Pancreatic cysts are found in about 3-15% of the US population. The likelihood of pancreatic cysts increases with increasing age(1).
How Long Will It Take To Recover From Pancreatic Cysts?
Reaching an accurate diagnosis is of utmost importance as neoplastic pancreatic cysts, especially the mucinous type has an increased risk of transforming into adenocarcinoma(1).
The recovery from pancreatic cysts depends primarily on the accurate diagnosis followed by the type of cyst, size of the cyst, the morphology of the cyst, age of the patient, and type of treatment modality taking into consideration the algorithm for pancreatic cyst management(2).
About 80% of the pancreatic cysts are pseudocysts, which develop after an episode of acute or chronic pancreatitis, and size ranges from 2-20 cm. Generally, small pseudocysts <4 cm do not require any treatment as they resolve on their own and are asymptomatic; hence, no recovery time is needed. Larger pseudocysts are mildly symptomatic and may require drainage.
Intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm (SCN), and solid pseudopapillary neoplasm (SPN) are the four most common types of pancreatic cystic neoplasms that may require treatment(2).
The management of pancreatic cystic neoplasms depends on whether the lesions are benign, malignant, or have an invasive tendency. IPMN can be managed conservatively or surgically based on the type- main duct (MD) or branch duct (BD) type IPMN. MD-IPMN requires surgical intervention and the BD-IPMN type requires a conservative approach. Patients who are managed with a conservative approach and who do not have symptoms or risk factors predicting malignancy require long term follow up and monitoring of the disease(2).
SCNs are usually benign lesions with a rare chance of malignant transformation. Larger and symptomatic SCNs >4 cm should be resected. MCN invariably needs to be resected as they can show low grade to high grade dysplastic cancerous cells. SPNs are considered low-grade malignant neoplasms and also need to be surgically removed.
How Long Do The Symptoms Last?
Acute pancreatic cyst symptoms go away within a few weeks. The symptoms of pancreatic cysts are varied as they range from being small asymptomatic pancreatic cystic lesions to mild to moderate symptomatic large pancreatic cystic lesions. Patients may present with symptoms of persistent/recurrent abdominal pain, anorexia, early satiety (feeling of fullness), pleural effusion, an abdominal mass (in cases of large cysts), fever, jaundice (yellowing of the eye, dark urine, itching, pale stools), or sepsis of the cyst when infected. Patients may also complain of pancreatitis like symptoms, which include nausea, vomiting, abdominal discomfort, abdominal/back pain, fatigue, and weakness. In cases of malignant carcinoma transformation, patients may also complain of weight loss, diabetes or worsening of diabetes, and jaundice(2).
Cysts are localized collection of fluid with a cystic lining, which may consist of a solid component. They can be found anywhere in the body, and when they are found in the pancreas they are termed as pancreatic cysts. The incidence of asymptomatic pancreatic cysts has increased dramatically after the increase in abdominal imaging done for unrelated causes(1).
Types Of Pancreatic Cysts
Broadly, pancreatic cysts can be classified into non-neoplastic and neoplastic cysts, and based on the type of cystic fluid (serous or mucinous) they can be further divided into mucinous and non-mucinous types. Generally, non-neoplastic pancreatic cysts account for 80% of all pancreatic cysts(2).
In the past, non-neoplastic pancreatic pseudocysts were believed to be more common; however, with an increase in image sensitivity smaller neoplastic cysts are also frequently detected(1). Therefore, it is important to differentiate non-neoplastic cysts from neoplastic cysts and non-mucinous cysts from mucinous cysts as mucinous cysts have the premalignant disposition and may progress to cancer if left unchecked(2).
Non-neoplastic pancreatic cysts can be further divided into
- Congenital cyst or simple cyst
- Retention cyst.
Neoplastic pancreatic cysts are further classified into
Mucinous cystic lesions:
- Intraductal papillary mucinous neoplasm (IPMN)
- Mucinous cystic neoplasm (MCN)
Non-mucinous cystic neoplastic lesions:
- Serous cystic neoplasm
- Solid-pseudopapillary neoplasm
- Cystic neuroendocrine neoplasm
- Acinar-cell cystic neoplasm
Other neoplastic lesions:
- Ductal adenocarcinoma with cystic degeneration
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