Giant pancreatic cyst with extension to spleen managed by laparoscopy

Abstract

To review the etiology, clinical presentation, diagnostic evaluation, management, and prognosis of giant pancreatic cysts. Giant pancreatic cysts, defined as cysts exceeding 5 cm in diameter, include a diverse group of lesions such as pseudocysts, serous cystadenomas, mucinous cystic neoplasms (MCNs), and intraductal papillary mucinous neoplasms (IPMNs). Their clinical significance stems from potential complications and the necessity to differentiate benign from malignant cysts. A comprehensive review of the literature was conducted, focusing on the pathophysiology, symptomatology, diagnostic modalities, treatment options, and outcomes associated with giant pancreatic cysts. The etiology of giant pancreatic cysts varies from benign conditions like pseudocysts and serous cystadenomas to potentially malignant or malignant neoplasms such as MCNs and IPMNs. Clinical presentation ranges from asymptomatic cases to severe abdominal symptoms and complications. Diagnostic evaluation includes imaging modalities like ultrasound, CT, MRI/MRCP, and endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) for cytology and biochemical analysis. Management strategies depend on the type and characteristics of the cyst, with options including observation, endoscopic drainage, surgical resection, and percutaneous drainage. The prognosis varies, with benign cysts generally having a favorable outcome, while cysts with malignant potential require timely surgical intervention to improve survival rates. Giant pancreatic cysts pose a diagnostic and therapeutic challenge due to their varied etiologies and potential complications. Accurate diagnosis through advanced imaging and fluid analysis is crucial. Management should be tailored based on the cyst type, symptoms, and malignancy risk, involving a multidisciplinary approach to optimize patient outcomes. Further advancements in diagnostic and therapeutic techniques are anticipated to enhance the management of these complex lesions.