Martin Kliment
Pancreatic cystic lesions are represented with non-neoplastic cysts, pancreatic cystic neoplasia and pseudocysts. Potentially
malignant are mucinous cystic neoplasia (MCN) and intraductal papillary mucinous neoplasia (IPMN). MCN is
a solitary septated cyst containing ovarian stroma. It occurs more often in middle-aged women in a pancreatic body or
tail. The risk of malignancy is < 15 % and a surgical therapy is recommended. IPMN is a mucin-producing papillary neoplasia
of the pancreatic ducts, showing a variable degree of atypia and causing a dilation of the pancreatic ducts. They
are represented with the main-duct IPMN (MD-IPMN), branch-duct IPMN (BD-IPMN) and mixed-type IPMN (MT-IPMN).
MD-IPMN are displayed as a segmental or diffuse dilation of the main pancreatic duct (MPD). Owing to the risk of malignancy
in 62 %, the surgical resection is generally recommended. BD-IPMN is displayed as a multilocular, often multifocal
grape-like cyst communicating with MPD. The risk of malignancy is 25.5 %.
The management of these patients is comprised of either surgical resection or a follow-up with imaging studies, depending
on the risk factors of malignancy, representing with a mass or nodule, MPD dilation ≥ 10 mm and obstructive
jaundice in BD-IPMN localised in a pancreatic head.