Diagnostic Endosonography - Pancreatic cyst

This is the case of a 54-year-old woman without any episodes of acute pancreatitis in her medical history. The patient suffered from intermittent epigastric pain for one year. Sonography and CT scan revealed a subtle cystic structure within the pancreatic head.
Here, a diagnostic endosonography is performed and the differential diagnosis of cystic lesions in the pancreas is discussed.

Take home messages:

Endosonography is the most sensitive diagnostic tool to visualize small cystic lesions in the pancreas.

The differential diagnosis in this case includes a serous cystic neoplasia, previously called serous cystadenoma, a mucinous cystic neoplasia, and an intraductal papillary mucinous neoplasia of the „branch duct“ type.

While serous cystic neoplasias do commonly not progress to malignancy, intraductal papillary mucinous neoplasias are known to be precancerous lesions.