[Cystic and intraductal tumors of the pancreas]

The management of cystic and intraductal pancreatic tumours has changed over the last ten years due to increasing fortuitous discovery of incidental cystic lesions of the pancreas and better knowledge of these lesions. CT-scan or MRI can usually differentiate the two most frequent cystic tumours: benign serous cystadenoma and potentially malignant mucinous cystadenoma. Conservative management is wholly justified for serous cystadenoma without complications, whereas mucinous cystadenoma can be cured by pancreatic resection. In case of doubt, endoscopic ultrasonography and study of cystic fluid may be helpful. Recently identified intraductal papillary mucinous neoplasms of the pancreas are premalignant or malignant tumours of the pancreatic ducts clearly visualized by magnetic resonance pancreatography. Curative pancreatic resection should be performed before the invasive adenocarcinoma stage.