One pancreatic cystic lesion It is a fluid-filled lesion that appears in the pancreas. Many are discovered incidentally when having an ultrasound, CT scan or MRI for another reason and do not always imply a serious illness.
There are different types of pancreatic cystic lesions. Some are benign and barely require monitoring, while others may present precancerous changes or have a higher risk of evolving into a malignant tumour. For this reason, it is important to correctly identify their characteristics.
In many cases they do not produce symptoms. When they appear, they can be related to:
- Abdominal pain or discomfort: especially if the lesion reaches a considerable size.
- Feeling of fullness: due to pressure on nearby structures.
- Pancreatitis: some types of cystic lesions can be associated with episodes of inflammation of the pancreas.
- Symptoms resulting from complications: less common and generally associated with larger lesions or specific characteristics.
Practical example: an incidentally discovered cyst
A person can have a abdominal MRI due to non-specific digestive discomfort, and discovered a small cystic lesion in her pancreas, despite her having previously shown no related symptoms.
Finding a lesion of this type it does not automatically mean that there is pancreatic cancer. The next step is to examine its size, location, appearance and relationship with the pancreatic duct in order to determine what type of lesion it is and whether it requires monitoring or further tests.
Pancreatic cystic lesions and the risk of malignancy
Not all cystic lesions of the pancreas behave in the same way. These include the pseudocysts, usually related to pancreatitis, the serous cystadenomas, generally benign, and mucinous lesions such as intraductal papillary mucinous neoplasms (IPMN) or the mucinous cystic neoplasms, which may present potential for malignant transformation.
To distinguish between them, imaging tests such as the magnetic resonance imaging and magnetic resonance cholangiopancreatography (MRI/MRCP). In certain cases, a Ecoendoscopia, which allows the lesion to be studied in greater detail and, when indicated, fluid to be obtained from the cyst for analysis.
A common misconception following the detection of a pancreatic cystic lesion is that all such lesions require surgery. In reality, the course of action depends on the type of lesion, its size, its characteristics, its evolution and the individual risk. Some simply require regular check-ups, whilst others require closer monitoring or treatment.