title: Overview of the investigation and management of cystic neoplasms of the pancreas.
abstract: BACKGROUND
  Cystic neoplasms of the pancreas contribute to 10-20% of pancreatic tumours. Malignant cystic tumours of the pancreas behave similar to adenocarcinomas and thus warrant aggressive management. However, certain benign cystic neoplasms do not require operative intervention. It is, therefore, important to differentiate benign lesions from malignant lesions and from those with malignant potential.
  
  
  OBJECTIVE
  To provide an overview of the role of radiological investigations in the management of cystic neoplasms of the pancreas, with emphasis on the characteristic features of aggressive tumours. The role of different imaging modalities is discussed, and an investigative algorithm suggested.
  
  
  METHODS
  A literature review was carried out on Medline, Cochrane library, and PubMed using the MeSH terms 'pancreas' and 'cysts' to source relevant papers. Search criteria were limited to English literature, meta-analyses, systematic reviews, prospective and retrospective case series, published during or after 1998.
  
  
  CONCLUSIONS
  Each pancreatic cystic lesion has characteristic radiological findings. However, the diagnostic accuracy of individual imaging techniques is still limited. A combination of imaging modalities is essential for preoperative diagnosis. CT complemented by endoscopic ultrasound and cyst fluid analysis appears to be the most promising investigation in diagnosing cystic neoplasms. Follow-up with serial imaging is useful for lesions of uncertain aetiology.
authors.affiliation: Hepatobiliary Unit, Mater Hospital, Belfast, UK. robert.spence@gmail.com
authors.forename: Robert A J
authors.initials: RA
authors.lastname: Spence
authors.forename: Bobby
authors.initials: B
authors.lastname: Dasari
authors.forename: Mark
authors.initials: M
authors.lastname: Love
authors.forename: Barry
authors.initials: B
authors.lastname: Kelly
authors.forename: Mark
authors.initials: M
authors.lastname: Taylor
mesh_terms: D003536:Cystadenocarcinoma / Q000175:diagnosis* / Q000601:surgery; D003537:Cystadenoma / Q000175:diagnosis* / Q000601:surgery; D019160:Endosonography; D006801:Humans; D008279:Magnetic Resonance Imaging; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D010192:Pancreatic Pseudocyst / Q000175:diagnosis* / Q000601:surgery; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed