A pancreatic cyst is a type of tumor that grows on or in your pancreas. It’s typically liquid inside, with an outer skin. Less than 1% of pancreatic cysts become cancerous, but healthcare providers keep them under surveillance just in case.
A pancreatic cyst is a fluid-filled growth on the inside or outside of your pancreas. There are different types, made of slightly different cellular materials. Some types are neoplastic, and others are nonneoplastic. Neoplastic cysts have the potential to become cancerous. Nonneoplastic types don’t.
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Some pancreatic cysts seem to be related to inflammation (pancreatitis), but most occur for unknown reasons. Most pancreatic cysts won’t cause any problems. Rarely, a neoplastic type of cyst can be the start of pancreatic cancer. This is more likely if you have a family history of pancreatic cancer.
If your healthcare provider discovers a pancreatic cyst on your imaging scan, they’ll classify it right away as low, medium or high risk, based on the image and whether you have symptoms. If it’s low risk, there’s likely nothing to worry about. If it’s medium or high risk, they’ll treat it according to their guidelines.
Most pancreatic cysts will simply go under surveillance. Healthcare providers keep an eye on them to see if they change over time. If a cyst changes from low to medium risk, they’ll take a biopsy to learn more about it. If a cyst changes from medium to high risk, they’ll schedule surgery to remove it.
Studies suggest that approximately 10% of CT scans (computed tomography scans) and MRIs (magnetic resonance imaging) discover pancreatic cysts. They’re usually an accidental finding on imaging tests taken for another reason. Since most pancreatic cysts don’t cause symptoms, we don’t know how many other people might have them without being aware of it.
Less than 1% of pancreatic cysts turn into cancer. But up to 30% of pancreatic cysts have the potential to turn into cancer. This is why healthcare providers keep an eye on them. Most precancerous cysts grow and change very slowly, so regular surveillance is likely to spot cancerous changes early in the process.
Neoplastic (precancerous) cysts are also called pancreatic cystic neoplasms (PCN). They include:
Nonneoplastic (benign) cysts include:
Pancreatic pseudocysts are sometimes mistaken for cysts. A pseudocyst isn’t a growth, however. It’s a pocket of fluid that forms when pancreatic juices leak from your pancreas. Pseudocysts are benign.
Most pancreatic cysts don’t cause any symptoms. They might cause symptoms if they grow large enough to interfere with your pancreatic duct, biliary tract or gastrointestinal (GI) tract. Possible symptoms include:
Pancreatic cysts are abnormal growths, which means that a genetic mutation occurred. But researchers don’t know why these occur. They might be partly hereditary and partly triggered by other factors, like inflammation and aging. A small percentage of cysts directly relate to hereditary conditions.
Hereditary syndromes associated with pancreatic cysts include:
Risk factors associated with pancreatic cysts include:
Complications are rare, but may include:
Healthcare providers diagnose a pancreatic cyst using:
Treatment options include:
Most cysts are treated with surveillance. That means you’ll have periodic imaging scans to check on your cysts. You’ll have EU-FNA and fluid analysis to investigate any suspicious changes. If the results raise concern for cancer, your provider might recommend removal, depending on your fitness for surgery.
Some types of benign cysts may shrink or even disappear on their own, but neoplastic types don’t. Most continue to grow, although very slowly. Healthcare providers watch them to track their growth. As long as they remain small and don’t grow or change significantly, healthcare providers leave them alone.
Different types of pancreatic cysts grow at different rates, but overall, they grow slowly. Healthcare providers become suspicious if a cyst grows more than 3 mm (millimeters) in a year. If they’re watching a cyst for changes, they’ll check it every year, two years or five years, depending on how fast it grows.
Some pancreatic cysts may need to be removed if they cause complications or look suspicious for cancer. But pancreatic surgery comes with its own risks and side effects, so healthcare providers consider each cyst carefully. They follow detailed guidelines to determine when they should intervene.
Some of the factors they consider include:
If your provider recommends cyst removal, this means surgery. Sometimes, a surgeon can carve out the cyst alone from your pancreas, but more often, they need to take a piece of your pancreas with it. They may even need to take pieces of other nearby organs, due to the location of the cyst.
Possible surgical procedures include:
Surgery on your pancreas can affect its ability to function. You need your pancreas to produce certain digestive enzymes and hormones, including insulin. If too many enzyme-producing or insulin-producing cells are removed during your pancreatectomy, you’ll need lifelong therapies to replace them.
Some pancreatectomy procedures also remove or alter other organs. They can affect your digestive system, your biliary system and your immune system. You may have trouble digesting certain foods and absorbing certain nutrients afterward. If you get a splenectomy, you may get sick more often.
Specific side effects can include:
Additional risks of surgery include:
Statistically, a pancreatic cyst is unlikely to cause serious problems. Healthcare providers take pancreatic cysts seriously out of an abundance of caution. They’ll assess your cysts to determine what precautions they should take. While pancreatic surgery is serious, most pancreatic cysts won’t require surgery.
Five-year survival rates after pancreatic cyst surgery are near 100% when the cyst was precancerous or noninvasive. For those with invasive cancer, the five-year survival rate after treatment is approximately 65%-75%, depending on the type of tumor it was. Pancreatic surgery in general has a 4% mortality rate.
You might want to ask:
A note from Cleveland Clinic
The prospect of pancreatic cancer and surgery, even if it’s very small, can evoke a lot of anxiety. But the vast majority of pancreatic cysts don’t deserve your worry. Healthcare guidelines for watching, testing and treating pancreatic cysts are meant to prevent the need for worry.
Abnormal growths commonly appear in many organs, especially as you get older. Pancreatic cysts just add one more organ to the list. The risk of cancer appearing in any of these growths is very small. If you have a precancerous cyst removed, it won’t have the chance to turn into cancer.
Last reviewed by a Cleveland Clinic medical professional on 10/11/2023.
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