Incidentally detected cystic lesions of the pancreas on CT: review of literature and management suggestions

• Published in: Abdominal imaging 2013-04, Vol.38 (2), p.331-341
• Main Authors: Zaheer, Atif, Pokharel, Sajal S., Wolfgang, Christopher, Fishman, Elliot K., Horton, Karen M.
• Format: Article
• Language: English
• Subjects: Benign; Computed tomography; Cystadenoma, Mucinous - diagnostic imaging; Cystadenoma, Serous - diagnostic imaging; Cysts; Endosonography; Gastroenterology; Hepatology; Humans; Imaging; Incidental Findings; Medicine; Medicine & Public Health; Pancreas; Pancreatic Cyst - diagnostic imaging; Pancreatic Cyst - physiopathology; Pancreatic Cyst - therapy; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - physiopathology; Pancreatic Pseudocyst - diagnostic imaging; Pancreatic Pseudocyst - therapy; Pancreatitis; Radiology; Tomography, X-Ray Computed - methods; Ultrasound
• ISSN: 0942-8925; 2366-004X; 1432-0509; 2366-0058
• DOI: 10.1007/s00261-012-9898-y

Purpose To facilitate a better understanding of incidentally noted cystic pancreatic lesions, since these lesions often pose a challenge regarding appropriate management. Methods This article reviews pathophysiology, prevalence, significance, and recommendations for management of the various pancreatic cystic lesions. Illustrative cases are demonstrated. Results Diagnostic benign lesions can be left alone. Cross-sectional imaging can be used to follow-up benign appearing lesions and to stage more aggressive ones. Endoscopic ultrasound with fine needle aspiration and cyst fluid analysis can be performed on certain indeterminate lesions. Lesions with high malignant potential should undergo resection. Conclusions A better understanding of the variety of incidentally detected pancreatic cystic lesions can help direct appropriate management.