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home - Pancreas - Pancreatic Cancers - Pancreatic Cysts Overview Written by Dr Sebastian Zeki
Knowledge


Knows the presentation investigation and staging of pancreatic
cancer

Recognises the importance of considering and being able to identify
uncommon pancreatic tumours (such as neuroendocrine or
intrapapillary mucinous tuours)

Knows the range of potential therapies and recognises the factors
that make such tumours potentially operable or inoperable

Knows the prevalence and natural history of benign cysts/serous
cystadenoma and potentially malignant cystic lesions

Knows the options for palliative treatment
Skills
Shows ability to sequence investigations appropriately
Understands value of multi-disciplinary team
Recognises the importance of considering possibility that the tumour
is unusual

Behaviours
Communicates effectively within the multi-disciplinary team and with
the patient and their family

Pancreatic Cysts Overview

DiagnosisTriple phase CT is the most useful test.EUS alone is not accurate enough.EUS FNA has a good specificity, and a poor sensitivity.EUS-FNA with tumour markers increases accuracy but can’t determine the need for surgery.Send cyst fluid for cytology(if glycogen rich= serous cystadenoma, but can be false negative), DNA and CEA.If an ERCP is done, a patulous pancreatic orifice exuding mucous is specific but not sensitive.For small incidental/ asymptomatic cysts may be reasonable to repeat imaging in 1 year. Pancreatic Cysts Differential Congenital Cysts: von Hippel-lindau syndrome.APCKD. Simple cysts Simple (true or retention) cysts of the pancreas are small, developmental, fluid-containing spaces lined by normal duct and centroacinar cells.They are usually incidental findings which are of no clinical signif-cance and can be left untreated. Primary Cystic Neoplasms Pancreatic pseudocysts Written by Dr Sebastian Zeki

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