Pancreatic Cysts: A Systematic Approach and Second Look

Background Pancreatic cysts are relatively rare, but constitute an important disease entity that poses a challenge with clinical, radiological, and pathological differential diagnosis. Methods New attention has been drawn to pancreatic cysts given their potential cure rates with resection. However, preoperative distinction between neoplastic and benign lesions needs further study for effective strategies in identification and management. The role and safety of cystic fluid analysis remains to be clarified in this context. Results The presence of mural nodules is a significant indicator for malignancy; however, size as a reliable predictor remains controversial. Specific criteria are required with particular focus on the histologic subtype of pancreatic lesions. Conclusion We review recent developments in the understanding and management of cystic lesions of the pancreas.