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Jani N, Bani Hani M, Schulick RD, et al. Diagnosis and management of cystic lesions of the pancreas. Diagn Ther Endosc. 2011;2011:478913doi: 10.1155/2011/478913.
Jani, N., Bani Hani, M., Schulick, R. D., Hruban, R. H., & Cunningham, S. C. (2011). Diagnosis and management of cystic lesions of the pancreas. Diagnostic and therapeutic endoscopy, 2011478913. https://doi.org/10.1155/2011/478913
Jani, Niraj, et al. "Diagnosis and management of cystic lesions of the pancreas." Diagnostic and therapeutic endoscopy vol. 2011 (2011): 478913. doi: https://doi.org/10.1155/2011/478913
Jani N, Bani Hani M, Schulick RD, Hruban RH, Cunningham SC. Diagnosis and management of cystic lesions of the pancreas. Diagn Ther Endosc. 2011;2011:478913. doi: 10.1155/2011/478913. Epub 2011 Aug 22. PMID: 21904442; PMCID: PMC3166757.
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Diagn Ther Endosc. 2011;2011:478913. doi: 10.1155/2011/478913. Epub 2011 Aug 22.

Diagnosis and management of cystic lesions of the pancreas.

Diagnostic and therapeutic endoscopy

Niraj Jani, Murad Bani Hani, Richard D Schulick, Ralph H Hruban, Steven C Cunningham

Affiliations

  1. Department of Medicine, Saint Agnes Hospital, Baltimore, MD 21229, USA.

PMID: 21904442 PMCID: PMC3166757 DOI: 10.1155/2011/478913

Abstract

Pancreatic cysts are challenging lesions to diagnose and to treat. Determining which of the five most common diagnoses-pancreatic pseudocyst, serous cystic neoplasm (SCN), solid pseudopapillary neoplasm (SPN), mucinous cystic neoplasm (MCN), and intraductal mucinous papillary neoplasm (IPMN)-is likely the correct one requires the careful integration of many historical, radiographic, laboratory, and other factors, and management is markedly different depending on the type of cystic lesion of the pancreas. Pseudocysts are generally distinguishable based on historical, clinical and radiographic characteristics, and among the others, the most important differentiation is between the mucin-producing MCN and IPMN (high risk for cancer) versus the serous SCN and SPN (low risk for cancer). EUS with FNA and cyst-fluid analysis will continue to play an important role in diagnosis. Among mucinous lesions, those that require treatment (resection currently) are any MCN, any MD IPMN, and BD IPMN larger than 3 cm, symptomatic, or with an associated mass, with the understanding that SCN or pseudocysts may be removed inadvertently due to diagnostic inaccuracy, and that a certain proportion of SPN will indeed be malignant at the time of removal. The role of ethanol ablation is under investigation as an alternative to resection in selected patients.

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