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Suggest Treatment For Multiple Cysts In The Kidney
Question: In May 2016, I had a follow up MRI on a benign kidney cyst, and it showed a "tiny barely perceptible cyst on the tail of the pancreas". The doctor said nothing worrisome and do a follow up in 6 months. In Dec. 2016, did an MRI with pancreatic protocol and it showed "few tiny cyst on pancreas" and can reassess at next follow up. I am concerned and my doc said forget about them and we will do a follow up in 1-2 years.
I was told that multiple cysts are almost always benign. Is that true?
Also, I was told that these cyst are just swollen glands that inflame on the pancreas?? Please explain?
I was told that this is not a life threatening situation and it will not shorten my normal life span. Do you agree?
Is there a way to know how long they have been there?
I was told that multiple cysts are almost always benign. Is that true?
Also, I was told that these cyst are just swollen glands that inflame on the pancreas?? Please explain?
I was told that this is not a life threatening situation and it will not shorten my normal life span. Do you agree?
Is there a way to know how long they have been there?
Brief Answer:
pancreatic cyst evaluation
Detailed Answer:
Hello,
I can understand your concern on incidental finding of pancreatic cyst on investigation
1) You should do follow up after 6 months. (1year is long follow up)
2) Multiple cysts are not ALWAYS benign.
3) Cyst in pancreas has many causes inflammation, simple cyst, malignancy are common causes although their incidence is low.
4) Yes, pancreatic cyst is not life-threatening condition but it need evaluation.
5) You can not know since when they were there in pancreas.
I read my last explanation to your query based on which I would recommend few points.
1) Pancreatic cyst require serial follow up investigations.
2) If any of these cysts enlarge in size compared to present MRI in future investigation, it is a indication to perform endoscopic USG guided FNAC of that cyst to rule out malignancy because it will decide further treatment approach.
3) This is not life-threatening condition. Even if being malignant nature of this pancreatic cyst, the prognosis is excellent.
4) Cyst related to inflammation in pancreas associated with previous episodes of pancreatitis.
Hope I answered your doubts. If you have any further questions, I would be happy to help you.
Have a good day!
pancreatic cyst evaluation
Detailed Answer:
Hello,
I can understand your concern on incidental finding of pancreatic cyst on investigation
1) You should do follow up after 6 months. (1year is long follow up)
2) Multiple cysts are not ALWAYS benign.
3) Cyst in pancreas has many causes inflammation, simple cyst, malignancy are common causes although their incidence is low.
4) Yes, pancreatic cyst is not life-threatening condition but it need evaluation.
5) You can not know since when they were there in pancreas.
I read my last explanation to your query based on which I would recommend few points.
1) Pancreatic cyst require serial follow up investigations.
2) If any of these cysts enlarge in size compared to present MRI in future investigation, it is a indication to perform endoscopic USG guided FNAC of that cyst to rule out malignancy because it will decide further treatment approach.
3) This is not life-threatening condition. Even if being malignant nature of this pancreatic cyst, the prognosis is excellent.
4) Cyst related to inflammation in pancreas associated with previous episodes of pancreatitis.
Hope I answered your doubts. If you have any further questions, I would be happy to help you.
Have a good day!
Above answer was peer-reviewed by :
Dr. Remy Koshy
I was told that these cysts can resolve on their own? What's your opinion?
I was told that with cysts like these there is a 97% chance they will stay the same for the remainder of my life, and a 2-3% they will resolve, and less than 1% will change. What is your opinion?
Also, I have done one follow up with no change. Does that mean they are benign and will remain so?
Do these cysts increase your risk of cancer?
I was told that with cysts like these there is a 97% chance they will stay the same for the remainder of my life, and a 2-3% they will resolve, and less than 1% will change. What is your opinion?
Also, I have done one follow up with no change. Does that mean they are benign and will remain so?
Do these cysts increase your risk of cancer?
Brief Answer:
simple pancreatic cysts has no risk for cancer
Detailed Answer:
Hello,
Yes, if you did last scan as follow up scan and cyst size was same in all time, it is most likely to be benign cysts.
If they are benign cysts, 99% they stay but they not harmful.It is very rare that pacretic cyst resolve by its own.
Cyst with risk of cancer has particular findings. But simple cyst which has collection of serum or fluid only is not dangerous for transformation into cancer.
simple pancreatic cysts has no risk for cancer
Detailed Answer:
Hello,
Yes, if you did last scan as follow up scan and cyst size was same in all time, it is most likely to be benign cysts.
If they are benign cysts, 99% they stay but they not harmful.It is very rare that pacretic cyst resolve by its own.
Cyst with risk of cancer has particular findings. But simple cyst which has collection of serum or fluid only is not dangerous for transformation into cancer.
Above answer was peer-reviewed by :
Dr. Remy Koshy
Brief Answer:
require one more follow up.
Detailed Answer:
hello,
Here I have two different conclusion
1) Size of cyst is very small and did not increase on follow up so it is likely to be benign simple cyst as I mentioned.
2) First MRI (August, 2016) suggested that features of small cyst is compatible with IPMN which can be cancerous on growth.
3) Based on these two different findings i would suggest following
a) consult a gastroenterologist with these reports and ask him/her for feasibility of doing endoscopic USG with FNAC to aspirate some fluid from cyst and analyse it. This could not be possible in very small cyst, so gastroenterologist's opinion is very important in this case.
b) endoscopic USG is more precise than MRI for such small pancreatic cyst. So definitely you will require one more follow up evaluation but with different modality.
Basic concept for such vigorous follow up is that any cyst must be confirmed that it is not from cancer so that delayed treatment can be avoided.
require one more follow up.
