Pancreatic cysts are fluid-filled sacs within the pancreas. They are usually discovered when patients undergo abdominal imaging because of other various reasons. They are a heterogeneous group of pancreatic cysts that include intraductal papillary mucinous neoplasms and other rare cyst lesions.
Pancreatic cysts manifest with different biological behaviors and variable risks of progression to malignancy.
Diagnosis of Pancreatic Cysts
During the diagnosis of pancreatic cysts, medical health providers use a computed tomography (CT) or magnetic resonance imaging (MRI) scans to confirm their presence and their type.
Specialists at times resort to using an endoscopic sound procedure because the imaging scans (CT and MRI) cannot identify the type of cysts or if the cyst has a concerning appearance. The endoscopic ultrasound procedure involves passing a tube called an endoscope through the patient’s mouth and past the stomach. With this intervention, these images can identify features on the cyst’s wall.
They use the endoscope to perform a biopsy, whereby the device guides a needle into the cyst to collect cell samples and fluid, whereby the cells are then tested to determine if the cyst is cancerous. Various substances like amylase, mucin, and other substances that might indicate cancer such as a carcinoembryonic antigen, are tested in the fluid.
Types of Pancreatic Cysts
- Pseudocysts: Inflammatory cysts of the pancreas are known as pancreatic pseudocysts. These cysts of the pancreas come as a result of inflammation of the pancreas (pancreatitis). In most cases, pseudocysts that result from acute pancreatitis resolve without treatment within several weeks.
However, pseudocysts that persist beyond six weeks causing symptoms such as obstruction of the stomach and pain, need treatment. - True cysts: This is a closed structure, a lining of cells that separates from the nearby tissue. Note that a pseudocyst isn’t closed and lacks a lining of epithelial cells separating it from the nearby tissue.
Types of true cysts include:
- Serous cystadenomas: Are mostly benign and occur commonly in middle-aged women.
- Mucinous cystadenomas: They also commonly occur in middle-aged women. Thirty percent of these cysts contain cancer and those that don’t contain cancer are considered precancerous.
- Intraductal papillary mucinous neoplasm (IPMN): There’s a high likelihood of these cysts becoming cancerous. These cysts are more common in middle-aged men and are commonly located in the head of the pancreas.
- Solid pseudopapillary tumor of the pancreas: These types of tumors are rare and have both solid and cyst components. They are commonly found in Young Asian and black women.
Causes of Pancreatic Cysts
- Chronic inflammatory conditions
- Gallstones
- Alcoholism
- Trauma
- Surgery
- Blockage of ducts in the body that cause fluids to build up.
- An injury that breaks a vessel
- Genetic conditions
- Tumors
Symptoms Pancreatic Cysts
In most cases, patients may not present aby symptoms from pancreatic cysts, which are often found when imaging tests of the abdomen are done for other reasons.
In the event where signs of pancreatic cysts do occur, they typically include:
- Persistent abdominal pain
- Nausea and vomiting
- Weight loss
- Feeling full soon after you start eating
Treatment of Pancreatic Cysts
Doctors treat pancreatic cysts based on the classification categories they are based on. Pancreatic cysts are divided into categories based on their potential to be cancerous. The categories of these cysts range from precancerous for instance those that have mucin, low, moderate, or high risk based on various features.
Low-risk cysts do not need any specific treatment and can usually be checked from time to time using imaging scans. Moderate-risk cysts may need endoscopic ultrasound monitoring, imaging scans, or a combination of both.
High-risk cysts usually show suspicious features like solid cyst walls which might indicate cancer. Therefore, for high-risk cysts, removal of the cyst and part of the pancreas is mostly recommended.
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