Beobachtung zystischer Pankreastumoren

At least 1 out of 40 adults without pre-existing pancreatic disease has a pancreatic cyst. Hence prophylactic resection of every cystic lesion is not a viable approach. However, in the total group of pancreatic cysts, mucinous cystic neoplasms are found in women aged 40–60 years and intraductal papillary mucinous neoplasms (IPNM) are more frequent in the group over 60 years old. Both entities bear a relevant potential of malignancy requiring a careful work-up including case history and qualified examinations with endoscopic ultrasound or magnetic resonance imaging. Using the diagnostic algorithm presented here the risk for an individual patient can be assessed. A resection of the cyst is recommended in cases of main duct IPNM, obstructive jaundice, cysts with solid parts and a lesion size of more than 3 cm. Even below this size increased attention is warranted in certain cases. For the majority of patients only one or a few control examinations are sufficient. After partial resection of the pancreas follow-up studies are necessary in cases of IPNM due to the risk of recurrence.