Is a cyst on pancreas dangerous

Pancreatic cysts are water or mucus filled structures in the pancreas, similar to cysts that appear in other parts of the body. The most common cause of benign (non-cancerous) cysts is pancreatitis, an inflammation of the pancreas. Pancreatitis can be a result of excessive alcohol use or gallstone disease. Additionally, some genetically inherited conditions can predispose a person to get cysts in the pancreas.

How do you know if you have a pancreatic cyst?

Most people do not have any symptoms or pain and their pancreatic cysts are discovered by pure chance. Approximately 2-3 percent of pancreatic cysts are discovered when that patient has a CT scan or MRI of the abdomen for other reasons. There may be some abdominal pain associated with large cysts. However, for small cysts, other causes of abdominal pain should be excluded before attributing the pain to the cyst.

What types of pancreatic cysts are there?

Cysts in the pancreas can arise as the result of several different processes. There are approximately five major types of pancreatic cysts, depending upon how they developed, where they are located and what they are made out of. Most pancreatic cysts are benign non-neoplastic (not a tumor) lesions resulting from pancreatitis. However, benign neoplastic (tumor) cysts are slightly more common in women.

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Do pancreatic cysts become cancerous?

Most cysts are not – less than 1-2 percent of pancreatic cysts are cancerous. However, some may be considered precancerous.

What does it mean if a pancreatic cyst is precancerous?

A precancerous pancreatic cyst is a benign tumor that has the potential to progress to pancreatic cancer over the course of years.

What should you do if you have a pancreatic cyst?

It is critical that patients with pancreatic cysts seek out clinicians who have extensive experience with pancreatic tumors and pancreatic pathology. The clinician will look at certain features in each cyst, such as the size and the presence of any solid components. They will also take into consideration the cysts’ growth rate over years when making a decision on whether surgery is needed.

How should these cysts be treated?

Most pancreatic cysts are not treated. In fact, patients may be at an increased risk for overtreatment at this condition. For the vast majority, proper treatment is continued observation by an experienced clinician. For some patients, surgery may be recommended after monitoring the cysts with a CT scan, MRI or endoscopic ultrasound. Often the cysts can be removed through a minimally invasive surgical approach.

Is a cyst on pancreas dangerous

Medically reviewed by Alana Biggers, M.D., MPHWritten by Scott Frothingham on January 16, 2019

  • Symptoms
  • Types
  • Risk factors
  • Treatment
  • Takeaway

The pancreas is a large organ behind the stomach that’s a crucial component of the digestive process. It creates hormones, like insulin, to help control blood sugar, as well as enzymes that help break down food in the small intestine.

Pancreatic cysts are pockets of fluid that are on — or in — your pancreas. They can be difficult to diagnose because they have minimal symptoms. They’re often found by chance when conducting an image test (such as a CT scan) for another issue.

According to the Mayo Clinic, the majority of cysts on the pancreas are not cancerous.

Pancreatic pseudocysts

Often the result of pancreatitis or an abdominal impact injury, a pancreatic pseudocyst is formed by a collection of tissue and fluids that are different from the tissue in a true cyst. A pseudocyst is less likely to be malignant (cancerous) than a true cyst.

Pancreatic cysts do not typically exhibit many symptoms. In the rare case that they do, symptoms can include:

  • persistent abdominal pain
  • the feeling of a mass in the upper abdomen
  • vomiting or nausea

If you have a fever in addition to these symptoms (especially persistent abdominal pain), contact your doctor immediately, as this may be the sign of a pancreatic cyst infection.

Another rare complication that can occur is a ruptured cyst or ruptured pseudocyst. The fluid that is released can cause massive internal bleeding and infection of the abdominal cavity. Seek immediate emergency attention if you’re experiencing any of the signs of shock or internal bleeding, such as:

  • severe abdominal pain
  • fainting or lack of consciousness
  • rapid or weak heartbeat
  • vomiting blood

There are two main types of pancreatic cysts: serous and mucinous. The main difference between them is the type of fluid they contain. Serous cysts have a thin fluid, whereas mucinous cysts have a stickier and thicker fluid.

Your age, sex, and the characteristics of the cyst help determine what type of cyst you’re likely to have.

The majority of pancreatic cysts are noncancerous (benign), however, there are several mucinous cysts that can be more concerning. This includes:

  • Mucinous cystic neoplasm (MCN) are mainly found in women and contain ovarian tissue.
  • Main-duct intrapapillary mucinous neoplasms (IPMN) involve the main duct of the pancreas and contains intestinal villus (small protrusions that look like fingers).

