Precancerous Lesions and Carcinoma of the Pancreas.

The current edition of VISZERALMEDIZIN addresses the topic of pancreatic cancer with a focus on the precursors of this fatal disease. These precursors – when recognized and evaluated correctly – might offer the unique opportunity of preventing pancreatic cancer. Today, the best characterized precancerous lesions of the pancreas are the different cystic neoplasms that are addressed in the invited articles and the interdisciplinary discussion of this issue. Focusing on cystic pancreatic neoplasms, various important aspects regarding diagnosis, surveillance, treatment, clinical and basic research as well as socio-economic relevance need to be considered. Some of these aspects are the subject of an ongoing intense and controversial interdisciplinary discussion and research. Consequently, international consensus statements and guidelines on these entities are still in a constant state of flux. With the widespread use of modern imaging modalities, asymptomatic cystic pancreatic lesions are increasingly found – some of them harmless, some of them showing incipient or already manifest malignancy. This increasing number of cystic neoplasms, which are mainly detected as asymptomatic lesions on advanced imaging, requires an adequate further management of the respective patients which implies education and integration of general practitioners, community hospitals, and tertiary referral centers specialized in pancreatic disease. Regardless of the individual management decision to act on a newly diagnosed cystic neoplasm, significant costs for the health care system may be associated – by lifelong surveillance as well as by surgery and potential additional therapies, e.g. due to consecutive exocrine or endocrine replacement therapy. In this special issue, renowned international experts covering radiological, pathological, gastroenterological, surgical and research topics have contributed their knowledge on cystic pancreatic neoplasms as the fundamental precursors of cancer. The review articles give detailed overviews from different angles while the interdisciplinary discussion summarizes the essential and underlines the current as well as upcoming topics of interest. With this issue, we hope to provide a comprehensive, focused, and interesting update on this fascinating and important field for our colleagues from all disciplines engaged in the clinical management as well as research of cystic pancreatic neoplasms.