MALIGNANT CYSTIC TUMOR OF THE PANCREAS AT A YOUNG AGE

This paper presents a clinical case of treating a 22-year-old female patient with a malignant cystic tumor of the pancreas. At the initial consultation, due to her age, no oncological history, small size of the tumor, no cancerous growth according to biopsy data, and no clinical manifestations, dynamic observation was recommended. In dynamics, after 6 months, an increase in the size of the pancreatic tumor was detected. After a comprehensive additional examination, indications for surgery were established and laparoscopic spleen-preserving distal resection of the pancreas according to the Warshaw type was performed. Postoperative pathohistological examination: mucinous cystic tumor of the pancreas with high-grade microfoci of epithelial dysplasia (Ca in situ). It is concluded that an  oncoguarded approach to cystic tumors of the pancreas should be used,  including in young people.

1. Zerboni G, Signoretti M, Crippa S, Falconi M, Arcidiacono PG, Capurso G. Systematic review and meta-analysis: Prevalence of incidentally detected pancreatic cystic lesions in asymptomatic individuals. Pancreatology. 2019; 19(1): 2-9. doi: 10.1016/j.pan.2018.11.014.

2. Laffan TA, Horton KM, Klein AP, et al. Prevalence of unsuspected pancreatic cysts on MDCT. AJR Am J Roentgenol. 2008; 191(3): 802-7. doi: 10.2214/AJR.07.3340.

3. Chang YR, Park JK, Jang JY, Kwon W, Yoon JH, Kim SW. Incidental pancreatic cystic neoplasms in an asymptomatic healthy population of 21,7-45 individuals: Large-scale, single-center cohort study. Medicine (Baltimore). 2016; 95(51): e5535. doi: 10.1097/MD.0000000000005535.

4. The World Gastroenterology Organisation. Global practice recommendations for pancreatic cysts. Available from: https://www.worldgastroenterology.org/guidelines/pancreatic-cysticlesions/pancreatic-cystic-lesions-russian.

5. Ardeshna DR, Cao T, Rodgers B, Onongaya C, et al. Recent advances in the diagnostic evaluation of pancreatic cystic lesions. World J Gastroenterol. 2022; 28(6): 624-634. doi: 10.3748/wjg.v28.i6.624.

6. European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut. 2018; 67(5): 789-804. doi: 10.1136/gutjnl-2018-316027.

7. Okasha HH, Awad A, El-Meligui A, Ezzat R, et al. Cystic pancreatic lesions, the endless dilemma. World J Gastroenterol. 2021; 27(21): 2664-2680. doi: 10.3748/wjg.v27.i21.2664.

8. Miller KD, Fidler-Benaoudia M, Keegan TH, Hipp HS, Jemal A, Siegel RL. Cancer statistics for adolescents and young adults, 2020. CA Cancer J Clin. 2020; 70(6): 443-459. doi: 10.3322/caac.21637.

9. Elta GH, Enestvedt BK, Sauer BG, Lennon AM. ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts. Am J Gastroenterol. 2018; 113(4): 464-479. doi: 10.1038/ajg.2018.14.

10. ASGE Standards of Practice Committee; Muthusamy VR, Chandrasekhara V, Acosta RD, Bruining DH, et al. The role of endoscopy in the diagnosis and treatment of cystic pancreatic neoplasms. Gastrointest Endosc. 2016; 84(1): 1-9. doi: 10.1016/j.gie.2016.04.014.

11. Karoumpalis I, Christodoulou DK. Cystic lesions of the pancreas. Ann Gastroenterol. 2016; 29(2): 155-61. doi: 10.20524/aog.2016.0007.

12. Lloyd RV, Osamura RY, Kloppel G, Rosai J, editors. World Health Organization classification of tumours of endocrine organs. In: World Health Organization classification of tumours. 4th edition. Vol. 10. Lyon: IARC Press; 2017. 355 p.