Pancreatic Cyst
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Incidental Pancreatic Cyst
Algorithms
ANY Incidental Pancreatic Cyst in patient >80 y/o
<1.5cm Incidental Pancreatic Cyst
1.5 - 2.5cm Incidental Panc Cyst WITH Main Duct communication
1.5 - 2.5cm Incidental Panc Cyst W/O (or indeterminate) Main Duct communication
ACG Guidelines (Gastroenterology)
"Worrisome Features"
- Cyst >= 3cm long axis
- Thickened/enhancing cyst wall
- Nonenhancing mural nodule
- Main pancreatic duct >= 7mm at thickest point
"High-Risk Stigmata"
- Obstructive jaundice with cyst in head of pancreas
- Enhancing solid component within cyst
- Main pancreatic duct >=10mm in absence of obstruction
Growth Definition
- Size <0.5cm: 100% increase in long axis diameter
- >0.5 and <1.5cm: 50% increase in long axis
- >1.5cm: 20% increase in long axis
Things to Report
- Morphology and location
- Size
- Possible communication with MPD
- Presence of "worrisome features" or "high-risk stigmata"
- Growth on f/u exam
- Multiplicity