The pancreas (pancreas) consists of the head, body and tail, it performs several functions in the human body: it produces enzymes that promote the digestion of food, and produces hormones (glucagon, insulin) that regulate metabolic processes in the human body. In some cases, pancreatic cystadenoma is observed - a benign neoplasm that affects organ tissues. Pathology in frequent cases affects the body or tail of the organ and is observed mainly in the fairer sex.
Description
Pancreatic cystadenoma is a cystic benign tumor that forms from the epithelium of an organ. The main part of the diagnosed neoplasms is oval or round tumors, which are most often located in the body and tail of the pancreas, cystadenoma of the pancreatic head is much less common. Cysts are placed in a dense capsule, which has a wall thickness of up to one and a half centimeters. Cystic formations can have as many cavities, separated by partitions, and consist of one large cavity.
Etiology of the disease
In most cases, the disease affects women from twenty-five to seventy-five years. Of all tumor diseases of the pancreas, cystadenoma is most common. It is found in 15% of people with cystic neoplasms and in 4% with tumor lesions of this organ. Typically, pancreatic cystadenoma (ICD 10 under the number K85 — K86) is benign and does not pose a risk to health and life.
But some of its varieties can develop into malignant neoplasms after a while. Usually these are tumors with papillary formations.
Varieties
In medicine, it is customary to distinguish three types of pancreatic tumors of a benign nature, each of which has its own characteristics:
- Serous cystadenoma, which has several cavities filled with serous fluid and separated by septa. These septa divide the tumor into a large number of small cysts. It grows slowly, does not turn into a malignant neoplasm, and develops as a result of a mutation of one of the chromosomes. The size of serous cystadenoma is about seven centimeters. For a long time, it does not manifest itself in any way, therefore, as a rule, it is accidentally detected during the examination. An important point here is the differential diagnosis, in which it is important not to confuse the tumor with the so-called pseudocyst.
- Mucinous cystadenoma. It is a multi-chamber tumor. Inside it is mucus. Doctors are of the opinion that it develops from the tissues of the ovary, which enter the pancreas during intrauterine development. Its dimensions are growing rapidly, it can grow up to fifteen centimeters. An important feature of such an ailment as mucinous cystadenoma is that it can develop into a malignant neoplasm called cystadenocarcinoma. If a disease develops, a person develops constant pain and discomfort. In this case, surgery is always used with the complete removal of the affected pancreas.
- Papillary cystadenoma intraductal is a very rare disease that develops from the ducts of the pancreas, and represents papillary epithelial growths. Inside the tumor is a thick viscous mucus. It can develop into a malignant neoplasm. Diagnosed intraductal papillary cystadenoma is quite difficult. Pathology can affect a certain section of the pancreas. The tumor is always removed by surgery, while an urgent histological examination is performed.
Symptoms
This disease is not common in medicine. The malignant nature of tumors is characterized by the formation of metastases, which cause the development of hypoglycemia and hyperinsulinism. With mild forms of the disease, tachycardia, weakness and nausea, an increase in pressure are observed. In severe cases, convulsions and impaired consciousness appear. Thus, the symptoms of pancreatic cystadenoma in patients are mild. Externally, patients look normal. In ten percent of patients, the disease does not manifest itself at all. The rest have signs that are similar to those that cause inflammatory processes of the peritoneal organs. Most of the neoplasms are palpable, while there may be mild pain. The main signs of the disease include:
- Violations of the hormonal system, which manifest themselves in the form of weakness, anxiety, in some cases - loss of consciousness.
- Moderate pain in the upper abdomen, which is given to the shoulder blade or arm. They can intensify after exercise.
- Discomfort when walking in the upper abdomen, epigastric region.
- Nausea, vomiting, heaviness in the stomach.
- The appearance of jaundice.
In some cases, pancreatic cystadenoma can lead to the development of dangerous conditions: pancreatitis, cancer, endocrine pathology, biliary intoxication, etc.
