Pancreatic cystadenoma: symptoms and treatment
The pancreas consists of the head, body and tail, it performs several functions in the human body: it produces enzymes that promote digestion of food, and produces hormones( glucagon, insulin) that regulate metabolic processes in the human body. In some cases, there is a pancreatic cystadenoma - a benign neoplasm that affects the tissue of the organ. Pathology in frequent cases affects the body or tail of the organ and is observed, mainly, in the fairer sex.
Cystadenoma of the prostate is a cystic benign tumor that is formed from the epithelium of the organ. Most of the diagnosed tumors are tumors of oval or round shape, which are most often located in the body and tail of the prostate, much less often there is a cystadenoma of the head of the pancreas. Cysts are placed in a tight 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 ailment affects women from twenty-five to seventy-five years old. Of all tumorous diseases, PZHZ, cystadenoma occurs most often. It is found in 15% of people with cystic neoplasms and 4% with tumor lesions of this organ. Usually cystadenoma of the pancreas( ICD 10 under number K85-K86) is benign in nature and does not pose a threat to health and life.
But some of its species later can develop into malignant tumors. Usually it is a tumor with papillary formations.
In medicine, it is customary to distinguish three types of tumors of a healthy benign, 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 cysts of small size. It grows slowly, it does not turn into a malignant neoplasm, and develops as a result of a mutation in one of the chromosomes. The size of serous cystadenoma is about seven centimeters. For a long time, it does not manifest itself at all, therefore, as a rule, it is accidentally detected during the examination. An important point here is differential diagnosis, in which it is important not to confuse the tumor with the so-called pseudocystea.
- Mucinous cystadenoma. It is a multi-compartment tumor. Inside it is mucus. Doctors are of the opinion that it develops from ovarian tissue that enter the prostate cancer during intrauterine development. Dimensions of her rapidly increase, she can grow up to fifteen centimeters. An important feature of such an ailment as mucinous cystadenoma is that it can grow into a malignant tumor, called cystadenocarcinoma. If the disease develops, a person has constant pain and discomfort. In this case, always operative intervention with complete removal of the affected department of the PZH.
- The papillary cystadenoma intra-flow is a very rare disease that develops from the pancreatic ducts, and is a papillary epithelial growth. Inside the tumor is a thick, viscous mucus. It can grow into a malignant tumor. Intra-flow papillary cystadenoma is difficult to diagnose. Pathology can affect a particular department of the PJV.The tumor is always removed by the operative route, and histological examination is carried out urgently.
This disease in medicine is infrequent. The malignant nature of tumors is characterized by the formation of metastases, which are the cause of the development of hypoglycemia and hyperinsulinism. With mild forms of ailment, tachycardia, weakness and nausea, an increase in pressure are observed. In severe cases, convulsions and impaired consciousness occur. Thus, the symptoms of pancreatic cystadenoma in patients are poorly expressed. Outwardly, the patients look normal. In ten percent of patients, the ailment does not manifest itself at all. The others have signs that are similar to those that cause the inflammatory processes of the peritoneal organs. Most of the neoplasms are probed, and there may be mild pain. The main signs of the disease include:
- Disorders from the hormonal system, which manifest themselves as weakness, anxiety, in some cases - loss of consciousness.
- Moderate pain in the upper abdomen, which is given in the shoulder blade or arm. They can increase after exercise.
- Discomfort when walking in the upper abdomen, epigastric region.
- Nausea, vomiting, heaviness in the abdomen.
- Appearance of jaundice.
In some cases, pancreatic cystadenoma can lead to the development of dangerous conditions: pancreatitis, cancer, endocrine pathology, bile intoxication, etc.
Small size of cystadenoma does not manifest itself in any way, they are accidentally detected during routine examination. When the tumor starts to grow, the surrounding tissue organ moves apart and squeezes the organs that are next to each other. In some cases, surgery is required, since the pancreatic cystadenoma compresses the ducts of the gallbladder or the prostate, duodenum. In the latter case, there are symptoms of intestinal obstruction, which are expressed in pain, bloating, stool retention, nausea and vomiting, as well as signs of stenosis. Also often one of the symptoms is jaundice, darkening of urine, discoloration of feces, developing liver failure. In some cases, diabetes can develop.
Over the last twenty years, the diagnosis of the disease has been carried out using highly informative, minimally invasive methods, which makes it possible to study the ailment very well. Treatment can be effective if the diagnosis is carried out in a timely manner. So, the expert appoints a radiography of organs of the peritoneum, MRI, ultrasound or CT, examination of the ducts of the prostate with the help of an endoscope( fibrogastroduodenoscopy), a biopsy with further histological examination of the sections. The patient himself has to think about the most effective procedures.
The most informative are MRI, CT and ultrasound. Based on the results obtained, it is possible to differentiate the types of cysts. Also, the collection of anamnesis, information about injuries received early, or previous operations, transferred diseases of the prostate cancer( in particular pancreatitis), etc., is of great importance in the diagnosis. Some researchers argue that when suspected of a disease, it is necessary, first of all, to carry out endoscopic retrograde pancreaticocholangiography( ERPHT), which will allow examining the mouth of the duodenum, as well as an enlarged duct of the prostate gland for the presence of pathologies. This method allows you to see abnormal formations of round or oval shape.
Treatment of cystadenoma of the pancreas must begin with stabilizing the level of insulin, which it synthesizes. This contributes to the elimination of weakness, high blood pressure, vomiting and nausea, as well as raising vitality. If the disease manifests itself in severe form, then the treatment is supposed to be only surgically. For this, the following operations are performed:
- Resection, which involves the removal of the affected part of the prostate( head, body or tail).
- Enucleation or vyluschivanie. The essence of the procedure is the complete removal of the neoplasm.
- Resection pancreatoduodenal - removal of the head of the prostate and duodenal ulcer.
- Laparoscopy is the elimination of a small tumor that lies in the tail of the organ.
After the operation, the histological examination of the remote segment is performed.
If the tumor is small and does not cause any inconvenience, doctors perform extraperitoneal drainage. This method involves the introduction into the cavity of the neoplasm of the catheter through which its contents are taken out. As a result, the tumor size becomes smaller. This method is also used in case of infection of the cyst. In some cases, doctors use internal drainage. The essence of the method is to impose an anastomosis between the tumor and the stomach. Through this anastomosis, the contents of the cyst are sucked into the stomach.
After the pancreatic cystadenoma has been removed, the patient undergoes a rehabilitation course. It implies strict adherence to the diet. The doctor recommends that you exclude from the diet acute, fatty and flour dishes for one year. In this period, the patient must take enzymes. For six months, you need to limit physical activity, and you also need to wear an elastic belt at this time. Sanatorium-and-spa treatment will not be superfluous.
Basically, the outlook for the future is favorable. Nine patients out of ten who had been operated on in time are fully recovered. In this case, relapses do not occur, and there are no complications after surgical intervention. But doctors insist that you need to closely monitor your health, as well as the state of the tumor, if necessary, you need to conduct an operation in time. Thanks to this, it is possible to prevent the development of negative consequences in the future.
If the tumor has acquired a malignant character, the operative intervention is supplemented with radiation or chemotherapy. If there is no metastasis, the survival rate is one hundred percent. In the case of metastasis, only half of the patients survive. Therefore, it is necessary to periodically conduct a complete examination of the body and promptly treat the detected disease so that the disease does not become malignant.