All authors read and approved the final manuscript.
The authors declare that they have no financial conflict of interest with regard to the content of this report.
The corresponding author is considered the guarantor for the integrity of the manuscript as a whole.
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