PANCREATIC CYSTIC NEOPLASMS: RADIOLOGY DIFFERENTIAL DIAGNOSIS

 

Stepanova Yu.A., Paklina O.V., Revishvili A.Sh.

 

A.V. Vishnevsky National Medical Research Center of Surgery. Moscow, Russia.

Pancreatic cystic neoplasms (PCNs) are tumors containing cystic components with different biological behavior, clinical manifestations, and imaging features, and their malignant potential varies. The most common PCNs are serous and mucinous cystadenomas, intraductal papillary mucinous tumors, and solid pseudopapillary tumors.

In recent years, awareness of these neoplasms has increased, partly due to the use of modern imaging techniques, and improved approaches to the treatment of different types of cystic lesions. However, overall, the diagnosis and treatment of PCNs remain challenging. PCNs are composed of different tissue components, and each of them exhibits different biological behavior, ranging from benign to borderline or even malignant. Due to the overlap between benign and malignant imaging features, differential diagnosis of benign and malignant PCNs is difficult.

Radiology imaging is useful in the differential diagnosis of PCNs, facilitating characterization, assessment of aggressive behavior, and evaluation of resectability in patients with obvious malignancy. Although various imaging techniques are available, distinguishing between PCNs subtypes can be challenging. The first step in the evaluation of PCNs is MRI/MRCP, which differentiates most PCNs. When differentiation is difficult with MSCT/MRI, EUS (contrast-enhanced EUS) is performed. Radiomics features have broad application potential in the differential diagnosis and prognosis of PCNs management. When combined with clinical manifestations and imaging features, radiomics enables accurate preoperative diagnosis of PCNs.

 

Keywords: pancreatic cystic neoplasm, serous cystadenoma, mucinous cystadenoma, intraductal papillary mucinous tumor, solid pseudopapillary tumor, diagnostics, radiology diagnostics, ultrasound, MSCT, MRI.

 

Corresponding author: Stepanova Yu.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Stepanova Yu.A., Paklina O.V., Revishvili A.Sh. Pancreatic cystic neoplasms: radiology differential diagnosis. REJR 2026; 16(1):191-209. DOI: 10.21569/2222-7415-2026-16-1-191-209.

Received: 10.10.25 Accepted:            12.11.25