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Pancreatic Cysts

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Management of Asymptomatic Neoplastic Pancreatic Cysts Repeat MRI in one year and then biennially to year five NO YES Two or more positive features on MRI EUS + FNA Concerning cytology and/or two features positive Consider surgery Positive features on MRI at any point during five-year surveillance Stop surveillance Positive feature = dilated main pancreatic duct, ≥ 3 cm cyst or solid component Cyst seen on imaging YES Repeat MRI in one year and then biennially to year five NO YES NO Interval change of positive features at any point during five-year surveillance NO YES Repeat EUS + FNA

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