RT Book, Section A1 Pucci, Michael J. A1 Yeo, Charles J. A2 Zinner, Michael J. A2 Ashley, Stanley W. A2 Hines, O. Joe SR Print(0) ID 1160045819 T1 Cystic Neoplasms of the Pancreas T2 Maingot's Abdominal Operations, 13e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9780071843072 LK accesssurgery.mhmedical.com/content.aspx?aid=1160045819 RD 2024/11/07 AB The collective phrase “cystic lesions of the pancreas,” typically described on cross-sectional imaging of the abdomen, refers to any cystic neoplasms of the pancreas and/or other cystic lesions, many of which cause “cyst-like” dilatations of the main or side branch pancreatic ducts. Specifically, the descriptor “cystic neoplasms of the pancreas” encompasses a wide variety of pathologic entities of the pancreas with variable malignant potential. The incidence of these cystic neoplasms seems to increase with age, with one autopsy study demonstrating that up to a quarter of elderly individuals harbor cystic lesions of the pancreas at their demise.1 As the use of abdominal computed tomography (CT) and magnetic resonance imaging (MRI) is increasing, cystic lesions of the pancreas are being defined more frequently, with the majority asymptomatic at discovery.2,3 Laffan and colleagues in 2008 estimated the incidence of asymptomatic discovered cysts on abdominal imaging for unrelated diagnoses at 2.6%.4 Some of these lesions will be malignant or have malignant potential at diagnosis, while others are clearly benign and may not warrant further surveillance. Resection of benign cystic pancreas lesions or those containing only high-grade dysplasia (premalignant) leads to nearly universal survival, while surgery for invasive carcinoma associated with cystic neoplasms generally has a more favorable prognosis than the results for resection of typical pancreatic ductal adenocarcinoma.5-7 Thus, careful consideration must be given to the diagnosis and prognostic implications of these lesions. As more becomes known about these neoplasms, the treatment and observation algorithm will continue to evolve to minimize unnecessary interventions, while maximizing the impact of surgical treatment.