Diagnostic and Treatment Algorithms of Pancreatic Cystic Tumors

Belyaev/Uhl: The initial diagnostic evaluation of a newly detected pancreatic cystic lesion (PCL) should identify the specific type of PCL and its individual risk of malignancy as accurately as possible. It includes a comprehensive structural and functional assessment of the pancreas. Besides family history for malignancy, standard physical examination, and complete laboratory workup including carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA), fecal elastase, and OGTT, dedicated pancreas protocol imaging by means of computed tomography (CT) and magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) play a central role. MRI is superior in detecting size, number, and pancreatic duct connection of PCLs and avoids radiation exposure, while CT is more reliable in detecting calcifications, solid nodules, and concomitant pancreatic cancer