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Pancreatic Cysts: Can be Benign, Precancerous, or Cancerous

Written By Tony Subia
June 2022

What is A Pancreatic Cyst?

Before explaining what a pancreatic cyst is, it’s important to explain the difference between a “cyst” and a “tumor”.

Many people assume that cysts and tumors are the same thing.  They are similar yet very different. Both cysts and tumors can either be non-cancerous (benign) or cancerous (malignant). Both can either be harmless or dangerous. Both would be difficult to “feel” during a routine physical hand examination of the pancreas. Generally an Ultrasound, CT scan. or an MRI would be necessary to find a cyst or tumor in or around the pancreas. Both cysts and tumors can exist in any body organ, in tissue surrounding organs, and even on bones and under the skin.

Here is the simple explanation of the differences between a cyst and a tumor:

• A cyst is sac-like growth that is usually filled with thick fluid and other soft substances. Cysts can even can be filled with air.

• A tumor on the other hand is mass resulting from the accumulation of millions of “abnormal cells”.  As abnormal cells progressively replicate, the larger the tumor becomes.

• Cysts and tumors can exist anywhere in the body including the pancreas

Like all cysts, pancreatic cysts are most often benign meaning they are not cancerous. While many causes of pancreatic cysts remain unknown, many are caused by pancreatitis which is a severe inflammation of the pancreas. Some are caused by blunt abdominal trauma such as a car accident.

How Serious is A Pancreatic Cyst? When Should One Be Surgically Removed?

Serious concern of a cyst of the pancreas can depend on many factors. including its size and location within the pancreas. Most pancreatic cysts are benign meaning they are not cancerous and arise from conditions other than cancer such as pancreas inflammation caused by bouts with pancreatitis. Some cysts of the pancreas are considered “precancerous” and likely should be removed before they turn cancerous. Some cysts may already be malignant (cancerous) and must be removed providing the cancer is still contained within the pancreas and has not spread to distant tissue or organs.

If an existing cyst is almost always benign even though it could be at a very low risk of becoming cancerous would not likely be removed. In those situations, a surveillance monitoring program would be established to watch for any indication the cyst may be beginning to become cancerous. In those situations the cancerous cyst would likely be surgically removed unless pancreatic cancer has already metastasized (spread) beyond the pancreas, particularly if it has spread to distant organs.

Pancreatic cysts that are considered benign but are at high risk becoming cancerous are most often surgically removed. However pursuit of surgery is not always automatic, it depends upon the particular patient. Doctors would consider risk versus benefit. A patient’s age, his or her overall health along with preexisting compromised conditions.

What Causes Pancreatic Cysts?

Most cysts of the pancreas develop for no apparent reason. In some cases, cysts are caused by a blunt trauma injury to the pancreas. Pancreatic cysts can also be caused by bouts of pancreatitis which is a severe inflammation of the pancreas and can cause extreme pain. There are two types of pancreatitis including Acute Pancreatitis and Chronic Pancreatitis. 

In some cases, a patient may develop pancreatic cysts as a result of a rare illness or a genetic condition such as von Hippel-Lindau Disease, Polycystic Kidney Disease, and Cystic Fibrosis.

The Most Common Types of Pancreatic Cysts

There are about 20 types of pancreatic cysts and most fall into two primary categories including “Non-Neoplastic Pancreatic Cysts” and “Neoplastic Pancreatic Cysts”.  Because of advanced methods of cross-sectional imaging. pancreatic cysts are diagnosed with increasing frequency. By some estimates, most pancreatic cysts are incidentally while scanning the abdominal area for unrelated medical reasons.

1. NON-NEOPLASTIC PANCREATIC CYSTS: These types of cysts only require treatment if they are symptomatic.

Mucinous Cystic Lesions:

• Pseudocysts:
• Lymphoepithelial Cyst
• Cystic Pancreatic Lymphangioma
• Dermoid/Epidermold Cyst
• Duplication Cyst/Ciliated Foregut Cyst
• Retention Cyst

2. NEOPLASTIC CYSTS (Pancreatic Cystic Neoplasms):  These types of cysts can have high malignant potential.

Nonmucinous Cystic Neoplastic Lesions:

• Serous Cystic Neoplasm
• Intraductal Papillary Mucinous Neoplasm (IPNM)
• Solid Pseudopapillary Neoplasms
• Cystic Pancreatic Neuroendocrine Tumor
• Cystic Acinar Cell Neoplasm
• Pancreatic Ductal Adenocarcinoma With Cystic Degeneration
• Intraductal Tubulopapillary Neoplasm of the Pancreas

What Are The Symptoms Associated With A Pancreatic Cyst?

Many pancreatic cysts do not produce symptoms at all. Those cysts that do present may have the following symptoms:

• Ongoing abdominal Pain
• Nausea and vomiting
• Weight loss with no apparent intention
• Unbearable feelings fullness and bloating

In some cases. pancreatic cysts may become infected. Persistent abdominal pain coupled with a fever may indicate and infection.

How Serious is A Pancreatic Cyst? When Should One Be Surgically Removed?

Serious concern of a cyst of the pancreas can depend on many factors including its size and location within the pancreas. Most pancreatic cysts are benign meaning they are not cancerous and arise from conditions other than cancer such as pancreas inflammation caused by bouts with pancreatitis. Some cysts of the pancreas are considered “precancerous” and likely should be removed before they turn cancerous. Some cysts may already be malignant (cancerous) and must be removed if the cancer is still contained within the pancreas

If an existing cyst is benign, most of the time, but in rare occasions it could become cancerous, it would not likely have to be removed. In those situations, a regular surveillance monitoring program would be established to watch for any indication the cyst was beginning to become cancerous in which case it would be surgically removed unless pancreatic cancer has already metastasized (spread) beyond the pancreas, particularly if it has spread to distant organs.

Pancreatic cysts that are considered benign at the time of discovery but are at high risk becoming cancerous are most often surgically removed. However pursing surgery is not always automatic. Depending upon the patient, doctors would consider risk versus benefit such as a patient’s age, underlying compromising conditions, and overall health

In summary, the seriousness of a pancreatic cyst depends upon several factors including size of the cyst, type of cyst, location of the cyst whether it is benign and not likely to become cancerous, or if it is precancerous and could develop cancer within time. It’s important to note that a precancerous pancreatic cyst can be a “Benign Tumor” in a cystic form and has the potential to progress into a “Malignant Tumor” over the course of time.

Reference Source

Mayo Clinic   
Sloan Kettering Cancer Center    
National Pancreas Foundation
Fox Chase Cancer Center
Cleveland Clinic
The Cancer Letter
National Library of Medicine

This article creates awareness of pancreatic cysts which can be benign, precancerous, or cancerous when detected. It is intended only as educational purposes only and is not intended as medical advice. Always consult with your medical providers for medical advice. However, consider sharing this vital information about cysts in the pancreas to create awareness of the symptoms of pancreatic cysts to discuss with your general practitioner.