Can Pancreatic Cysts Turn Into Cancer? What to Know

Some pancreatic cysts can develop into cancer but most do not. There are many different types of pancreatic cysts, the majority of which are benign and do not cause any problems. However, the doctor needs to know if it is a mucinous cyst, as some of these can transform slowly into pancreatic cancer. Others, like serous cystadenomas, are benign, though they may still be followed up with scans. Again, it depends on the type of cyst, its size and the presence of any “high risk features”. Are pancreatic cysts cancerous? No, only some of them are, and with good diagnostic tools your doctor can tell you which type you have.

For Dr. Sandeep Nayak, who provides cancer treatment in Bangalore, the first step is to classify the cyst into different types. “Some of the pancreatic cysts are pseudocysts which occur after an episode of pancreatitis and are not malignant. Others are serous cystic neoplasms, which are benign. But mucinous cystic neoplasms and IPMNs have the potential to transform into cancer and hence need to be observed closely. We use MRI to monitor the cysts and at times obtain a sample of the fluid by performing Endoscopic Ultrasound to classify them into different types. Majority of the pancreatic cysts need to be just observed and scanned from time to time. However, a few of them may need to be surgically removed based on characteristics like presence of solid components, dilated main pancreatic duct, rapid growth and presence of jaundice.”

• Different types of pancreatic cysts exist. Pseudocysts after pancreatitis are benign. Serous cystadenomas are benign as well. Mucinous cystic neoplasms as well as IPMNs have the potential to transform into cancer. Our page on pancreas and bile duct tumours covers the surgical side.
• Pain in the upper back or abdomen, nausea, early satiety, weight loss, jaundice or recurrent episodes of pancreatitis are unusual symptoms of pancreatic cysts and require assessment.
• Team MACS Surgeons can review your reports for pancreatic cysts and advise whether you need nothing more than monitoring or indeed an operation.

• Many cysts are monitored by repeat MRI scans at set time intervals. The length of follow-up varies between the guidelines and needs to be discussed with your doctor as to what is recommended for you.
• For the diagnosis of pancreatic cysts, besides clinical assessment, various investigations like MRI of the pancreas with assessment of the pancreatic duct by means of MRCP, endoscopic ultrasound with fine-needle aspiration of the fluid and measurement of blood CA 19-9 levels are used by the pancreatic cancer surgeons.
• A pancreatic cyst is removed when it has high-risk features. The type of operation, such as a Whipple’s pancreatic resection, pancreas tail removal or other operation, depends on the position of the cyst within the pancreas. This is typically discussed by a tumour board.
• Surgery for pancreatic cysts can be performed as keyhole surgery in some cases, depending on the location of the cyst. We have written a separate blog about minimally invasive surgery which explains more about this.

When considering surgery for a pancreatic cyst there is no single criterion that is used. Often a number of points are considered and a balance struck.

• The type of cyst. If a mucinous cystic neoplasm is diagnosed, it is generally recommended for removal by surgery if the patient is fit enough for the operation. However, most serous cysts need no surgery at all.
• Size and growth on imaging: important features are increasing size (>3cm), wall thickness, presence of a solid component, main pancreatic duct dilatation (>10mm) and change in size over time. Additionally, an increase in CA 19-9 levels, an episode of pancreatitis or development of diabetes mellitus are considered as indicators for resection.
• High risk features. These include jaundice, a solid component greater than 5mm, a dilated pancreatic duct greater than 10mm and fluid cytology showing suspicious cells.
• Age and overall health: The patient’s age and general health will be taken into account as major surgery for the removal of the pancreas is involved and will need to be balanced against the risk posed by the cyst.
• Your preference for best management options after being fully informed of the pros and cons for each strategy as well as the implications of follow-up by regular scanning.

• Most pancreatic cysts are benign, i.e. do not develop into cancer. Only mucinous cysts and some forms of IPMNs have the potential to develop into cancer.
• It is rare for a pancreatic cyst to cause any symptoms at all. A person with a pancreatic cyst typically has no problems until they have jaundice, new onset of pain or a decline in general health, weight loss or repeated episodes of pancreatitis.
• Just because you have a pancreatic cyst does not mean you will need surgery. The majority of pancreatic cysts are of no harm and require only follow-up of their scans.
• Follow up even when you are feeling perfectly well and have no complaints. Keep your scheduled scan appointments.
• For any queries regarding your scan please contact the clinic on +91 9482202240.

Reference Links:

• Pancreatic Cystic Lesions in Adults: Diagnosis and Management, BC Medical Journal
• A Review of the Diagnosis and Management of Premalignant Pancreatic Cystic Lesions, PubMed Central
• Humoral Predictors of Malignancy in IPMN: A Review of the Literature, International Journal of Molecular Sciences, PubMed Central
• Identification of Patients With Branch-Duct IPMN and Very Low Risk of Cancer: A Multicentre Study, PubMed Central
• Pancreatic Cystic Lesions, World Gastroenterology Organisation Global Guidelines
• Pancreas & Bile Duct Tumors, MACS Clinic
• Team MACS, MACS Clinic

Disclaimer

Information provided on this site is for education purposes only. You should always consult a medical professional for information on your individual situation.