TY - JOUR
T1 - The natural history of the incidentally discovered small simple pancreatic cyst
T2 - Long-term follow-up and clinical implications
AU - Handrich, Stephen J.
AU - Hough, David M.
AU - Fletcher, Joel G.
AU - Sarr, Michael G.
PY - 2005/1
Y1 - 2005/1
N2 - OBJECTIVE. The purpose of our study was to determine the natural history of small (≤ 2 cm) simple pancreatic cystic lesions. MATERIALS AND METHODS. A retrospective review was performed of patients with long-term follow-up who were diagnosed with small (≤ 2 cm) simple pancreatic cysts on sonography or CT from 1985 to 1996. Long-term surveillance included radiographic surveillance of 5 years or longer, clinical follow-up of 8 years or longer, or response to questionnaire or telephone inquiry 8 year or longer after the original diagnosis. Cause of death was recorded for patients who died within 5-8 years of diagnosis. Patients were excluded if a history of pancreatitis or systemic cystic disease existed. RESULTS. Seventy-nine patients had small simple pancreatic cysts. Forty-nine (62%) had adequate radiologic, clinical, or questionnaire follow-up. Of the 22 patients with radiologic follow-up, 13 (59%) had cysts that remained unchanged or became smaller (mean size, 8 mm; mean follow-up, 9 years), and nine (41%) had cysts that enlarged, from a mean of 14 mm to a mean of 26 mm (mean follow-up, 8 years). Of the 27 patients with clinical or questionnaire follow-up (mean follow-up, 10 years), none developed symptomatic pancreatic disease. Eighteen patients (23%) died within 8 years without adequate radiologic follow-up, none of pancreas-related causes. Twelve patients (15%) were lost to follow-up. CONCLUSION. Although small, incidental, simple pancreatic cysts of 2 cm or smaller may enlarge over a prolonged time, morbidity or mortality due to these small simple cysts is extremely unlikely, and observation appears to be a safe management option.
AB - OBJECTIVE. The purpose of our study was to determine the natural history of small (≤ 2 cm) simple pancreatic cystic lesions. MATERIALS AND METHODS. A retrospective review was performed of patients with long-term follow-up who were diagnosed with small (≤ 2 cm) simple pancreatic cysts on sonography or CT from 1985 to 1996. Long-term surveillance included radiographic surveillance of 5 years or longer, clinical follow-up of 8 years or longer, or response to questionnaire or telephone inquiry 8 year or longer after the original diagnosis. Cause of death was recorded for patients who died within 5-8 years of diagnosis. Patients were excluded if a history of pancreatitis or systemic cystic disease existed. RESULTS. Seventy-nine patients had small simple pancreatic cysts. Forty-nine (62%) had adequate radiologic, clinical, or questionnaire follow-up. Of the 22 patients with radiologic follow-up, 13 (59%) had cysts that remained unchanged or became smaller (mean size, 8 mm; mean follow-up, 9 years), and nine (41%) had cysts that enlarged, from a mean of 14 mm to a mean of 26 mm (mean follow-up, 8 years). Of the 27 patients with clinical or questionnaire follow-up (mean follow-up, 10 years), none developed symptomatic pancreatic disease. Eighteen patients (23%) died within 8 years without adequate radiologic follow-up, none of pancreas-related causes. Twelve patients (15%) were lost to follow-up. CONCLUSION. Although small, incidental, simple pancreatic cysts of 2 cm or smaller may enlarge over a prolonged time, morbidity or mortality due to these small simple cysts is extremely unlikely, and observation appears to be a safe management option.
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U2 - 10.2214/ajr.184.1.01840020
DO - 10.2214/ajr.184.1.01840020
M3 - Review article
C2 - 15615944
AN - SCOPUS:11144297935
SN - 0361-803X
VL - 184
SP - 20
EP - 23
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 1
ER -