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Pregnancy-associated mucinous cystic neoplasms of the pancreas - A systematic review

Published:November 16, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.11.002

      Highlights

      • MCN during pregnancy may be more aggressive.
      • They are more symptomatic during pregnancy when compared to general population.
      • Despite evidence of aggressive growth, no significant difference in tumour biology is reported when associated with pregnancy.
      • No definitive correlation between receptor expression profile and rate of tumour growth of MCN during pregnancy is reported.
      • Surgical decision making is complex and emphasis should be on the safety of both mother and child.

      Abstract

      Introduction

      Mucinous cystic neoplasms (MCN) are mucin-producing epithelial cell tumors of pancreas. They consist of an ovarian-type stroma expressing estrogen and progesterone receptors. Pregnancy-associated MCNs are presumed to be larger in size and more aggressive without any concrete evidence.

      Objective

      and Data Sources: Systematic review of published literature using PubMed and Google Scholar databases. Original articles including case reports and series published between 1970&2021 were included wherein MCN was diagnosed during pregnancy/within one-year post-partum. Thirty-three publications having 36 cases, adding one of our own patient were analyzed in this review.

      Result

      Median age at presentation was 32 years. Only three (9%) patients were asymptomatic. Mean size of MCN was 135 mm. Ten patients (27%) reported an increase in size during pregnancy. Most tumors involved body and tail of pancreas (60%). Distal pancreatectomy with splenectomy was the most common resection performed (57%). No foetal mortality was reported to date.

      Conclusion

      Pregnancy may cause a rapid increase in size of MCN. Decision-making is more complex and needs a fine balance between optimal oncological and obstetric outcomes.
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