Most pancreatic cysts develop for no apparent reason and are discovered by chance during a scan
done for another purpose. Advances in the imaging studies as well as the increased frequency of
health screening these days have increased the number of pancreatic cysts detected.
Fortunately, most pancreatic cysts are benign (non-cancerous) and unlikely cause symptoms or harm.
But some are pre-cancerous and can develop into pancreatic cancer. The characterization and management of these cysts is a challenge as there is a significant overlap in the features of benign and pre-cancerous cyst. Thus, it is important to find out what type of cyst you have.
Types of Pancreatic Cysts
There are many types of pancreatic cysts. Common ones include:
- These are mostly made of fluid and can start in or next to the pancreas.
- A common complication of acute pancreatitis (inflammation of the pancreas)
Serous cystadenomas (SCAs)
- Almost all SCAs are benign
- They may cause pain, jaundice, or cause abdominal discomfort as they grow
Intraductal Papillary Mucinous Neoplasms (IPMNs)
- These start in the ducts that connect the pancreas to the intestine
- Most common type of pre-cancerous cyst. They produce large amounts of proteins that form mucus (mucin) in the cyst lining and fluid
- It’s difficult to predict if and when an IPMN will become cancerous - thus these require careful evaluation and follow-up
Mucinous Cystic Neoplasms (MCNs)
- These are pre-cancerous growths that are more common in the body & tail of the pancreas.
- More common in women rather than men
When you come to Surgical Associates with a diagnosis of a possible pancreatic cyst, we will review your medical history and imaging tests thoroughly together, including if there is a family history of pancreatic or other gastrointestinal cancers such as stomach, gallbladder, or liver cancer. This can make a difference in the risk of the cyst becoming cancerous over time.
Additional tests to further evaluate the cyst may include:
- Blood Tests: Tumor markers – CA 19-9, CEA, Liver function tests
- Imaging Studies: Computed Tomography (CT), Magnetic Resonance Imaging (MRI)/MRCP
- Others: Endoscopic ultrasound (EUS) +/- Biopsy (if necessary) - this involves taking a sample of the pancreatic cyst tissue and/or fluid to examine the risk of cancer
Being told you have a cyst in your pancreas can be unsettling. Usually, these cysts kind of are
harmless and doesn’t need to be removed or actively treated in any way.
However, if it is deemed that the cyst has suspicious or worrisome features, in another words, it harbours cancerous cells or a risk of becoming a cancer – Surgery may be recommended to confirm the diagnosis and to treat it definitely as well.
It is important to monitor the cysts carefully over time, since they may to a point where it’s best to surgically remove them.
To find out more, please consult our pancreas specialist here.
Senior Consultant Hepatopancreatobiliary Surgeon
MBBS, MMed (Surgery), MSc, FAMS, FRCSEd
Prior to private practice, Dr Lee Ser Yee was a founding member and Senior Consultant at the Department of Hepatopancreatobiliary (HPB) and Transplant Surgery at Singapore General Hospital (SGH). He served as the Director of the Laparoscopic programme and the Director of the Surgical Skills Training Program and the SingHealth Surgical Skills Centre.
He started his medical training at the National University of Singapore in 1996 and completed his training in General Surgery, HPB surgery and Liver Transplantation at SGH and National Cancer Centre, Singapore.
He also completed dual USA-fellowships in Advanced Laparoscopic HPB surgery and Liver Transplantation under Professor Daniel Cherqui at the New York Presbyterian Hospital-Weill Cornell Medical Center and a Complex Surgical Oncology clinical fellowship at Memorial Sloan Kettering Cancer Center in New York.