While the main cause of pancreatic cysts is unknown, there are several risk factors including:

  • Von Hippel-Lindau disease. This genetic disorder affects the pancreas.
  • Pancreatitis. When enzymes that help with digestion are active prematurely, it can lead to irritation of the pancreas, which can result in cysts.
  • Gallstones and heavy alcohol use. These are both risk factors for pancreatitis, so in turn, they’re risk factors for pancreatic cysts.
  • Abdominal injury. Cysts are more likely to form after abdominal trauma, such as after a car accident.

There are few noninvasive treatments for pancreatic cysts, with the only real option being watchful waiting. This is because a benign cyst, even a large one, does not need any type of treatment as long as it does not bother you. However, you should still watch closely for any signs or symptoms that arise.

The more invasive treatment options include:

  • Drainage. In this procedure, an endoscope (small tube) is placed in your mouth and directed to your small intestine. The small tube contains an endoscopic ultrasound, along with a needle to drain fluid from the cyst. In some cases, drainage through a needle in your skin may be the only viable option.
  • Pancreatic cyst surgery. This surgical option is primarily used for enlarged, painful, or cancerous pancreatic cysts.

There are several steps you can take to prevent a pancreatic cyst from occurring again, including:

Avoiding pancreatitis

Pancreatitis is typically the result of gallstones and/or heavy alcohol use.

  • Removing the gallbladder can reduce the risk of pancreatitis for individuals with gallstones.
  • Reducing alcohol consumption can reduce the risk of pancreatitis.

Another cause of pancreatitis is hypertriglyceridemia. If you have this disorder, you have a higher-than-normal triglyceride level. Elevated triglycerides of greater than 1000 mg/dL increase a person’s risk for pancreatitis. Hypertriglyceridemia is the third most common cause for acute pancreatitis after gallstones and alcohol.

Hypertriglyceridemia can be genetic (primary) or due to other causes (secondary) such as diabetes, medications, alcohol, or pregnancy.

Following a low-fat diet

Restricting your daily fat intake to 30 to 50 grams can also reduce your risk of pancreatic cysts. A low-fat diet includes:

  • baked, broiled, grilled, or steamed meat
  • low- or nonfat dairy
  • meat and dairy alternatives (like almond milk, tofu)
  • whole grains
  • fruits, with the exception of avocado
  • vegetables
  • avoid

You should also avoid sugary sodas and drinks with cream (like eggnog), and fried foods (including fried vegetables).

If you’re concerned about a potential pancreatic cyst, contact your doctor. Along with examining your medical history, they can run a number of tests, including CT scans, MRI scans, and endoscopic ultrasounds.

After testing, your doctor may take a sample of the fluid in order to determine whether or not the cells are cancerous. It’s also important to note that cysts may return if you have an ongoing case of pancreatitis.

Last medically reviewed on January 16, 2019

Pancreatic cysts and pseudocysts are growths in the pancreas. Symptoms may include nausea, abdominal bloating and pain. Cysts and pseudocysts should be treated to avoid complications such as rupture or infection.

Pancreatic Cysts and Pseudocysts

A pancreatic cyst is a closed sac lined with epithelium and located on or in your pancreas (see below). Pancreatic cysts contain fluid. They can range from benign pseudocysts to malignant cysts (cancerous and spreading). There are several different types of pancreatic cysts. Some pancreatic cysts result from certain rare diseases, such as von Hippel-Lindau disease (a genetic disorder).

What is a pancreatic pseudocyst?

A pancreatic pseudocyst is a type of cyst that it is not contained inside an enclosed sac of its own with an epithelium lining. Instead, the pseudocyst forms within a cavity or space inside the pancreas and is surrounded by fibrous tissue. Pancreatic pseudocysts do contain inflammatory pancreatic fluid (particularly the digestive enzyme amylase) or semisolid matter.

Pancreatic pseudocysts:

  • Are health problems caused by acute or chronic pancreatitis (see below).
  • Are caused by a blockage in the pancreatic ductal system.
  • Are round or oval in shape.
  • Are the most common pancreatic cystic lesions (about 75% to 80% of all pancreatic cystic lesions).
  • Are benign (non-cancerous).
  • Affect approximately 1 in 1,000 adults per year.

What is the pancreas?

Your pancreas is a 6-inch gland located below your liver, between your stomach and your spine. The pancreas is made up of three parts: a "head" that is tucked into the duodenum (the upper part of the small intestine); a flattened, longer "body;" and a "tail" that is connected to the spleen.

