Are pancreatic masses benign?

Pancreatic space-occupying units can also be benign. We know that pancreatic space-occupying units are a relatively common type of tumor. Malignant tumors are more common. Malignant tumors are very harmful to patients and often lead to lymph node and liver metastasis. Therefore, if this happens, further examinations should be carried out in time. When the tumor is examined and pathologically diagnosed, if it is malignant, the prognosis is often not very good.

Pancreatic mass examination

If you have persistent upper abdominal pain that radiates to the lower back and is more severe at night and worse when lying on your back, but the pain is relieved by curling up or sitting forward, then it is highly suggestive of a pancreatic tumor and further laboratory and other auxiliary tests are needed. B-ultrasound, CT, MRI, ERCP, PTCD, angiography, laparoscopy, tumor marker determination, oncogene analysis, etc. are of great help in confirming the diagnosis of pancreatic tumors and determining whether they can be surgically removed. However, surgeons still cannot ignore the patient's medical history and comprehensive physical examination. To assess the safety of radical surgery for patients, the information obtained from detailed medical history and careful physical examination is more important than a single heart and lung function test. In general, B-ultrasound, CA19-9, and CEA can be used as screening tests. Once a pancreatic tumor is suspected, a CT scan is necessary. If the patient has severe jaundice and the diagnosis cannot be confirmed after CT examination, ERCP and PTCD examinations can be selected. If catheter drainage is successful, surgery can be delayed for 1 to 2 weeks for patients with severe jaundice. The diagnostic value of MRI for pancreatic cancer is not superior to that of CT. When pancreatic tumors have been confirmed but it is unclear whether they can be surgically removed, it is clinically significant to choose angiography and/or laparoscopy to avoid unnecessary surgical exploration.

Treatment

1. Pancreatic sarcoma

Surgical treatment is the first choice. Pancreaticoduodenectomy is performed for tumors in the head of the pancreas, and splenectomy is performed for tumors in the body and tail of the pancreas. When tumors in the body and tail of the pancreas invade the stomach, colon and other surrounding organs, partial gastrectomy and colon resection can be performed in combination. Pancreatic sarcoma rarely metastasizes to distant or lymph nodes.

2. Pancreatic cystadenoma

Surgery is the only treatment for pancreatic cystic tumors. Cystadenomas often have intact capsules and are more common in the body and tail of the pancreas. Small cystadenomas can be removed; most patients require a pancreatectomy of the body and tail, including the spleen. Cystic tumors of the pancreatic head can be treated with pancreaticoduodenectomy.

3. Pancreatic cystadenocarcinoma

(1) Surgical resection of pancreatic cystadenocarcinoma, including part of the normal pancreas at the site of the tumor, is the preferred treatment for this disease. In principle, most pancreatic cystadenocarcinomas should be radically resected. Depending on the location and extent of the lesion, the relationship between the cancer and adjacent organs, and the degree of metastasis and infiltration, simple cystectomy, pancreatic tail plus splenectomy, pancreaticoduodenectomy or total pancreatectomy can be selected. (2) For pancreatic cystic masses whose nature is difficult to determine, especially mucinous cysts, they should be treated according to the treatment principles of pancreatic cystadenocarcinoma, and the mass and part of the pancreatic tissue in its area should be removed. For pancreatic cystadenocarcinoma, internal or external drainage of the cyst must not be performed lightly. Not only will it fail to achieve the purpose of surgical treatment, but it will increase the chance of cyst infection and delay the opportunity for radical surgery.