Differentiation between pancreatic cancer and true pancreatic cyst

For patients, it is crucial to accurately distinguish pancreatic cancer from other diseases. So, how to distinguish the two clinically?

Different causes

The most common true cyst is the retention cyst, which is mostly caused by extra-pancreatic duct compression, pancreatic duct stones, inflammatory stenosis, etc. It can also be caused by congenital abnormal development of the pancreatic duct, which is also called congenital cyst.

The causes of pancreatic cancer are more complicated, and are mostly related to chronic pancreatitis, diabetes, and the patient's high-protein, high-fat, high-calorie diet. In addition, it is also related to the patient's smoking.

Symptoms vary

Typical symptoms of pancreatic cancer are jaundice and abdominal pain. In addition, other symptoms include weight loss, upper abdominal distension, back pain, fatigue, etc.

If the pancreatic true cyst is small, the patient may have no obvious symptoms; if it is large, due to the compression of the cyst, high pressure in the cyst cavity and pancreatic duct, the patient may experience upper abdominal or back pain and digestive system symptoms such as fullness, nausea, vomiting, constipation, abdominal mass, etc. If the cyst ruptures into the abdominal cavity, there will be acute peritonitis; if it ruptures into the digestive tract, it may form an internal fistula, and there will be repeated high fever, abdominal pain, and even upper digestive tract bleeding.

Imaging tests

Ultrasound examination: patients with pancreatic cancer may have enlarged pancreatic head, irregular pancreatic body, dilated pancreatic duct, enlarged gallbladder, and metastatic lesions in the liver, etc. Patients with true pancreatic cysts may have a liquid dark area with a clear location and range in the upper abdomen.

Ultrasound examination: The ultrasound manifestation of true pancreatic cysts is an echo-free area in the pancreas with a capsule, smooth and clear borders, and an echo enhancement effect at the back. Congenital cysts are mostly multiple and often protrude from the surface of the pancreas. Retention cysts are generally single and small in size, often accompanied by compression of the surrounding pancreatic tissue, and have rough echoes. Parasitic cysts have different manifestations depending on the parasite, and can be single-chambered or multi-chambered, with a thick and rough capsule, and subcysts or head segments can be seen in the cysts.

Pancreatic head cancer can be seen as enlarged and thickened pancreatic head with irregular shape, low echo in tumor area, blurry and clear boundary between pancreatic tissue on both sides, compression of main pancreatic duct, abdominal aorta and inferior vena cava. If splenic vein is compressed, spleen will be congested and enlarged. When reexamination after drinking water, compression of gastric antrum and gastric angle can be seen, and stomach is pushed forward and shifted upward.