Pancreatic serous cystadenomas (PSCs) are pancreatic cysts that are almost always noncancerous. They appear as clusters of fluid-filled cysts that often form a honeycomb shape. Serous cystadenomas make up about a third of pancreatic cysts and are usually diagnosed incidentally during unrelated abdominal imaging.

Most people with PSCs don’t have any symptoms, and treatment often isn’t necessary. Surgery is usually only required for large or rapidly growing cysts that are causing problems.

Even if you don’t need surgery, a doctor or healthcare professional will likely want to monitor these cysts with imaging because there’s a small risk they’ll become cancerous in the future.

Continue reading to learn more about PSCs, including their causes, potential symptoms, and outlook.

Pancreatic cysts make up about 15% of pancreatic tumors. PSCs make up about 25% of pancreatic cysts. The largest studies available suggest that fewer than 1% are cancerous.

Each part of the name pancreatic serous cystadenomas describes where they form and what they look like:

  • Pancreatic: They develop in the pancreas.
  • Serous: They’re filled with serous fluid, a clear-to-pale-yellow fluid found between organs and their membranes.
  • Cyst: They’re fluid-filled growths.
  • Adenoma: They form in epithelial cells that cover your pancreas.

PSCs are subdivided into microcystic or macrocytic depending on their appearance.

  • Microcystic PSCs are more common. They’re made up of clusters of many small cysts less than 2 centimeters (cm) (0.8 inches) in diameter that often make a honeycomb shape.
  • Macrocytic PSCs are characterized by a smaller number of cysts with a diameter greater than 2 cm. Usually, there are fewer than six cysts.

Other pancreatic cysts

  • Intraductal papillary mucinous neoplasm: These cysts connect with the pancreatic ducts and contain fluid that usually contains large amounts of digestive enzymes. They occur mostly in people over the age of 50.
  • Mucinous cystic neoplasm: These cysts are found almost exclusively in middle-aged women. They have a distinct appearance when examined under a microscope.
  • Solid pseudopapillary neoplasm: These cysts have a combination of a solid and cyst-like portion. They’re mostly found in young women.

The exact cause of PSCs isn’t clear. It’s thought that certain genetic mutations might contribute to their development. They develop more frequently in the body or tail of the pancreas as opposed to the head.

Females develop PSCs about 3 times more often than males. They usually appear in people over 60.

PCSs are frequently associated with von Hippel-Lindau syndrome, a rare genetic disorder that causes tumors and cysts to grow throughout the body. About 77% of people with this syndrome develop cysts on their pancreas.

About 60% of people with PSCs don’t have any symptoms. PSCs are usually diagnosed incidentally when performing abdominal imaging for an unrelated condition.

If they grow large, they can cause symptoms such as:

Abdominal imaging is the primary way that PSCs are identified. A biopsy, where a small piece of tissue is removed and analyzed, can help differentiate them from other types of tumors.

CT scans and MRIs are the main imaging techniques used in diagnosis.

If these types of imaging fail to show your cysts or if a doctor thinks they could be cancer, they may recommend an endoscopic ultrasound with fine needle aspiration.

This minimally invasive procedure involves inserting a long tube with an ultrasound probe down your throat and into your digestive tract. Ultrasound emits high-frequency sound waves to create a detailed image. Doctors can use a thin needle attached to the endoscope to take a small sample of tissue from the cysts so that they can be examined in a laboratory.

Treatment depends on the type and size of your cysts. Nonsurgical treatment is usually recommended if you don’t have any symptoms. PSCs tend to grow slowly, so doctors recommend monitoring them over time to see how they change.

Surgery may be needed for fast-growing cysts or cysts causing symptoms. The type of surgery your surgeon performs depends on the location and size of the cysts. It might include:

  • Whipple procedure, an extensive procedure that removes the head of your pancreas and other parts of your digestive system
  • mid-pancreatectomy, the removal of the middle segment of your pancreas
  • distal pancreatectomy, the removal of the tail of your pancreas, with or without spleen removal

An alternative to surgery for small tumors is endoscopic ultrasound ablation by ethanol injection. This procedure is minimally invasive and, according to this 2020 review of the literature, clinically successful in 98.5% of cases studied.

The outlook for people with PSCs is usually excellent. Cysts tend to grow slowly and rarely become cancerous. Long-term survival has been reported even in people with cysts that have become cancerous

In a 2016 review of studies, researchers found that among 27 people with cancerous PSCs:

  • Fourteen people had cancer spread to distant organs.
  • The time between diagnosis and spread to distant organs ranged from 1 to 10 years.
  • Death was reported in five of the people, with two of these deaths from advanced tumors, two from surgery, and one from an unrelated medical condition.
  • Seventeen of the people were still alive at the time of publication with a median follow-up time of 2 years.

Can pancreatic cystadenomas (PSCs) become cancerous?

PSCs can become cancerous in rare cases. The largest studies available suggest that fewer than 1% of PSCs become cancer.

Can pancreatic cystadenomas (PSCs) cause pancreatitis?

Growing PSCs can cause pancreatitis if they’re left untreated. They can also lead to jaundice if they obstruct your bile ducts.

Is there anything you can do to prevent pancreatic cystadenomas from developing?

Doctors aren’t completely sure why pancreatic cystadenomas develop and what you can do to prevent them. You may be able to lower your chances of developing pancreatic cysts in general by avoiding heavy alcohol. This can lower your chances of developing pancreatitis.

What should I do if my doctor tells me I have pancreatic cystadenomas?

A doctor can best advise you if treatment is needed. If they don’t suspect cancer and the cysts are small, they’ll likely suggest monitoring them over time.

If your cysts are causing you problems, they may recommend surgery.

PSCs are cysts that grow on your pancreas. Most cases aren’t cancerous. No particular treatment is usually needed unless you’re experiencing symptoms or if the cysts are growing quickly.

A doctor can advise you on whether you should have the cysts removed. Even if you don’t need surgery, a doctor will likely recommend monitoring them over time.