European experts consensus statement on cystic tumours of the pancreas
Abstract
Cystic lesions of the pancreas are increasingly recognized. While some lesions show benign behaviour (serous cystic neoplasm), others have an unequivocal malignant potential (mucinous cystic neoplasm, branch- and main duct intraductal papillary mucinous neoplasm and solid pseudo-papillary neoplasm). European expert pancreatologists provide updated recommendations: diagnostic computerized tomography and/or magnetic resonance imaging are indicated in all patients with cystic lesion of the pancreas. Endoscopic ultrasound with cyst fluid analysis may be used but there is no evidence to suggest this as a routine diagnostic method. The role of pancreatoscopy remains to be established. Resection should be considered in all symptomatic lesions, in mucinous cystic neoplasm, main duct intraductal papillary mucinous neoplasm and solid pseudo-papillary neoplasm as well as in branch duct intraductal papillary mucinous neoplasm with mural nodules, dilated main pancreatic duct >6mm and possibly if rapidly increasing in size. An oncological partial resection should be performed in main duct intraductal papillary mucinous neoplasm and in lesions with a suspicion of malignancy, otherwise organ preserving procedures may be considered. Frozen section of the transection margin in intraductal papillary mucinous neoplasm is suggested. Follow up after resection is recommended for intraductal papillary mucinous neoplasm, solid pseudo-papillary neoplasm and invasive cancer.
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High-risk groups for pancreatic ductal adenocarcinoma include people with inherited predisposition, people with pancreatic cystic lesions, and people older than 50 years with newly diagnosed type 2 diabetes.
“Here, we review groups at high risk for pancreatic ductal adenocarcinoma, including individuals with inherited predisposition and patients with pancreatic cystic lesions.”
From Early detection of pancreatic cancer (2020) · cites this paper as [20]
The 5% lifetime-risk target group includes individuals with at least two first-degree relatives with pancreatic ductal adenocarcinoma, patients with hereditary pancreatitis or particular genetic syndromes, and individuals with mucinous cystic lesions of the pancreas.
“This target includes individuals with at least two first-degree relatives with pancreatic ductal adenocarcinoma, patients with hereditary pancreatitis or particular genetic syndromes (eg, Peutz-Jeghers syndrome, or germline mutations in the CDKN2A, BRCA2, or PALB2),6,54 and individuals with mucinous cystic lesions of the pancreas.19–21”
From Early detection of pancreatic cancer (2020) · cites this paper as [20]
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- Authors
- Del Chiaro, M., Verbeke, C., Salvia, R., Klöppel, G., Werner, J., McKay, C., Friess, H., Manfredi, R., Van Cutsem, E., Löhr, M., Segersvärd, R., Abakken, L., Adham, M., Albin, N., Andren-Sandberg, Å., Arnelo, U., Bruno, M., Cahen, D., Cappelli, C., Costamagna, G., Del Chiaro, M., Delle Fave, G., Esposito, I., Falconi, M., Friess, H., Ghaneh, P., Gladhaug, I., Haas, S., Hauge, T., Izbicki, Jr., Klöppel, G., Lerch, M., Lundell, L., Lüttges, J., Löhr, M., Manfredi, R., Mayerle, J., McKay, C., Oppong, K., Pukitis, A., Rangelova, E., Rosch, T., Salvia, R., Schulick, R., Segersvärd, R., Sufferlein, T., Van Cutsem, E., Van der Merwe, S., Verbeke, C., Werner, J., & Zamboni, G.
- Affiliations
- University of Oslo (NO)
- Université de Lyon (FR)
- Karolinska Institutet (SE)
- Erasmus University Rotterdam (NL)
- University of Pisa (IT)
- Università Cattolica del Sacro Cuore (IT)
- Technical University of Munich (DE)
- Marche Polytechnic University (IT)
- University of Liverpool (GB)
- Universität Hamburg (DE)
- Karolinska University Hospital (SE)
- Heidelberg University (DE)
- Glasgow Royal Infirmary (GB)
- University of Colorado Boulder (US)
- Universität Ulm (DE)
- University of Verona (IT)
- ORCID
- Venue
- Digestive and Liver Disease
- Publisher
- Elsevier BV
- Published
- 2013-09
- Volume
- 45
- Issue
- 9
- Pages
- 703-711
- ISSN
- 1590-8658 (ISSN-L)
- OpenAlex
- W2009895341
- Cited by
- 498
- References
- 123
- Citations by year
- 2026: 19 · 2025: 13 · 2024: 41 · 2023: 31 · 2022: 29 · 2021: 33 · 2020: 51 · 2019: 34 · 2018: 64 · 2017: 52 · 2016: 58 · 2015: 30 · 2014: 31 · 2013: 11
- FWCI
- 23.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Digestive and Liver Disease (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Keywords
- serous cystic neoplasm, mucinous cystic neoplasm, intraductal papillary mucinous neoplasm, diagnostic imaging, endoscopic ultrasound, cyst fluid analysis, pancreatoscopy, pancreatic resection, pancreatic cancer
- MeSH terms
- Adenocarcinoma, Carcinoma, Papillary, Cholangiopancreatography, Endoscopic Retrograde, Cystadenocarcinoma, Cystadenoma, Europe, Humans, Magnetic Resonance Imaging, Pancreas, Pancreatic Neoplasms, Tomography, X-Ray Computed, Cystadenocarcinoma, Mucinous, Cystadenoma, Mucinous, Cystadenoma, Serous, Endosonography, Carcinoma, Pancreatic Ductal
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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