What to do for the incidental pancreatic cystic lesion?
BACKGROUND
Incidental pancreatic cysts are identified in 1% of all patients undergoing CT scans of the abdomen for whatever reason. The aim of this review was to provide an overview of the current evidence relating to the investigation and management of these lesions.


METHODS
PubMed was searched to identify relevant studies relating to the investigation and management of incidentally discovered pancreatic cystic lesions.


RESULTS
Initial investigation of incidentally discovered pancreatic cysts should be with either specific pancreas protocol CT or contrast enhanced MRI with MRCP. The diagnostic yield of these investigations can be increased with the addition of EUS/FNA and cyst fluid analysis in appropriately selected patients. Surgical intervention may be indicated in otherwise fit patients who are identified as having mucinous neoplasms.


CONCLUSIONS
Applying a systematic approach to the investigation of incidentally discovered pancreatic cysts means that in the majority of cases cyst aetiology can be accurately determined and appropriate management plans developed.
HPB Unit, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK. Electronic address: s.m.robinson@ncl.ac.uk.
S M
SM
Robinson
Radiology Department, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK.
J
J
Scott
HPB Unit, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK.
K W
KW
Oppong
HPB Unit, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK.
S A
SA
White
D014408:Biomarkers, Tumor / Q000097:blood*; D049448:Cholangiopancreatography, Magnetic Resonance; D003937:Diagnosis, Differential; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D019160:Endosonography; D006801:Humans; D033162:Incidental Findings; D025202:Molecular Diagnostic Techniques; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000175:diagnosis* / Q000628:therapy*; D010180:Pancreatectomy; D010181:Pancreatic Cyst / Q000175:diagnosis*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D057832:Watchful Waiting
D014408:Biomarkers, Tumor
Endoscopic ultrasound; Intraductal papillary mucinous neoplasm; Mucinous cystic neoplasm; Pancreatic cyst; Serous cystic neoplasm