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The international rulebook for pancreatic cysts: which features mean a cyst should be removed straight away (high-risk stigmata), which mean it needs a closer look with endoscopic ultrasound (worrisome features), and how often smaller cysts should be scanned.
Revision of the 2012 Fukuoka consensus from the International Association of Pancreatology for intraductal papillary mucinous neoplasms and mucinous cystic neoplasms. High-risk stigmata that indicate resection are obstructive jaundice from a cyst in the head, an enhancing mural nodule of 5 mm or more and a main pancreatic duct of 10 mm or more. Worrisome features that indicate endoscopic ultrasound include cyst size of 3 cm or more, enhancing mural nodule under 5 mm, thickened enhancing cyst walls, main duct 5 to 9 mm, abrupt change in duct calibre with distal atrophy, lymphadenopathy, raised CA19-9 and cyst growth of 5 mm or more in two years.
Surveillance intervals for cysts without these features are set by cyst size, and the revision addresses surgery for main-duct IPMN, extent of resection and follow-up after resection.
Most radiology reports and surgical decisions on pancreatic cysts still follow the Fukuoka criteria or their 2024 Kyoto revision.
Shares Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatic ductal adenocarcinoma.
Shares Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatic ductal adenocarcinoma.
Shares Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatic ductal adenocarcinoma.
Shares Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatic ductal adenocarcinoma.
Shares Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatic ductal adenocarcinoma.
Shares Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatic ductal adenocarcinoma.
Shares Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatic ductal adenocarcinoma.
Shares Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatic ductal adenocarcinoma.