Diagnosis and management of cystic pancreatic lesions

AJR Am J Roentgenol. 2013 Feb;200(2):343-54. doi: 10.2214/AJR.12.8862.


Objective: The purpose of this review is to outline the management guidelines for the care of patients with cystic pancreatic lesions.

Conclusion: The guidelines are as follows: Annual imaging surveillance is generally sufficient for benign serous cystadenomas smaller than 4 cm and for asymptomatic lesions. Asymptomatic thin-walled unilocular cystic lesions smaller than 3 cm or side-branch intraductal papillary mucinous neoplasms should be followed up with CT or MRI at 6 and 12 months interval after detection. Cystic lesions with more complex features or with growth rates greater than 1 cm/year should be followed more closely or recommended for resection if the patient's condition allows surgery. Symptomatic cystic lesions, neoplasms with high malignant potential, and lesions larger than 3 cm should be referred for surgical evaluation. Endoscopic ultrasound with fine-needle aspiration (FNA) biopsy can be used preoperatively to assess the risk of malignancy.

Publication types

  • Review

MeSH terms

  • Diagnosis, Differential
  • Diagnostic Imaging*
  • Humans
  • Pancreatic Cyst / diagnosis*
  • Pancreatic Cyst / therapy*
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / therapy*
  • Practice Guidelines as Topic*