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