Fact-sheet: Mucinous cystic neoplasm
Updated on 09/17/2019 at 3:25 PM
View all RADEOS cases associated with this fact-sheet
Definition
Rare benign primary cystic tumor of the pancreas
Risk of malignant transformation
Accounts for approximately 10% of pancreatic tumors
Lesion preferentially located in the pancreatic tail
Female predominance with a sex ratio of 6/1
Mean age: 50 years
Clinical features
Most often an incidental finding
Possible abdominal pain, anorexia, palpable mass, jaundice, or acute pancreatitis.
Laboratory findings
Elevated CEA
Ultrasound
Multicystic lesion
Thin septa or intracystic echoes
CT
- Multicystic lesion (generally well-defined margins)
- Multiseptated
- Peripheral macrocalcifications may be present
- Thick fibrous wall with progressive delayed enhancement
- Thin intracystic septa enhancing after contrast injection
MRI
Uni- or oligolocular pancreatic macrocyst (T1 hypointense, markedly T2 hyperintense)
Body-tail location in 95% of cases
Septa may be present
Gadolinium: septal enhancement, wall enhancement if wall is thickened
Imaging features suggestive of malignant transformation include:
- diameter > 6 cm
- mural nodule
- eggshell calcifications
- irregular wall contour
- obstruction or displacement of the main pancreatic duct
Management
Possible degeneration into cystadenocarcinoma, especially if size > 4 cm
Surgical management recommended
Complete resection: 5-year survival rate = 90%
Differential diagnosis
Pancreatic pseudocyst, but with a context of pancreatitis and absence of septa
Serous cystadenoma, but with more numerous cysts, preferentially cephalic location, and central calcifications
IPMN: saccular dilatations communicating with the main pancreatic duct
Cystadenocarcinoma