Cystic Degeneration of the Pancreas in a Young Male Adult

A young adult male patient with cystic fibrosis (CF), CF-related diabetes mellitus, and exocrine pancreatic insufficiency presented due to increasing upper abdominal pain. As part of the further evaluation of these acute symptoms, contrast-enhanced MRI (gadolinium) of the abdomen was performed. This revealed complete cystic degeneration of the pancreatic parenchyma as well as individual susceptibility artifacts, likely due to additional parenchymal calcification. No suspect lesions were detected. The observed cystic degeneration of the pancreas (pancreatic cystosis) affects around 8% of CF patients. It is characterized by macrocysts (> 1 cm) that replace the entire pancreatic parenchyma. These cysts are often benign and discovered as an incidental finding in patients with nonspecific symptoms. In the absence of manifest CF, the differential diagnosis should take into consideration von Hippel–Lindau syndrome and multifocal intraductal papillary mucinous neoplasms, among others. Complications arising due to the space-occupying effect may, in rare cases, require surgical treatment such as partial pancreatectomy. In our patient, short-term oral analgesia in addition to his already existing causal CR therapy was sufficient. The patient is currently free of symptoms.

Figure

Multiple smoothly marginated, T2W hyperintense lesions throughout the pancreatic parenchyma (red ellipse), with a maximum diameter of 1.7 cm in the body of the pancreas (red asterisk)

Dr. med. Max Striegler, Dr. med. Martin Sinn, Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, [e-mail]

Conflict of interest statement: The authors state that no conflict of interest exists.

Translated from the original German by Christine Rye.

Cite this as: Striegler M, Sinn M: Cystic degeneration of the pancreas in a young male adult. Dtsch Arztebl Int 2025; 122: 264a. DOI: 10.3238/arztebl.m2025.0038