-
Gastrointestinal Endoscopy Clinics of... Jul 2023
Topics: Humans; Magnetic Resonance Imaging; Pancreatic Cyst; Pancreatic Neoplasms
PubMed: 37245942
DOI: 10.1016/j.giec.2023.04.009 -
Gastroenterology Apr 2015
Topics: Adenocarcinoma; Asymptomatic Diseases; Carcinoma, Pancreatic Ductal; Disease Management; Gastroenterology; Humans; Incidental Findings; Pancreatic Cyst; Pancreatic Neoplasms; Risk Assessment; Societies, Medical
PubMed: 25805375
DOI: 10.1053/j.gastro.2015.01.015 -
Digestive Diseases and Sciences Jul 2017
Topics: Humans; Pancreatic Cyst; Pancreatitis, Chronic
PubMed: 28523572
DOI: 10.1007/s10620-017-4613-z -
Current Gastroenterology Reports Jun 2018The goal of this review is to critically analyze the current literature regarding the management of incidental pancreatic cysts. Given their increased rates of detection... (Review)
Review
PURPOSE OF REVIEW
The goal of this review is to critically analyze the current literature regarding the management of incidental pancreatic cysts. Given their increased rates of detection due to the frequent use of cross-sectional imaging, correctly identifying the subset of high risk lesions that are appropriate for surgical resection is critical. However, the existing consensus and societal guidelines discussed in this review lack high quality data to create evidence-based recommendations, making achieving this important aim challenging.
RECENT FINDINGS
Several recent studies have focused on the natural history of pancreatic cysts and defining the role of endoscopic ultrasound, which remains unclear. EUS-guided diagnostic tools include molecular analysis of obtained fluid; EUS-guided FNA, FNB, and intracystic forceps biopsy of the cyst wall; and confocal endomicroscopy. While their precise role in diagnosing pancreatic cystic neoplasms remains to be defined, they represent promising innovations that may play a future role in cyst assessment and management. Large, long-term, prospective studies of incidentally identified pancreatic cysts are essential to fully understand their natural history and potential for neoplastic progression. Given the absence of such data at present, an individualized patient approach is recommended.
Topics: Humans; Incidental Findings; Pancreatic Cyst
PubMed: 29886564
DOI: 10.1007/s11894-018-0638-5 -
Advances in Anatomic Pathology Nov 2022Pancreatic cysts are increasingly detected on imaging studies. Accurate determination of the type of cyst is important to provide appropriate care for patients. It is... (Review)
Review
Pancreatic cysts are increasingly detected on imaging studies. Accurate determination of the type of cyst is important to provide appropriate care for patients. It is also very clear that not one single modality can provide adequate diagnostic information for pancreatic cysts. A multimodal approach to the diagnosis of pancreatic cyst is the key. This review will highlight how to approach to fine-needle aspiration of pancreatic cysts. The review will also highlight salient features of common neoplastic pancreatic cysts along with the use of ancillary testing which includes biochemical testing, commonly utilized molecular tests, and/or immunohistochemical tests to provide an accurate diagnosis.
Topics: Humans; Biopsy, Fine-Needle; Pancreatic Neoplasms; Pancreatic Cyst; Immunohistochemistry
PubMed: 36306184
DOI: 10.1097/PAP.0000000000000378 -
Radiologic Clinics of North America Jul 2021Incidental pancreatic cysts are commonly encountered in radiology practice. Although some of these are benign, mucinous varieties have a potential to undergo malignant... (Review)
Review
Incidental pancreatic cysts are commonly encountered in radiology practice. Although some of these are benign, mucinous varieties have a potential to undergo malignant transformation. Characterization of some incidental pancreatic cysts based on imaging alone is limited, and given that some pancreatic cysts have a malignant potential, various societies have created guidelines for the management and follow-up of incidental pancreatic cysts. This article reviews the imaging findings and work-up of pancreatic cysts and gives an overview of the societal guidelines for the management and follow-up of incidental pancreatic cysts.
Topics: Diagnostic Imaging; Humans; Incidental Findings; Pancreas; Pancreatic Cyst
PubMed: 34053609
DOI: 10.1016/j.rcl.2021.03.010 -
Gastrointestinal Endoscopy Clinics of... Jul 2023Pancreatic cysts are an increasingly identified entity with significant health care implications. Although some cysts present with concurrent symptoms that often require... (Review)
Review
Pancreatic cysts are an increasingly identified entity with significant health care implications. Although some cysts present with concurrent symptoms that often require operative intervention, the advent of improved cross-sectional imaging has heralded an era of increased incidentally detected pancreatic cysts. Although the rate of malignant progression in pancreatic cysts remains low, the poor prognosis of pancreatic malignancy has driven recommendations for ongoing surveillance. A uniform consensus has not been reached on the management and surveillance of pancreatic cysts leading clinicians to grapple with the burden of how best to approach pancreatic cysts from a health, psychosocial, and cost perspective.
