Overview

Cystic neoplasms of the pancreas are abnormal fluid-filled sacs that can be benign or malignant. They vary in their biological behavior and management approaches.

1. Serous Cystadenoma

Serous cystadenoma is a benign neoplasm characterized by the presence of multiple small cysts. They are typically asymptomatic and more common in women.

• Symptoms: Often asymptomatic; may cause abdominal pain if large.
• Diagnosis: Imaging (CT or MRI) shows small cysts; fluid is usually clear.
• Treatment: Surgical resection is rarely necessary unless symptomatic.

2. Mucinous Cystadenoma

Mucinous cystadenoma is a neoplasm that produces thick, mucinous fluid. These lesions can become malignant and are more common in women.

• Symptoms: Abdominal pain, nausea, and potentially jaundice.
• Diagnosis: Imaging shows a unilocular or multilocular cyst; cytology may reveal mucin.
• Treatment: Surgical resection is usually indicated due to the risk of malignancy.

3. Intraductal Papillary Mucinous Neoplasm (IPMN)

IPMN is a cystic neoplasm arising from the pancreatic duct that secretes mucin. It can be classified as main duct or branch duct type.

• Symptoms: Abdominal pain, jaundice, and pancreatitis-like symptoms.
• Diagnosis: MRI or CT shows dilated pancreatic duct; endoscopic ultrasound may help.
• Treatment: Surgical resection for high-risk lesions; surveillance for low-risk cases.

4. Solid Pseudopapillary Tumor (SPEN)

SPEN is a rare pancreatic tumor, often found in young women. It has a low malignant potential but can be aggressive.

• Symptoms: Abdominal pain, nausea, and a palpable abdominal mass.
• Diagnosis: Imaging shows a well-circumscribed mass; histology shows solid and cystic areas.
• Treatment: Surgical resection is the treatment of choice, with good prognosis in most cases.