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Familial pancreatic cancer (FPC) is a rare, mostly autosomal hereditary hereditary cancer whose genetic cause has not yet been clearly determined. In recent years, several national case collections have been established, including the FaPaCa registry. The aim was to detect the genetic causes and to examine high-risk individuals (HRP) of FPC families in an early detection program. Ideally, small PDAC and, even better, their high-grade precursor lesions could be detected early to achieve a cure if possible. MRI and endosonography are among the preferred examination methods. In the context of these early detection programs, extrapancreatic incidental tumors of benign and malignant nature are often detected in the screening of asymptomatic individuals. The aim of the presented study was to investigate how many of the HRP in the FaPaCa program show extrapancreatic benign and malignant incidentalomas and how the spectrum of incidentalomas differs from the findings in other screening programs. Therefore, the MRI and endosonographic findings of the FaPaCa program were evaluated retrospectively.
In 213 of 268 (79.5%) HRPs examined, at least one extrapancreatic incidentaloma was found during participation in the screening program. The most frequent random findings of the collective included liver cysts (37.3%) and kidney cysts (28.0%). Most of these incidentalomas have no clinical relevance, malignant tumours or findings that need further intervention are rare (<3%). The benign incidentalomas found do not differ significantly in their entity and frequency from those found in other FPC screening programs and in studies in asymptomatic subjects.
Participants in screening programs should be informed before the start of screening that the tests may detect incidentalomas, which may also have diagnostic and therapeutic consequences. Guidelines exist to facilitate the handling of such incidentalomas in imaging examinations, which should be used to manage the respective incidentaloma depending on its localisation.