Pancreatic Cysts

Excerpt

The pancreas is an important organ in the digestive system that produces enzymes for digestion and releases important hormones into our circulation that helps with metabolism. Pancreatic cysts are often detected in patients undergoing imaging with either CT or MRI for unrelated reasons due to a combination of an aging population and the overall increased use of imaging. Pancreatic cysts are identified in 2% to 20% of patients undergoing CT or MRI; however, these rates can be lower in those with no history of pancreatitis.,, On the other hand, these rates can increase to nearly one-third of patients in high-risk populations with a family history of pancreatic cancer.,

These cysts can be either neoplastic or nonneoplastic. Neoplastic cysts include intraductal papillary mucinous neoplasms (IPMN), mucinous cystic neoplasm, solid pseudopapillary neoplasm, and cystic pancreatic neuroendocrine tumors. IPMNs can be subclassified as main duct IPMN, branch duct IPMN, and mixed IPMN. Nonneoplastic cysts include serous cystic adenoma, simple cysts, lymphoepithelial cysts, and mucinous nonneoplastic cysts. Correct diagnosis is important as management drastically changes if the cyst is neoplastic or nonneoplastic.

Moreover, surgical resection is not always the best option for all pancreatic cysts as resection can be complicated and have many risks associated with it. Depending on the cyst type, growth pattern, and symptoms, surveillance can sometimes be the best option. Moreover, with the ever-growing concern about pancreatic cysts and their risk of malignancy, new advances, such as endoscopic ultrasound, have greatly improved surveillance and proper diagnosis to guide treatment options.