Endoscopic ultrasound features of pancreatic serous cystic neoplasms: a single-center experience

Abstract

Aims: Currently, preoperative diagnostic accuracy for serous cystic neoplasms (SCNs) of the pancreas is still suboptimal. Endoscopic ultrasound (EUS) offers high-resolution imaging for pancreatic cystic lesions, enabling precise characterization supporting SCNs. We presented EUS features of distinct SCN subtypes, enhancing precise diagnosis preoperatively. Material and methods: This single-center retrospective study was conducted at a tertiary center. We analyzed the clinical, radiological and EUS characteristics of patients with pathologically proved SCN from January 2019 to July 2024. Results: A total of 18 patients were collected. The average age was 49.50 years. 15 out of 18 cases (83.3%) were identified incidentally. Microcystic type accounted for the majority (n=10, 55.6%), followed by macro-cystic type (n=5, 27.8%) and solid type (n=3, 16.6%). No significant differences in radiological imaging were observed among subtypes (p>0.05). EUS features including cyst wall thickening, intra-cystic echogenicity, intralesional vascularity and internal septations, demonstrated significant variations across SCN subtypes (p<0.05). Notably, the stellate scar was a hallmark feature for the microcystic subtype. Conclusions: EUS demonstrates the superior capability in characterizing subtle SCN features, allowing for further subtype classification. Integration of EUS into preoperative diagnostic protocols should be considered for individualized surgical planning.