[Cystic lesions of the pancreas].

CYSTIC LESIONS OF THE PANCREAS. The practice of every gastroenterologist is daily punctuated by the management of patients with pancreatic cystic lesions (PCL). The discovery is usually fortuitous and the lesions in majority are small (less than 10mm). The prevalence of PCL in the general population of adults is very high and probably greater than 40% if we consider lesions of 2 mm. Some PCL are precancerous lesions, (as intraductal papillary mucinous neoplasm [IPMN]) with a real risk of pancreatic adenocarcinoma and others cystic lesions have a risk of metastases such as pseudopapillary and solid tumors or cystic neuroendocrine tumors. The follow-up protocol, recommended by international experts, is highly debated because it is expensive, potentially invasive (in case of repeated use of endoscopic ultrasound) and not perfect. Only a few patients will develop aggressive and potentially invasive lesions. However, the lack of specific diagnostic tools for the grade of dysplasia and the mortality rate of pancreatic cancer leads European experts to recommend regular monitoring.