Management of pancreatic serous cystadenomas

With more widespread use of imaging, cystic neoplasms of the pancreas are being diagnosed with increased frequency. Serous cystadenomas are the most common type of cystic neoplasm of the pancreas and have a natural history and malignant potential different than that of other cystic neoplasms. Although characteristic findings on imaging may be supportive, definitive diagnosis of these lesions often cannot be made by imaging alone. Endoscopic ultrasound with fine needle aspiration and cyst aspiration may facilitate the diagnosis, and after definitive diagnosis, patients with lesions that are small and asymptomatic may be followed with serial imaging. If definitive diagnosis cannot be made or if the patient is symptomatic, resection is warranted. In addition, large (> 4 cm) serous cystadenomas should be resected in appropriate surgical candidates given their propensity for growth and developing symptoms.