Pancreatic Cancer pp 1125-1139 | Cite as

Management of Cystic Neoplasms of the Pancreas

  • Cristina R. Ferrone
  • Carlos Fernandez-del Castillo
  • Andrew L. Warshaw
Reference work entry


The classification and management of cystic neoplasms of the pancreas has changed dramatically over the past 30 years. The pathologic differential diagnosis of this heterogeneous group of lesions began in 1978 with landmark publications by Compagno and Oertel [1,2]. Serous cystic lesions, mucinous cystic lesions and intraductal papillary mucinous neoplasms (IPMNs) together comprise about 90% of cystic neoplasms of the pancreas. Serous cystadenomas are indolent slow-growing tumors which are firm, well-circumscribed, and multinodular. Mucinous cystic neoplasms (MCNs) have an ovarian-like stromal layer and encompass a wide spectrum from benign lesions with malignant potential to aggressive carcinomas. These lesions demonstrate histologic heterogeneity, with benign-appearing and malignant epithelia in almost every lesion. One of the most common lesions identified in the pancreas is the IPMN. Of the two variants the main duct IPMNs are more aggressive than the branch duct IPMNs. Currently, incidentally discovered cysts comprise up to 71% of cystic lesions identified. The management of cystic lesions has evolved from resection of all lesions, to selective resection or close follow-up with imaging, due to the improved understanding of the natural history of these lesions. This chapter will address the surgical management of serous cystic lesions, mucinous cystic lesions and IPMNs.


Cystic Lesion Main Pancreatic Duct Cystic Neoplasm Intraductal Papillary Mucinous Neoplasm Massachusetts General Hospital 
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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Cristina R. Ferrone
    • 1
  • Carlos Fernandez-del Castillo
    • 1
  • Andrew L. Warshaw
    • 1
  1. 1.Massachusetts General HospitalBostonUSA

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