Pancreatic Cancer pp 1131-1156 | Cite as

Management of Cystic Neoplasms of the Pancreas Including IPMNs

  • C. Tjaden
  • Thilo Hackert
  • Markus W. Büchler
Reference work entry


The management of cystic pancreatic lesions fundamentally depends on knowing the cyst type and the risk or presence of malignancy. Only serous cystic neoplasms (SCN) are generally benign lesions, while mucinous cystic neoplasms (MCN) and intraductal papillary mucinous neoplasms (IPMN) as the most common cystic lesion and solid-pseudopapillary neoplasm (SPN) show different risk profiles for the development of invasive cancer. Once a cystic lesion is detected, the clinical decision is necessary if an upfront resection with the inherent morbidity of pancreatic surgery should be performed or if an observational management can be preferred. Whereas these strategies are clearly defined for certain cystic lesions including SCN, MCN, and SPN, the management of IPMN, especially with regard to the branch-duct type, remains partly controversial, and current guidelines differ with regard to indications for surgery and/or surveillance. The present chapter gives an overview on the different types of pancreatic cystic neoplasms and current diagnostic modalities. Furthermore, the indications for surgery, the variety of surgical resections, and the surveillance/follow-up strategies are discussed in the light of the current literature and guidelines.


Intraductal papillary mucinous neoplasm Mucinous cystic neoplasm Serous cystic neoplasm Solid-pseudopapillary neoplasm 



American Gastroenterological Association


Branch duct


Caudal-related homeobox transcription factor


Computer tomography


Endoscopic retrograde cholangiopancreaticography


Endoscopic ultrasound


Fine needle aspiration


International Association of Pancreatology


Intraductal papillary mucinous neoplasm


Kirsten rat sarcoma viral oncogene homolog


Mucinous cystic neoplasm


Main duct


Magnetic resonance cholangiopancreaticography


Magnetic resonance imaging


Mucin protein


Neuroendocrine cyst of the pancreas


Pancreatic intraepithelial neoplasm


Pancreatic ductal adenocarcinoma


Serous cystic neoplasm


Solid-pseudopapillary neoplasm


von Hippel-Lindau


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of General, Visceral and Transplantation SurgeryHeidelberg University HospitalHeidelbergGermany
  2. 2.Department of General, Visceral and Transplantation SurgeryUniversity of HeidelbergHeidelbergGermany

Section editors and affiliations

  • James L. Abbruzzese
    • 1
  • Raul A. Urrutia
    • 2
  • John Neoptolemos
    • 3
  • Markus W. Büchler
    • 4
  1. 1.Duke University Medical CenterDurhamUSA
  2. 2.Mayo Clinic Cancer CenterMayo ClinicRochesterUSA
  3. 3.Division of Surgery and OncologyUniversity of LiverpoolLiverpoolUK
  4. 4.Department of General, Visceral and Transplantation SurgeryUniversity of HeidelbergHeidelbergGermany

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