Abstract
Incidental discovery of pancreatic cysts has increased significantly with advancements
in imaging techniques, prompting the need to accurately distinguish benign cysts from
those with precancerous or malignant potential. Serous cystic neoplasms, formally
known as serous cystadenomas (SCAs), are benign cysts found predominantly in older
women and are generally asymptomatic. However, large SCAs (>4 cm) may be symptomatic
and exhibit aggressive growth, so it becomes important to diagnose and manage these
cysts accurately. Current diagnostic modalities include cross-sectional imaging (CT
and MRI scans), cyst fluid analysis, and molecular marker evaluation, with emerging
techniques such as radiomics and artificial intelligence-based models showing promise
to further enhance diagnostic accuracy. Management strategies for large SCAs (>4 cm)
remain variable, with official guidelines and single-institution decisions offering
different perspectives regarding criteria for surveillance versus surgical resection.
This review explores the diagnostic approaches and evolving management strategies
for large SCAs (>4 cm), emphasizing the importance of patient care based on cyst morphology,
growth pattern, radiographic findings, clinical presentation, and patient-informed
discussions.
Keywords
serous cystadenomas - serous cystic neoplasm - pancreatic cyst - diagnosis - management