Detailed Answer:
hello,
Here I have two different conclusion
1) Size of cyst is very small and did not increase on follow up so it is likely to be benign simple cyst as I mentioned.
2) First MRI (August, 2016) suggested that features of small cyst is compatible with IPMN which can be cancerous on growth.
3) Based on these two different findings i would suggest following
a) consult a gastroenterologist with these reports and ask him/her for feasibility of doing endoscopic USG with FNAC to aspirate some fluid from cyst and analyse it. This could not be possible in very small cyst, so gastroenterologist's opinion is very important in this case.
b) endoscopic USG is more precise than MRI for such small pancreatic cyst. So definitely you will require one more follow up evaluation but with different modality.
Basic concept for such vigorous follow up is that any cyst must be confirmed that it is not from cancer so that delayed treatment can be avoided.
Above answer was peer-reviewed by :
Dr. Yogesh D
I had a follow up with a pancreas specialist at an university who gave this explanation.
He said there is a 97% chance that the cysts remain the same size and benign, 2-3% chance that they resolve, and less than 1% they change.
He also said he felt no IPMN because there was no mention of it on follow up MRI.
His recommendations were since stable at 6 months do a repeat MRI in 1-2 years, and it is highly likely the result will be the same size or possibly resolve.
Your opinion?
He said there is a 97% chance that the cysts remain the same size and benign, 2-3% chance that they resolve, and less than 1% they change.
He also said he felt no IPMN because there was no mention of it on follow up MRI.
His recommendations were since stable at 6 months do a repeat MRI in 1-2 years, and it is highly likely the result will be the same size or possibly resolve.
Your opinion?
Brief Answer:
Simple cyst does not require any intervention
Detailed Answer:
Hello,
I agree with his explanation on pancreatic cysts.
There is no risk at all for that 97% and also for that 2-3%.
If there is no suspicion on IPMN then there is no need to do any further except follow up.
My concern was to discuss with your gastroenterologist to discuss about feasibility of endoscopic USG as a next follow up modality rather than MRI.
Regards
Simple cyst does not require any intervention
Detailed Answer:
Hello,
I agree with his explanation on pancreatic cysts.
There is no risk at all for that 97% and also for that 2-3%.
If there is no suspicion on IPMN then there is no need to do any further except follow up.
My concern was to discuss with your gastroenterologist to discuss about feasibility of endoscopic USG as a next follow up modality rather than MRI.
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
The specialist said that unless its 2cm no need to do Ercp. He said these cyst are common. Do you agree?
Based on the information given, do you agree that the cysts have a less than 1% chance of changing. He even said that he feels it's as low as .001% chance of changing. Your opinion?
What's your opinion on a 99% of these cyst staying the same or resolving on the next MRI in 1-2 years?
I asked him if this would cause me not to live a full normal life. He said it would definitely not cause any issues? Do you agree?
Do you see these in your practice? If so, do they ever cause people not to live a normal life span?
Based on the information given, do you agree that the cysts have a less than 1% chance of changing. He even said that he feels it's as low as .001% chance of changing. Your opinion?
What's your opinion on a 99% of these cyst staying the same or resolving on the next MRI in 1-2 years?
I asked him if this would cause me not to live a full normal life. He said it would definitely not cause any issues? Do you agree?
Do you see these in your practice? If so, do they ever cause people not to live a normal life span?
Brief Answer:
simple pancreatic cyst
Detailed Answer:
Hello again,
1) I am not saying about ERCP. It is different. I was asking about endoscopic USG or endo-sonography.
2) Pancreatic cysts are not common.
3) About your doubt on 99%, yes I do agree. They stay life long but never create any issue.
4) I also agree that it will not affect your quality of life in future. Quality of life after such incidental findings in pancreas is affected only if person undergo surgery for this. Without any need for intervention, there will be no any impact on quality of life.
Hope this is clear now
Regards
simple pancreatic cyst
Detailed Answer:
Hello again,
1) I am not saying about ERCP. It is different. I was asking about endoscopic USG or endo-sonography.
2) Pancreatic cysts are not common.
3) About your doubt on 99%, yes I do agree. They stay life long but never create any issue.
4) I also agree that it will not affect your quality of life in future. Quality of life after such incidental findings in pancreas is affected only if person undergo surgery for this. Without any need for intervention, there will be no any impact on quality of life.
Hope this is clear now
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
One last question, even if one of them grows and it is pre cancerous, would it affect me living a full life span? Granted, they remove it, and what are the odds?
Thank you
Thank you
Brief Answer:
surgery affects quality of life.
Detailed Answer:
Welcome back,
1) If it will be pre-cancerous means it may grow to cancer, 100%. So it must be removed by surgery. And IPMN is pre-cancerous condition. That is why my concern was to confirm this diagnosis by confirming its fluid characteristic if possible. In case if it comes as IPMN, you can do surgery in very early stage which have best outcome.
2) If you do surgery for any reason anywhere on body, it will affect quality of life to some extent.
3) Once these cysts are removed, there is no risk for re-appearance of such cysts.
Take Care
surgery affects quality of life.
Detailed Answer:
Welcome back,
1) If it will be pre-cancerous means it may grow to cancer, 100%. So it must be removed by surgery. And IPMN is pre-cancerous condition. That is why my concern was to confirm this diagnosis by confirming its fluid characteristic if possible. In case if it comes as IPMN, you can do surgery in very early stage which have best outcome.
2) If you do surgery for any reason anywhere on body, it will affect quality of life to some extent.
3) Once these cysts are removed, there is no risk for re-appearance of such cysts.
Take Care
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Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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