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Neoplastic pancreatic cysts
Background
Overview
Definition
Neoplastic pancreatic cysts are abnormal, fluid-filled sacs in the pancreas that have the potential to develop into tumors.
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Pathophysiology
Neoplastic pancreatic cysts are usually caused by genetic mutations and abnormal cell growth. Mutations in genes such as KRAS and GNAS have been detected in pancreatic fluid samples.
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Epidemiology
The incidence of neoplastic pancreatic cysts in the US is estimated at 31.3 per 100,000 person-years.
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Risk factors
Risk factors for pancreatic cysts include advancing age, male sex, tobacco use, familial history of pancreatic cancer, and specific genetic syndromes.
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Disease course
Clinical manifestations include symptoms like abdominal pain, jaundice, unexplained weight loss, and new-onset diabetes. However, many of these cysts are asymptomatic and are incidentally discovered on routine cross-sectional imaging.
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Prognosis and risk of recurrence
The prognosis varies depending on their biological behavior and potential for progression to malignancy. Routine surveillance of pancreatic cysts without high-grade dysplasia or malignancy at surgical resection is not recommended, as these cysts have a lower risk of progression.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of neoplastic pancreatic cysts are prepared by our editorial team based on guidelines from the American College of Radiology (ACR 2020), the American College of Gastroenterology (ACG 2018), the American Society for Gastrointestinal Endoscopy (ASGE 2016), and the American Gastroenterological Association (AGA 2015).
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