Diagnosis and management of cystic pancreatic lesions.
OBJECTIVE
The purpose of this review is to outline the management guidelines for the care of patients with cystic pancreatic lesions.


CONCLUSIONS
The guidelines are as follows: Annual imaging surveillance is generally sufficient for benign serous cystadenomas smaller than 4 cm and for asymptomatic lesions. Asymptomatic thin-walled unilocular cystic lesions smaller than 3 cm or side-branch intraductal papillary mucinous neoplasms should be followed up with CT or MRI at 6 and 12 months interval after detection. Cystic lesions with more complex features or with growth rates greater than 1 cm/year should be followed more closely or recommended for resection if the patient's condition allows surgery. Symptomatic cystic lesions, neoplasms with high malignant potential, and lesions larger than 3 cm should be referred for surgical evaluation. Endoscopic ultrasound with fine-needle aspiration (FNA) biopsy can be used preoperatively to assess the risk of malignancy.
Department of Radiology, Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White 270, Boston, MA 02114, USA. dsahani@partners.org
Dushyant V
DV
Sahani
Avinash
A
Kambadakone
Michael
M
Macari
Noaki
N
Takahashi
Suresh
S
Chari
Carlos
C
Fernandez-del Castillo
D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D006801:Humans; D010181:Pancreatic Cyst / Q000175:diagnosis* / Q000628:therapy*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D017410:Practice Guidelines as Topic