Complications
Small cystadenomas do not manifest themselves in any way, they are accidentally detected during a routine examination. When the tumor begins to grow, the tissues surrounding the organ move apart and begin to squeeze the organs that are nearby. In some cases, surgical intervention is required, since pancreatic cystadenoma compresses the ducts of the gallbladder or pancreas, the duodenum. In the latter case, symptoms of intestinal obstruction appear, which are expressed in pain, bloating, stool retention, nausea and vomiting, as well as signs of stenosis. Often, one of the symptoms is jaundice, dark urine, discoloration of feces, developed liver failure. In some cases, diabetes can develop.
Diagnostics
In the last twenty years, the diagnosis of the disease is carried out using highly informative minimally invasive methods, which allows you to study the disease very well. Treatment can be effective if the diagnosis is done in a timely manner. So, the specialist prescribes a radiography of the peritoneal organs, MRI, ultrasound or CT, examination of the pancreatic ducts with an endoscope (fibrogastroduodenoscopy), a biopsy with further histological examination of the sections. It makes sense for the patient to think about the most effective procedures.
The most informative are MRI, CT and ultrasound. According to the results obtained, types of cysts can be differentiated. Also of great importance in the diagnosis is the collection of anamnesis, information about injuries received earlier, or previous operations, previous pancreatic diseases (in particular pancreatitis), etc. Some researchers argue that if a disease is suspected, it is necessary, first of all, to conduct endoscopic retrograde pancreaticocholangiography (ERCP), which will allow you to examine the mouth of the duodenum, as well as the enlarged pancreas duct for pathologies. This method allows you to see abnormal formations of a round or oval shape.
Treatment
Treatment of pancreatic cystadenoma should begin with stabilization of the level of insulin that it synthesizes. This helps to eliminate weakness, high blood pressure, vomiting and nausea, as well as increase vitality. If the disease manifests itself in a severe form, then treatment is supposed only by surgery. For this, the following operations are carried out:
- Resection, which involves the removal of the affected part of the pancreas (head, body or tail).
- Enucleation or husking. The essence of the procedure is the complete removal of the neoplasm.
- Pancreatoduodenal resection - removal of the pancreatic head and duodenum.
- Laparoscopy is the elimination of a small neoplasm that is located in the tail of an organ.
After the operation, a histological examination of the removed segment is performed.
Drainage
If the tumor is small and does not cause any inconvenience, doctors perform extraperitoneal drainage. This method involves the introduction of a catheter into the neoplasm of the neoplasm, through which its contents are brought out. As a result, the size of the tumor becomes smaller. Also, this method is used in case of infection of the cyst. In some cases, doctors use internal drainage. The essence of the method is to impose anastomosis between the tumor and the stomach. Through this anastomosis, the contents of the cyst are sucked into the stomach.
Rehabilitation
After the pancreatic cystadenoma has been removed, the patient undergoes a rehabilitation course. It implies strict adherence to diet. The doctor recommends excluding spicy, fatty and floury foods from the diet for one year. Moreover, during this period, the patient should take enzymes. For six months, it is necessary to limit physical activity, you also need to wear an elastic belt at this time. Sanatorium treatment will not be superfluous.
Forecast
Basically, the outlook for the future is favorable. Nine out of ten patients who were operated on time fully recover. In this case, relapses do not occur, nor are there any complications after surgery. But doctors insist that it is necessary to closely monitor their health, as well as the state of the neoplasm, if necessary, an operation must be performed in a timely manner. Thanks to this, the development of negative consequences in the future can be prevented.
If the neoplasm has become malignant, then surgery is supplemented by radiation or chemotherapy. If there is no metastasis, then the survival rate is one hundred percent. In case of metastasis, only half of the patients survive. Therefore, it is necessary to periodically conduct a full examination of the body and treat the identified disease in a timely manner so that the disease does not turn into a malignant form.