Clinicopathologic features and outcomes of pancreatic cysts during a 12-year period

Pancreas. 2013 Mar;42(2):230-8. doi: 10.1097/MPA.0b013e31826ae31a.


Objective: Pancreatic cysts are being detected more frequently with advances in abdominal imaging. We designed this study to identify the characteristics of pancreatic cysts upon long-term follow-up and to define the proper management of them.

Methods: We identified 1386 patients diagnosed with pancreatic cysts at our hospital from 1999 to 2010 and analyzed clinicopathologic data including radiological findings.

Results: At initial diagnosis, 515 patients (37.2%) were classified as being at high-risk for malignancy, and 247 patients (17.8%) underwent surgery identifying 128 borderline or malignant cysts (51.8%). Borderline or malignant cysts were associated with older age, male sex, elevated serum level of lipase, carcinoembryonic antigen (CEA) or carbohydrate antigen 19-9 (CA 19-9), and a dilated pancreatic duct. Long-term follow-up for at least 24 months revealed that most of cystic lesions unchanged in size but malignant transformation was observed in 7 patients.

Conclusions: Most lesions with low or indeterminate risk did not changed in size during follow-up period, but one fifth of high-risk lesions were identified as borderline or malignant after surgery. Surgical resection should be performed in patients with high-risk cysts considering their clinical condition, and radiological follow-up of nonsurgically managed cysts should be continued for more than 6 years.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood
  • Cell Transformation, Neoplastic / metabolism
  • Cell Transformation, Neoplastic / pathology*
  • Chi-Square Distribution
  • Disease Progression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatectomy
  • Pancreatic Cyst / blood
  • Pancreatic Cyst / complications*
  • Pancreatic Cyst / diagnostic imaging
  • Pancreatic Cyst / pathology*
  • Pancreatic Cyst / therapy
  • Pancreatic Neoplasms / blood
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / etiology*
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery
  • Prognosis
  • Radiography
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Young Adult


  • Biomarkers, Tumor