Pancreatic Mucinous Lesions: How Dangerous are they?

Copyright: © 2012 Williamson JB, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Pancreatic cysts are being discovered with increasing frequency due to the expanding use of cross-sectional imaging. The prevalence of incidental pancreatic cystic lesions found on Multidetector Computed Tomography (MDCT) has been reported to be as high as 2.6% [1]. Retrospective reviews of Magnetic Resonance Imaging (MRI) have shown an even higher prevalence of pancreatic cysts, from 13.5% to 19.6% [2,3]. Mucinous cystic neoplasm (MCN) and Intraductal Papillary Mucinous Neoplasm (IPMN) comprise up to half of all resected pancreatic cysts that are incidentally discovered [4,5]. Most of these lesions harbor no malignancy at the time of diagnosis, though they are considered premalignant [6]. Traditional management has been to surgically resect all mucinous lesions; however, this paradigm is changing because risk of malignancy is not uniform among all types. The advent of Endoscopic Ultrasound with Fine Needle Aspiration (EUS-FNA) has significantly facilitated the diagnosis of mucinous pancreatic lesions [7]. Nevertheless, in everyday practice, we frequently struggle to firmly establish the mucinous nature of a lesion and to precisely determine its malignant potential.