Your pancreas makes potent digestive enzymes and hormones that help manage blood glucose (blood sugar). Normally, these enzymes and hormones don't become active until they exit the pancreas and enter other parts of the body.

Your pancreas also produces bicarbonates that neutralize stomach acids. Small ducts (tubes) move these fluids into a larger pancreatic duct, down into the duodenum. The common bile duct also carries bile (a substance that breaks down fats) from your liver and gall bladder through the head of the pancreas into your small intestine.

What is pancreatitis?

An inflammation of the pancreas is called pancreatitis. Pancreatitis can either be acute (a sudden, sharp, and/or severe attack) or chronic (recurring and/or lasting for a long period of time). When the pancreas is inflamed, digestive enzymes become activated while still inside the pancreas, which can cause the pancreas to begin "digesting" its own tissues.

The two most common causes of pancreatitis are gallstones (bile that has hardened into little pebble-like masses) and chronic, heavy alcohol use. Pancreatitis can also result from certain diseases or injury. Pancreatic pseudocysts can develop as a serious complication of pancreatitis.

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Pancreatic cysts, including pseudocysts, can be asymptomatic (having no obvious symptoms) or can produce moderate to severe symptoms. Symptoms may occur within days to months following a pancreatitis attack. The most common symptoms include:

What are the complications of pancreatic cysts/pseudocysts?

Rarely, complications can come from pancreatic cysts/pseudocysts, including:

  • Infection, which can sometimes lead to pancreatic abscess.
  • Pseudocyst rupture (breaking open) or hemorrhage (bleeding), which can
    happen without warning and which can be life-threatening.
  • Biliary complications, which can occur when a large cyst blocks thecommon bile duct, causing skin, mucous membranes and whites of the eyes to

    appear yellow (obstructive jaundice).

  • Portal hypertension, or high blood pressure of the splenic vein/portal
    vein, which requires surgery.

Pancreatic pseudocysts can be hard to diagnose because the symptoms can be similar to various other diseases. Since the pancreas is located deep inside the abdominal cavity, cross-sectional imaging is often used to locate and diagnose pancreatic cysts and pseudocysts.

Testing may include the following:

  • Transabdominal US (ultrasound), which uses sound waves to detect a pancreatic pseudocyst, or gallstones that could potentially cause a pseudocyst.
  • Abdominal CT (computed tomography) scan, which usually provides all the diagnostic information necessary, and shows more detailed surrounding anatomy and pathology information than ultrasound does.
  • MRI (magnetic resonance imaging) and MRCP (magnetic resonance cholangiopancreatography), though not typically used, provide sharper imaging of fluids and debris in pseudocysts than CT scans do.
  • EUS (endoscopic ultrasound) is usually a secondary test (following US, CT or MRI) to further evaluate a pancreatic cyst and/or to distinguish a pancreatic pseudocyst from other types of cystic lesions. Analysis of fluid obtained by the cyst via a fine needle is done to differentiate the types of cysts and pseudocysts.
  • ERCP (endoscopic retrograde cholangiopancreatography) enables the doctor to view the structure of the common bile duct, other bile ducts and the pancreatic duct.

Most pseudocysts resolve on their own without treatment, over time. However, when symptoms become persistent, complications emerge or a cyst become larger than 6 centimeters in size, it should be drained.

There are three methods of cyst drainage:

  • Endoscopic drainage.
  • Percutaneous catheter drainage, which uses hollow tube inserted into the body to remove fluid.
  • Surgical drainage, either via open surgery or laparoscopic surgery (using a laparoscope, a surgical tool that only requires a small incision).

Endoscopic drainage is gaining acceptance because it's less invasive, has less risk of complications than open surgery, doesn't require an external drain, and its long-term success rate is high.

Pseudocysts should be drained when they are causing symptoms. Some cysts require surgical removal if there is a concern for cancer or a precancerous condition.

In most cases, the prognosis is good for people who undergo treatment for pancreatic cysts and pseudocysts.

Last reviewed by a Cleveland Clinic medical professional on 07/29/2020.

References

  • National Pancreas Foundation. Pancreatic Cysts. (https://pancreasfoundation.org/patient-information/ailments-pancreas/pancreatic-cysts/) Accessed 8/24/2020.
  • National Digestive Disease Information Clearinghouse. Pancreatitis (https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis) Accessed 8/24/2020.
  • American Gastroenterological Association. Understanding Pancreatitis (https://www.gastro.org/practice-guidance/gi-patient-center/topic/pancreatitis) Accessed 8/24/2020.

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy