Pancreatic Cystic Lesions in Children: A Comprehensive Scoping Review.

Racha T Khalaf, Jacob A Mark, Marco Del Chiaro, Yuhua Zheng, Andrew T Trout, Michael J Wilsey, Travis L Piester, Jaimie D Nathan, Salvador Rodriguez Franco, Maisam Abu El-Haija

Journal: Pancreas 2025;54(2):e150-e165

PMID: 39928893

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Abstract

OBJECTIVE

Pediatric pancreatic cystic lesions (PPCLs) are uncommon and differ from adult pancreatic cystic lesions. Literature is limited on the etiologies, evaluation, and management of PPCL. A multidisciplinary working group formed to provide a comprehensive description of PPCL and recommend best available evidence-based evaluation and management.

MATERIALS AND METHODS

The PPCL working group performed a scoping review by 2 methods: 1) a targeted literature review to describe PPCL and 2) a systematic literature review for management recommendations for PPCL. The systematic review was completed using a 2-stage sifting approach: title and abstract screening followed by a full text review.

RESULTS

One hundred thirty-one studies were included in the systematic review and an additional 20 were included in the targeted search to complete a comprehensive list of PPCL. Five neoplastic PPCL and 10 nonneoplastic PPCL were identified, and prevalence of different cystic lesions differs widely in adults and children. Recommendations on evaluation and management of PPCL are presented based on best available evidence.

CONCLUSIONS

We present a comprehensive review and evidence-based management recommendations with management algorithms for pediatric pancreatic cystic lesions. Given the rarity of many of these entities, this review also highlights many aspects of PPCL, which are not adequately described in the current literature.

Address: From the Digestive Health Institute, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO.; Gastroenterology, Hepatology and Nutrition, Children's Hospital Los Angeles, Los Angeles, CA.; Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado.; Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, FL.; Department of Radiology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH.; Department of Pediatrics, Division of Gastroenterology Seattle Children's Hospital and University of Washington, Seattle, WA.; Division of Pediatric Gastroenterology, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, OH.; Department of Pediatric Gastroenterology, Johns Hopkins All Children's Hospital, St. Petersburg, FL.

DOI: 10.1097/MPA.0000000000002407

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MeSH Terms: Humans, Pancreatic Cyst, Child, Pancreatic Neoplasms, Pancreas, Evidence-Based Medicine, Child, Preschool