Cystic neoplasms of the pancreas are found with increasing prevalence, especially in elderly asymptomatic individuals. Although the overall risk of malignancy is very low, the presence of these pancreas cysts is associated with a large degree of anxiety and further medical investigation, due to concerns about malignancy. The differential diagnosis for cystic neoplasms of the pancreas (Box 41.1) ranges from benign processes such as serous cystadenomas (Figure 41.1), to pancreatic cysts of low malignant potential such as cystic pancreatic endocrine tumors (Figure 41.2) and solid pseudopapillary neoplasms (Figure 41.3), to the premalignant or malignant mucinous cystic neoplasms of the pancreas including intraductal papillary mucinous neoplasms (IPMN) (Figures 41.4–41.6) and mucinous cystic neoplasms (MCN) (Figure 41.7). Often, preoperative diagnosis is possible based on clinical features and imaging data, with surgical and nonsurgical management of the most common cystic neoplasms, IPMNs and MCNs, based on several available clinical guidelines (Figures 41.8–41.10).

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