Pancreatic cyst

Not to be confused with Pancreatic pseudocyst.
Pancreatic cyst
SpecialtyGastroenterology
SymptomsUsually asymptomatic. In some cases abdominal pain, jaundice, weight loss[1]
ComplicationsPancreatitis, pancreatic cancer
TreatmentSurgical resection for high risk cysts
Relative incidences of various pancreatic neoplasms, with cysts annotated at center right.[2] Also, non-neoplastic cysts include pseudocyst, retention cyst, benign epithelial cysts, lymphoepithelial cysts, squamous lined cysts (dermoid cyst and epidermal cyst in intrapancreatic accessory spleen), mucinous nonneoplastic cysts, and lymphangiomas.[3]

A pancreatic cyst is a fluid filled sac within the pancreas. The prevalence of pancreatic cysts is 2-15% based on imaging studies, but the prevalence may be as high as 50% based on autopsy series.[1] Most pancreatic cysts are benign and the risk of malignancy (pancreatic cancer) is 0.5-1.5%. Pancreatic pseudocysts and serous cystadenomas (which collectively account for 15-25% of all pancreatic cysts) are considered benign pancreatic cysts with a risk of malignancy of 0%.[1]

Causes range from benign to malignant. Pancreatic cysts can occur in the setting of pancreatitis, though they are only reliably diagnosed 6 weeks after the episode of acute pancreatitis.

Main branch intraductal papillary mucinous neoplasms (IPMNs) are associated with dilatation of the main pancreatic duct, while side branch IPMNs are not associated with dilatation. MRCP can help distinguish the position of the cysts relative to the pancreatic duct, and direct appropriate treatment and follow-up. The most common malignancy that can present as a pancreatic cyst is a mucinous cystic neoplasm.

  1. ^ a b c Gonda, Tamas A.; Cahen, Djuna L.; Farrell, James J. (5 September 2024). "Pancreatic Cysts". New England Journal of Medicine. 391 (9): 832–843. doi:10.1056/NEJMra2309041. PMID 39231345.
  2. ^ Wang Y, Miller FH, Chen ZE, Merrick L, Mortele KJ, Hoff FL; et al. (2011). "Diffusion-weighted MR imaging of solid and cystic lesions of the pancreas". Radiographics. 31 (3): E47-64. doi:10.1148/rg.313105174. PMID 21721197.{{cite journal}}: CS1 maint: multiple names: authors list (link)
    Diagram by Mikael Häggström, M.D.
  3. ^ Kim YS, Cho JH (2015). "Rare nonneoplastic cysts of pancreas". Clin Endosc. 48 (1): 31–8. doi:10.5946/ce.2015.48.1.31. PMC 4323429. PMID 25674524.