Topics: Humans; Pancreatic Cyst; Pancreatic Neoplasms
PubMed: 37245931
DOI: 10.1016/j.giec.2023.03.001 -
The American Journal of Gastroenterology Jul 2017The management of patients with pancreatic cysts, especially presumed branch duct intraductal papillary mucinous neoplasms (BD-IPMNs), remains a challenge. BD-IPMNs...
The management of patients with pancreatic cysts, especially presumed branch duct intraductal papillary mucinous neoplasms (BD-IPMNs), remains a challenge. BD-IPMNs carry a very low risk of malignancy and occur in predominantly older individuals who often die from causes not related to their pancreatic disease. The specific decision to stop surveillance of presumed low risk BD-IPMNs (those without either worrisome features (WF) or high risk stigmata (HRS)) is controversial, and needs to balance the real risk of malignancy or developing malignancy and IPMN-related mortality, with the patient's life expectancy, quality of life expectations, and mortality from non-pancreatic-related causes. With improved life expectancy, improved survival from non-pancreatic malignancies, rising health costs, and growing detection of ever smaller presumed BD-IPMNs, this issue is becoming ever more critical.
Topics: Adenocarcinoma, Mucinous; Carcinoma, Pancreatic Ductal; Humans; Pancreatic Cyst; Pancreatic Ducts; Pancreatic Neoplasms; Quality of Life
PubMed: 28725064
DOI: 10.1038/ajg.2017.163 -
Journal of Clinical Ultrasound : JCU Mar 2021To assess sonographic characteristics and outcome of patients with pancreatic cystic lesions seen by ultrasound.
OBJECTIVES
To assess sonographic characteristics and outcome of patients with pancreatic cystic lesions seen by ultrasound.
METHODS
From our ultrasound electronic reporting database we identified all patients in which "pancreatic cyst" or "pancreatic cysts" were reported from 1995 to 2018. In patients with more than one sonogram, the first was used for our study. For each case, we recorded sonographic characteristics, maximal diameter, cyst location, and results of follow-up ultrasound, CT or magnetic resonance imaging, as well as patient sex, age, relative clinical history, and endoscopic ultrasound (EUS) or surgical findings when available.
RESULTS
Our study included 177 patients of whom 121 were female (68.4%). Mean age at diagnosis was 65 (±16, SD, range 22-99). Ultrasound was the initial diagnostic test in 122 (68.9%). Mean diameter of the index cyst was 13.7 mm (±11.5 mm, SD, range 2-91 mm). Among 177 index cysts, 155 were simple and 22 complex. Three complex cysts were surgically resected, yielding a primary pancreatic malignancy, a metastasis, and an epithelial-lined cyst. One simple cyst was resected, yielding a benign intraductal papillary mucinous neoplasm. Seventeen patients underwent EUS showing six mucinous cysts and 11 nonmucinous cysts. One hundred-eighteen patients had follow-up imaging for a mean time of 5.6 years (±3.8, range 0.25-21 years). One patient was presumed to have primary pancreatic cancer. The overall rate for primary pancreatic malignancy was 1.7% (2/118).
CONCLUSIONS
Cystic pancreatic lesions seen on ultrasound are most often benign, with a low risk of pancreatic malignancy. Ultrasound is an excellent method to follow-up these cysts.
Topics: Adult; Aged; Aged, 80 and over; Endosonography; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Pancreatic Cyst; Young Adult
PubMed: 33305462
DOI: 10.1002/jcu.22960 -
Digestive Diseases and Sciences Jul 2017With increased utilization and ongoing advancements in cross-sectional abdominal imaging, the identification of a pancreatic cyst has become a frequent finding. While... (Review)
Review
With increased utilization and ongoing advancements in cross-sectional abdominal imaging, the identification of a pancreatic cyst has become a frequent finding. While many pancreatic cysts are associated with a benign clinical course, others may transform into pancreatic ductal adenocarcinoma. However, distinguishing a benign from a malignant pancreatic cyst or pancreatic cyst with malignant potential on the basis of standard clinical findings, imaging parameters and ancillary studies can be challenging. Hence, a significant interest within the past decade has been the identification of novel biomarkers to accurately classify and prognosticate a pancreatic cyst. Within this review, we discuss novel DNA, miRNA, protein and metabolite biomarkers, and their relevance in clinical practice. In addition, we focus on future areas of research that have the potential to change pancreatic cyst management.
Topics: Biomarkers; DNA; Humans; MicroRNAs; Pancreatic Cyst; Proteins
PubMed: 28197742
DOI: 10.1007/s10620-017-4491-4