Pancreatic Cysts

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Overview

• What is the pancreas?

  The pancreas is a soft, pear-shaped organ that sits behind the stomach in your belly.

  The pancreas has 2 main jobs:

  • Help digest food. It makes juices that flow through small tubes into your intestines to break down protein, carbohydrates, and fats.
  • Control your blood sugar. It makes hormones, like insulin, that travel into your blood to keep blood sugar levels steady.
• What are pancreatic cysts?

  Pancreatic cysts are fluid filled sacs in or on your pancreas. There are a few kinds:

  • Cysts from swelling (pancreatitis)
  • Simple, harmless fluid pockets
  • Cysts that have a small chance of becoming cancer

  Fluid can either be within the pancreatic tissue itself or an outpouching/dilation of one of the many ducts that are within the pancreas. There are many different types of pancreatic cysts. Some pancreatic cysts can be related to prior episodes of inflammation of the pancreas (pancreatitis). Other cysts can be benign fluid collections and lastly some cysts can have risks for developing into cancer over time. Knowing which type of cyst you have is very important because it guides how your provider will watch or treat you.

  Benign (Not precancerous):

  • Pseudocyst: Pocket full of fluid sometimes mistaken as pancreatic cysts. From when pancreatic juices leak from the pancreas due to injury which can be from acute or chronic pancreatitis.
  • Serous Cystadenoma (SCA): Common. Made of tiny fluid filled sacs that look like honeycomb. Found mostly in women > 60 years old. Cause complications such as blocking ducts if they get too big. May need surgical removal but are not cancer.
  • Simple Pancreatic Cyst: Cavity filled with clear fluid.

  Neoplastic/Pancreatic Cystic Neoplasm (Can be precancerous):

  • Intraductal Papillary Mucinous Neoplasm (IPMN): Most common. Mucus-producing cysts that grow from pancreatic duct. Fluid is mix of pancreatic juices and mucin (makes up mucus). May lead to duct swelling. Risk of changing to cancer depends on type.
  • Side Branch IPMN: IPMN off a side pancreas duct. 2-25% cancer risk.
  • Main Duct IPMN: IPMN off the main pancreas duct. 40-70% cancer risk.
  • Mixed IPMN: IPMN with features from main and side pancreas duct IPMNs. Similar risk to main duct IPMN for cancer.
  • Mucinous cystic neoplasm (MCN): Less common than IPMN. Only in Females > 50 years old. Does not connect to the pancreas duct. 10-30% cancer risk.
  • Solid Pseudopapillary neoplasm (SPN): Rare. Made of solid and liquid parts. More common in young females (20-30 years old). 10-15% spread.
  • Cystic pancreatic neuroendocrine tumor (cNET): Usually solid but sometimes look like cysts.
• How common are pancreatic cysts?

  Pancreatic cysts are very common. About 1 in 7 people will have a pancreas cyst if we check the right scan. Most cysts do not cause symptoms and are found when we are looking at something else. For example, a patient who comes in for a car accident may get a CT scan of the abdomen and a small pancreatic cyst is seen unrelated to the car accident. It is thought that pancreatic cysts happen more as we age.

Risk Factors

• What are the risk factors of pancreatic cysts?

  Some cysts can slowly turn into cancer. By finding and checking these cysts early, we can:

  • Spot early pancreatic cancers
  • Remove cysts before they become a health risk

  Most pancreatic cysts never become cancer. We usually follow them closely over time rather than jumping to major surgery.

Diagnosis

• How are pancreatic cysts diagnosed?

  Imaging tests are used to find cysts:

  • Computed tomography (CT) scan: Series of special x rays
  • Magnetic resonance imaging (MRI): Picture made by a strong magnet
  • Endoscopic ultrasound (EUS): A specialized test done with an endoscope in the stomach and the intestine that has an ultrasound probe on the end. The pancreas lies behind the stomach and doctors can see the pancreas up close during this test.

  Important factors for diagnosing pancreatic cysts include:

  • Size
  • Fluid type in the cyst
  • Shape of the tiny tubes (ducts) in your pancreas
  • Any symptoms you may have that can be seen in the pancreas (pain, inflammation, yellow eyes/skin)

Treatment

• How are pancreatic cysts treated?

  Most pancreatic cysts don’t need treatment. We simply watch them with repeated scans. If a cyst is large, painful or infected, it may need to be drained.

  If the cyst has precancerous changes over time, surgery to remove that part of the pancreas may be recommended to lower the risk of getting pancreatic cancer.

Author(s) and Publication Date(s)

Victoria M.B. Howard, PA, University of Rochester, Rochester, NY and Muhammad A. Memon, MD, Methodist Mansfield Medical Center, Mansfield, TX - Updated August 2026.

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