Indeterminate Pancreatic Lesion
An indeterminate pancreatic lesion is an abnormal finding on imaging where a mass, cyst, or structural change in the pancreas cannot be confidently classified as benign or malignant. These lesions may represent cysts, inflammation, benign tumors, neuroendocrine tumors, or pancreatic cancer. Because early pancreatic diseases can appear subtle, additional imaging or follow-up is often required to clarify the nature of the lesion.
What is it?
An indeterminate pancreatic lesion refers to any abnormality in the pancreas that cannot be clearly defined on a single imaging study. These may appear as small masses, cysts with mixed features, subtle areas of enhancement, or irregularities in the pancreatic ducts. Benign possibilities include pseudocysts, serous cystadenomas, fat-containing lesions, or mild inflammation. More serious possibilities include pancreatic adenocarcinoma, neuroendocrine tumors, or mucinous cystic neoplasms.
MRI with MRCP and EUS are often used as follow-up studies because they provide more detail than CT. EUS allows for direct visualization and tissue sampling (biopsy) when necessary. Radiologists assess features such as cyst contents, duct involvement, enhancement patterns, and growth over time to help determine risk.
Important to Know
Most small or subtle pancreatic lesions turn out to be benign, especially when found incidentally. However, because pancreatic cancer can begin with subtle findings, careful follow-up is essential. Timing of follow-up depends on lesion size, appearance, and patient risk factors.
Red flag symptoms include jaundice, persistent abdominal or back pain, unexplained weight loss, new-onset diabetes, or recurrent pancreatitis. These may indicate a more serious underlying condition and require prompt evaluation. Regular imaging helps detect changes early if they develop.