Pancreatic Cysts: Causes, Symptoms and Treatment

Pancreatic cysts are a rare condition that is asymptomatic. They are diagnosed by chance in many cases.

Last update: 10 September, 2022

The pancreas is a gland located behind the stomach, whose Its main function is to synthesize hormones related to glucose metabolism.. In addition, it releases enzymes that participate in digestion. It can be affected by different pathologies that alter its functioning, such as pancreatic cysts.

A pancreatic cyst is a closed, fluid-filled cavity that is lined by epithelial cells. They can be located anywhere in the pancreas and be made up of different types of tissue. In addition, it is important to note that they could be located on the pancreas or inside the organ.

Fortunately, most have benign behavior, so they do not include cancer cells. However, a small percentage becomes malignant.

Types of pancreatic cysts

Cysts in the pancreas can be divided into two large groups: pseudocysts and cysts themselves. The main difference between the two is that the former are not covered with epithelial cells. Instead, they have a layer of fibrous tissue around them.

Pancreatic pseudocysts are the most common tumors in the pancreas, and may appear in up to 90% of cases, according to some statistics. The remaining 10% is divided among the different types of pancreatic cysts:

  • Serous cystadenoma: It is a tumor with a benign behavior, so the risk of cancer is very low. However, it has the ability to increase in size, compress other organs and cause abdominal pain.
  • Mucinous cystadenoma: It is a cyst that appears with great frequency in the tail of the pancreas. It has the ability to become malignant, so proper monitoring should be done.
  • Papillary cystic tumor: also know as Franz’s tumor, is a neoplasm that usually affects young women and is unlikely to become cancerous. Its location is usually the tail of the pancreas.
  • Intraductal papillary mucinous neoplasm: This tumor is located in the main pancreatic duct, obstructing it in many cases. The neoplasm can be both precancerous and cancerous.
The pancreas is an endocrine and exocrine gland. That is, it produces substances that go into the blood and the digestive tract.


Symptoms

Most people with pancreatic cysts are asymptomaticTherefore, its diagnosis is usually made by chance. The symptoms that appear are nonspecific and are usually due to compression of other organs.

In this sense, some associated signs are the following:

  • Nausea and vomiting.
  • Persistent pain in the upper abdomen.
  • Jaundice or yellowish color of skin and mucous membranes.
  • Palpable mass in the upper abdomen.

For its part, intraductal papillary mucinous neoplasia can also generate symptoms similar to those of chronic or acute pancreatitis. Also, other symptoms may appear as the disease progresses, such as weight loss, dyspepsia, and anorexia. Some people even develop diabetes mellitis.

What can be its causes?

Pancreatic cysts do not usually have a specific cause. Pseudocysts may be related to pancreatitis or some other inflammatory process of the gland. This is because digestive enzymes, such as amylase, become activated and irritate the pancreas.

On the other hand, tumors can also be associated with rarer genetic pathologies, such as polycystic kidney disease or von Hippel-Lindau disease. In fact, studies showed that 47% of people with the latter had pancreatic cysts.

Diagnosis

The diagnosis of pancreatic cysts is made by chance in many cases. In general, it is common to detect the alteration when imaging tests are performed in search of other pathologies.

Once the cyst is detected, the specialist should indicate the performance of other tests to study the characteristics. In addition, they will allow you to determine the best therapeutic behavior.

Some of the most useful tests are:

  • Magnetic resonance.
  • Computed tomography.
  • Abdominal ultrasound.
  • Endoscopic ultrasound.
  • Magnetic resonance cholangiopancreatography.
  • Endoscopic retrograde cholangiopancreatography (ERCP).

Magnetic resonance imaging is one of the imaging tests that offers the most information., since it detects small cysts and changes that suggest malignancy. For its part, endoscopic ultrasound and ERCP are useful for differentiating malignant and benign tumors because they allow samples to be taken for biopsies.

With magnetic resonance it is possible to locate small pancreatic cysts and in locations that are difficult to access.


Treatment of pancreatic cysts

The treatment of a cyst in the pancreas will depend on its size, the symptoms it causes and the possibility of malignancy. Most pseudocysts go away on their own, so the approach option is medical follow-up.

For its part, drainage may be necessary when the cyst is very large or generates uncomfortable symptoms for those who suffer from it. Drainage of pancreatic cysts can be done endoscopically, laparoscopically, or through the skin surface.

Surgical resection of the tumor will always be the preferred option in case of large cysts or with obvious risk of becoming malignant. All cells in the cyst must be removed during surgery to prevent recurrence.

In the case of malignant tumors, chemotherapy can also be useful.

A pathology with a favorable prognosis

The prognosis for pancreatic cysts and pseudocysts is positive in most cases. Let us remember that these are pathologies that tend to be benign and that disappear on their own. Furthermore, complications, such as cyst rupture and portal hypertension, are very rare.

In case you are diagnosed with a cyst in the pancreas, the first thing you should do is remain calm. It is a very simple condition to treat and does not usually represent a risk to life.

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