OBJECTIVE The purpose of this study was to update a previous study of cystic neoplasms of the pancreas (PCNs) conducted in Korea by the authors.

METHODS Clinicopathologic data and factors associated with malignancy were evaluated from PCNs originating from the exocrine pancreas diagnosed between January 1993 and June 2005 in 30 university hospitals throughout Korea.

RESULTS A total of 1064 pathologically confirmed PCNs, which consisted of the following diagnoses, were collected: intraductal papillary mucinous neoplasm (IPMN), 436; mucinous cystic neoplasm (MCN), 268; solid pseudopapillary neoplasm (SPN), 195; serous cystic neoplasm (SCN), 162; acinar cell cystic neoplasm 2; and mature teratoma, 1. No malignant SCNs were diagnosed. In IPMN, advanced age, pancreatic head involvement, and hyperbilirubinemia were associated with malignancy based on multivariate analysis. In MCN, pancreatic head involvement was associated with malignancy based on multivariate analysis.

CONCLUSIONS Intraductal papillary mucinous neoplasms were the most common PCN observed in Korea. Solid pseudopapillary neoplasms were observed more frequently than those in studies from western countries. In IPMNs, advanced age was associated with malignancy, suggesting an adenoma-carcinoma sequence. Involvement of the pancreatic head was associated with malignancy in both IPMNs and MCNs, possibly warranting prompt surgical interventions.