Pancreatic Cyst

 MCN - (Mother cyst)

  • >95% in pre-menopausal women
  • Mostly in body and tail of pancreas
  • Thick-walled cyst, lined by Ovarian type stroma. Cyst contains mucinous / hemorrhagic material. Does not communicate with PD (unlike IPMN)
  • 10-20% have in-dwelling cancer
  • One review found - no dysplasia in cysts <3 cm in size
  • LN mets is rare. Distal pancreatectomy usually suffices. 
  • Doesnt result in metachronous lesions. Surveillance isnt really necessary

SCA - (Grandmother cyst)
  • 75% of SCAs seen in post-menopausal women
  • Can be anywhere in pancreas
  • Honeycombing, with tiny cysts containing clear fluid distributed around central scarring. Central scarring may bear calcification in 30% cases
  • Microcystic SCAs can undergo degeneration and become macrocystic variants
  • zero risk of malignancy, but they can continue to grow and cause obstructive symptoms

SPN - (daughter lesion)
- Solid Pseudopapillary Neoplasm
  • 90% of lesion occur in young women, in teens / twenties
  • Anywhere in pancreas
  • Solid / Solid-cystic lesions
  • Requires surgery. Excellent (>98%) 5 year survival!






Source: ACG Guideline / Sleisenger txt book


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