The value of cyst fluid analysis in the pre-operative evaluation of pancreatic cysts.

Abstract

Like any clinical diagnostic test, analysis of pancreatic cyst fluid should add value in the decision making process of patient management. Pancreatic cysts are a complex group of benign, malignant and premalignant lesions with diverse clinical, radiological and pathological features (1). No longer are the vast majority of pancreatic cysts thought to be pseudocysts, inclusion cysts or benign neoplastic cysts that do not require follow-up. Our knowledge and understanding of neoplastic pancreatic cysts in general and mucinous pancreatic cysts in particular has grown exponentially since the recognition of intraductal papillary mucinous neoplasm (IPMN) as a distinct entity from mucinous cystic neoplasm (MCN) (2). Our realization that all neoplastic mucinous cysts have malignant potential has led to intensive evaluation of patients with both symptomatic and asymptomatic pancreatic cysts to determine the nature of the cyst, and thus the possible need for resection (3).