Pancreatic cysts are fluid-filled, sacks or pockets located in the pancreas. Most pancreatic cysts are found during unrelated imaging tests of the stomach and abdomen, and do not cause symptoms. The most common type of pancreatic cysts are Intraductal Papillary Mucinous Neoplasms (IPMNs), other types of pancreatic cysts include:
- Intraductal Papillary Mucinous Neoplasms (IPMN): These cysts continue a mucous-like fluid. They are defined as “pre-cancerous”; however, only a small subset will develop into pancreatic cancer. Due to this possibility, careful evaluation is recommended, and long-term follow-up is generally recommended. Surgery may be an option for patients with a high risk IPMN.
- Mucinous cystadenoma: These mucinous cysts are also considered “pre-cancerous”. They are typically found in women and often have a characteristic appearance.
- Pseudocysts: These non-cancerous cysts develop in patients with a history of acute or chronic pancreatitis. The cysts are lined with scar or inflammatory tissue. In some situations these cysts can become very large and require drainage.
- Serous cystadenoma: This is a rare type of cyst that has characteristic test findings. Although they do not change into cancer, they typically grow slowly over time. Depending on the size and location, this growth can produce symptoms or problems for some patients.
- Other: There are several other types of pancreatic cysts that are rare.
Causes of pancreatic cysts
The cause of most pancreatic cysts is unknown. Some cysts are associated with rare illnesses including von Hippel-Lindau disease, a genetic disorder that can affect the pancreas and other organs.
Pseudocysts often follow a bout of a painful condition in which digestive enzymes become prematurely active and irritate the pancreas (pancreatitis). Pseudocysts can also result from injury to the abdomen, such as from a car accident.
Symptoms of pancreatic cysts
The vast majority of cysts do not cause symptoms. However, for cysts that are large, symptoms could potentially include:
- Difficulty eating full sized meal
- Acute pancreatitis
- Jaundice (a condition where the skin turns a yellow color)
Diagnosis of pancreatic cysts
Due to improved imaging technology, pancreatic cysts are more frequently identified during scanning tests performed for other conditions. Next, an evaluation is recommended to determine the potential connection with symptoms and the risk of pancreatic cancer. One of the following tests may be recommended to provide additional information to make management decisions:
- Medical history- A previous abdominal injury or pancreatitis may indicate a pseudocyst.
- CT scan - provides detailed information about the structure of a pancreatic cyst.
- MRI imaging - gives additional information on the characteristics of the cyst, such as whether it has solid components.
- Endoscopic ultrasound (EUS) - Along with a detailed image of the cyst, the EUS allows for diagnostic aspiration of cyst fluid to detect possible signs of cancer. Fluid from cysts and samples of tissue also can be obtained by passing special needles through the endoscope and into the cysts.
Treatment of pancreatic cysts
Most cysts may be periodically monitored; however, if there are concerning findings, then surgical resection may be recommended.
- Small cysts (<10 millimeters) can be imaged with a CT or MRI scan after 1-2 years after being discovered, and then less frequently if they remain unchanged.
- An endoscopic ultrasound may be recommended for larger cysts.
Treatment options include:
- Surgical procedures for removal of cysts that are at high risk for pancreatic cancer.
Why choose Ohio State for treatment of pancreatic cysts?
Recognized by U.S. News & World Report as one of the nation's highest performing hospitals in gastroenterology and GI surgery, The Ohio State University Wexner Medical Center takes a multidisciplinary team approach to pancreatic disease. Physicians and other health care professionals in gastroenterology, radiology, and pancreatic surgery review each patient’s condition and make recommendations as to how cysts should be managed.
The specialists in the Division of Gastroenterology, Hepatology, & Nutrition are dedicated to treating pancreatic diseases. Our gastroenterologists are experts in the performance of advanced endoscopic procedures. Many of them not only treat patients, but also conduct research to advance care and treatment for those with pancreatic cysts.