Misdiagnosis of cystic pancreatic tumors during a 30-year study period

Abstract

Background: Cystic pancreatic tumors are increasingly found in medical practice. The aim of this study was to examine the prevalence of misdiagnosis of these lesions and the factors associated with preoperative misdiagnosis. Methods: A retrospective analysis included 66 patients treated in the Clinic for Digestive Surgery, Clinical Center of Serbia, from 1983 to 2013. We included all patients with biopsy-confirmed cystic pancreatic tumors during the study period. We analyzed preoperative parameters, intraoperative and postoperative data of examined patients. Based on the preoperative diagnosis and the biopsy findings, patients were divided into two groups: correct preoperative diagnosis and misdiagnosis. Results: Prevalence of misdiagnosis was 34.85%. Average age was 45.3 ± 16.9 years, 54 (81.8%) were females. Patients with misdiagnosis had significantly higher odds of being older (Odds ratio [OR]: 1.06, 95% Confidence interval [CI]: 1.01–17.86), to present with symptoms of nausea or vomiting (OR: 5.85, 95% CI: 1.49–23.00), to have a clinically palpable tumor (OR: 4.64, 95% CI: 1.21–17.86), and to have received the diagnosis in the period between 1992 and 2003. Conclusion: During the 30-year study period, more than one third of the patients in our study had a misdiagnosis preoperatively. The likelihood of misdiagnosis was higher among older patients, patients with symptoms of nausea or vomiting, patients with a clinically palpable tumor, and patients treated during the period between 1992 and 2003. The decline in the prevalence of misdiagnoses should be expected, due to advances in imaging methods and their availability, which are increasing significantly. © 2020, Springer-Verlag GmbH Austria, part of Springer Nature.