Pancreatic Mass AKA Pancreatic Lesions

Pancreatic Mass AKA Pancreatic Lesions

The pancreas functions as both an exocrine and endocrine
gland, producing digestive enzymes such as amylase, lipase,
and proteases that are secreted into the duodenum to
facilitate macronutrient digestion. Its endocrine component
consists of the islets of Langerhans, which secrete key
hormones including insulin and glucagon to maintain glucose
homeostasis. These integrated functions are essential for
effective nutrient metabolism and systemic energy regulation.
Pancreatic masses can be small growths in the pancreas,
often discovered by chance during imaging tests called

“incidental findings”.
What causes them?
Masses can be cysts, inflammatory changes, or tumors.
Do they cause symptoms?
Usually not. Many are silent and only found on scans.
How are they evaluated?
Your doctor may recommend imaging such as a CT, MRI, or endoscopic ultrasound. And in
some cases, a biopsy.
What are the types of nodules?
1. Cystic Lesions (Fluid filled)
a. Pancreatic pseudocyst – Often a result of pancreatitis; not a true tumor.
b. Serous cystadenoma – Benign, typically does not become cancer.
c. Mucinous cystic neoplasm– Precancerous potential; usually in middle-aged
women.
d. Intraductal papillary mucinous neoplasm – Can involve main duct or side
branches; has malignant potential.
e. Solid pseudopapillary neoplasm– Rare, low-grade malignant potential, often in
young women
2. Solid Lesions (Tissue growths)
a. Pancreatic adenocarcinoma – The most common and aggressive pancreatic
cancer.
b. Neuroendocrine tumors – Can be hormone-producing or non-functional; may be
benign or malignant.

3. Metastatic lesions – Originating from cancer elsewhere
4. Inflammatory Lesions
a. Focal pancreatitis or autoimmune pancreatitis – Can mimic nodules on imaging.
b. Hyperplastic or reactive nodules – Related to prior inflammation

What is the prevalence of pancreatic cysts?
Based on a 2024 meta- analysis:

Age Group Pancreatic Cyst Prevalence

50–59 About 9%
60–69 Around 18%
70–79 26%
80+ Nearly 38%

Do they always need treatment?
Depends on the type. Often they can be followed with serial imaging.
If you’ve been told you have a pancreatic mass or lesion, please call your usual physician or
you can book an appointment with us at Westchester Putnam Gastroenterology.

Bibliography:
1. American Cancer Society. Tests for Pancreatic Cancer. American Cancer Society.
Updated February 1, 2023. https://www.cancer.org/cancer/pancreatic-cancer/detection-
diagnosis-staging/how-diagnosed.html
2. Johns Hopkins Medicine. Pancreatic Cysts.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/pancreatic-cysts
3. National Cancer Institute. Pancreatic Cancer Screening (PDQ®)–Patient Version.
Updated July 19, 2024. https://www.cancer.gov/types/pancreatic/patient/pancreatic-
screening-pdq
4. Cleveland Clinic. Pancreatic Cysts. Reviewed February 3, 2023.
https://my.clevelandclinic.org/health/diseases/15499-pancreatic-cysts
5. Mayo Clinic. Pancreatic Cysts – Symptoms & Causes. Updated April 11, 2023.
https://www.mayoclinic.org/diseases-conditions/pancreatic-cysts/symptoms-causes/syc-
20375993

6. Sung J, Lee J, Lee S, et al. Prevalence and risk factors of pancreatic cystic lesions in the
general population: A nationwide study. J Gastroenterol Hepatol. 2024;39(5):1052-1059.
doi:10.1016/j.jgh.2023.12.012.