Central European Journal of Medicine

, Volume 9, Issue 1, pp 92–107 | Cite as

Pancreatic cysts: etiology, diagnosis and management

  • Beata Jabłońska
Review Article


Pancreatic cysts involve a wide spectrum of pathologies from post-inflammatory cysts to malignant neoplasms. Pancreatic pseudocysts, serous cystadenomas, mucinous cystadenomas, intraductal papillary mucinous neoplasms (IPMNs) and solid pseudopapillary tumors occur most frequently. Differential diagnosis involves the following imaging investigations: transabdominal ultrasonography (TUS), contrast enhanced ultrasonography (CEUS) and endoscopic ultrasonography (EUS), computed tomography (CT), magnetic resonance (MR) and magnetic resonance cholangiopancretography (MRCP), endoscopic retrograde cholangiopancretography (ERCP). The cyst fluid cytology is performed in difficult differential diagnosis between pseudocysts and benign and potentially malignant or malignant tumors. Most frequently, viscosity, amylase, CEA and CA 19-9 levels are determined. Imaging findings should be correlated with cytology. The management depends on the cyst type and size. Small asymptomatic pseudocysts, serous cystadenomas and branchduct IPMNs should be carefully observed, whereas symptomatic large or uncertain serous cystadenomas and cystadenocarcinomas, mucinous cystadenomas and cystadenocarcinomas, main-duct IPMNs and large branch-duct IPMNs with malignant features, serous and mucinous cystadenocarcinomas, and solid pseudopapillary tumors require surgery. Pseudocysts are usually drained. Percutaneous / EUS-guided or surgical cyst drainage can be performed. Complicated and uncertain pseudocysts and cystic tumors need surgical resection. The type of surgery depends on cyst location and size and includes proximal, central, distal, total pancreatectomies and enucleation.


Hyoid bone Pancreas Cyst Pseudocyst Neoplasm Cystadenoma Drainage Resection 



acute necrotic collection


acute peripancreatic fluid collection




contrast enhanced ultrasonography


computer tomography


endoscopic retrograde cholangiopancretography


European Society of Gastrointestinal Endoscopy


endoscopic ultrasonography


BR endoscopic ultrasonography guided cytology brushing


ine needle aspiration


intraductal papillary mucinous neoplasm


mucinous cystadenoma


magnetic resonance cholangiopancretography


magnetic resonance imaging


Natural Orifice Translumenal Endoscopic Surgery


serous cystadenoma


solid pseudopapillary neoplasm


solid pseudopapillary tumor


transabdominal ultrasonography


walled-off necrosis


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© Versita Warsaw and Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Department of Digestive Tract SurgeryMedical University of SilesiaKatowicePoland

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