Pancreatic Cysts

Pancreatic cysts are fluid filled sacs in the pancreas. Most of the pancreatic cysts are not cancerous, but some can progress to cancer. Small cysts usually do not cause symptoms, and are found accidentally by image studies for other reasons.

Types of pancreatic cysts

  • Pseudocyst. This type of cyst usually comes from pancreatits. After pancreatitis, the normal draining structure is destroyed. However, some remaining pancreatic tissue continues to secret pancreatic fluids, which accumulate in the scar tissue and forms this type of cyst. Since the cyst wall is from scar tissue and not from the pancreas, it is called pseudocyst.
  • Serous cystadenoma. It is usually found in middle-aged women and rarely progresses to cancer.
  • Mucinous cystadenoma. Most of the mucinous cystadenoma locates in the body or tail of the pancreas and frequently found in middle-aged women. This type of cyst has great risk of cancer.
  • Intraductal papillary mucinous neoplasm (IPMN). IPMN is frequently found in the head of the pancreas in middle-aged men. It secrets excessive amount of thick mucus. Some IPMNs are located at the branches of the main duct, the others grow from the main duct. Main duct IPMNs carry great risk of cancer. Although branch IPMN also has cancer risk, it is much less than main duct IPMNs.
  • Solid pseudopapillary tumor of the pancreas. This type of cyst is rare and mostly found in young Asian and black females. It can become cancer.

Symptoms and Signs

The symptoms are related to the type, location, and size of the cyst. Small cyst may not cause any symptoms at all. The most common symptoms and signs are:

  • Abdominal pain or discomfort
  • Fullness
  • Nausea
  • Vomiting
  • Jaundice
  • Fever and chills

Diagnosis and Treatment

Diagnosis of pancreatic cyst is based on clinical presentation and one or more of the follow tests:

  • Blood works
  • Abdominal ultrasound
  • CT
  • MRI/MRCP
  • ERCP
  • EUS

Treatment depends on the size, type, and symptoms of the cyst. Small, asymptomatic, and benign may not need any treatment except close observation. The following modalities are used for treatment of pancreatic cyst:

  • Close observation with periodic image study
  • Endoscopy drainage
  • ERCP
  • EUS
  • Surgery

References:

  1. PubMed Health.
  2. Wikipedia.
  3. Mayo clinic online health information.
  4. Sleisenger and Fordtran's Gastrointestinal and Liver Disease- by Mark Feldman MD, et al.
  5. The Little Black Book of Gastroenterology-by David W. Hay.
  6. Principles of Clinical Gastroenterology by Tadataka Yamada, et al.


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