Interdisciplinary Management of Cystic Neoplasms of the Pancreas

Table 1

Characteristics of common pancreatic cysts.

	Pseudocyst	IPMN	MCN	SCA
Gender (male : female)	1 : 1	2 : 1	0.5 : 9.5	1 : 4
Age range (yr)	40–70	60–80	30–50	60–80
Imaging features
(i) Communication with main duct	Variable	Yes	No	No
(ii) Location	Any	Head/uncinate—50%	Body/tail—90%	Variable
Cyst fluid analysis
(i) Amylase	High (>250 U/L)	High (>250 U/L)	Low (<250 U/L)	Low (<250 U/L)
(ii) Mucin	Low	High	High	Low
(iii) CEA (elevated: >192 ng/mL)	Low	Elevated	Elevated	Low
Malignant potential	No	Yes	Yes	No
Features suggestive of malignancy	None	Main duct > 10 mm,; Branch duct:  solid component, mural nodule, cytology suspicious or positive for malignancy	Larger than 6 cm, solid component, mural nodule	None
Incidence of invasive cancer (%)	0	MD-IPMN:  40–50; BD-IPMN:  15	12	Very rare
Treatment	Observation; Resection if symptomatic	Resection: MD-IPMN; Resection or surveillance:  BD-IPMN based on presence of features suggestive of malignancy and comorbid disease	Resection	Resection if symptomatic