Pancreatic apudomas: Diagnostic problems and surgical treatment [Gli apudomi pancreatici: approccio diagnostico ed opzioni terapeutiche]

Pancreatic apudomas are rare neoplasms with different biological characteristics, which present problems for early diagnosis and consequent curative surgical treatment. Ecography and TC scanning rarely allow the recognition and accurate location of these neoplasms, particularly at an early stage: consequently, invasive techniques, such as digital angiography, selective celiac and meseraic arteriography and trans-hepatic-portal catheterism are requested. Surgery is the therapeutic approach of choice: conservative or demolitive operations are performed according to the stage, location and extention of the neoplasms, which sometimes have a wide local diffusion so that only palliative biliary and digestive divertions are allowed. The authors report their experience of two cases of pancreatic apudomas, describing their diagnostic approach and surgical treatment.