Asymptomatic Lesions of the Pancreas: An Overview

Abstract

The issue of pancreatic incidentaloma is relevant in clinical practice, and the correct management of these asymptomatic lesions found incidentally at imaging techniques requires prospective studies with adequate follow-ups. The current literature on this issue was reviewed and incidentalomas, both solid and cystic, are frequently diagnosed at an advanced age and the percentage of males ranged from 14.3 to 80.7%. The percentage of incidentalomas varies from 6% to 23% of the pancreatic resections performed for any cause. The prevalence of cystic incidentalomas diagnosed with imaging techniques varies from 1.2 to 2.6%. Further injury can be identified on the basis of biochemical or endoscopic examinations. Incidentalomas are found more frequently in examinations carried out for genito-urinary symptoms, chest pain or screening tests for cancer surveillance. Up to 50% of these lesions are solid and the vast majority are malignant or precancerous. Biopsy and analysis of the CEA and amylase in the cystic fluid obtained especially with an endoscopic ultrasonography is of particular importance. Given the imperfect diagnostic information available, it is necessary to evaluate the risk and benefit of a pancreatic resection when deemed appropriate because pancreatic resection involves high morbidity, and a surgical approach should be avoided for a benign condition. Solid incidentalomas generally seem to have a better prognosis than symptomatic lesions.