MRI MRCP - Cyst (IPMN) - Newbie

I will begin my research this week by checking online for a liver specialist at UC Davis. My niece did the same thing for her dad who is 72 years young and has severe dementia, and she wanted to find the best neurologist at UC Davis, which she was able to do as my sister is having an especially difficult time with her husband's downward spiral. I choose not to discuss my health issues with her because I know she is dealing with enough as it is. I will let you know of my progress. Thank you again for your kindness and support.

Hi,
my wife has been having dull pain on her right abdomen for a while.
she took MRI/MCP. here is one note from radiologist
"There are a few punctate scattered cystic pancreatic lesions measuring 2 mm. These are probably pseudocysis or intraducial papillary mucinous neopiasm. Recommend one-year follow-up MIR/MRCP per ACR criteria". should we be concerned? I heard IPMN can develop into cancer. we are having a follow-up meeting with the radiologist. any pointers would be appreciated.

Welcome, @rjtx. Getting imaging results before being able to review them with a specialist can be frightening. You'll notice that I moved your post to this existing discussion in the Pancreatic Cancer group here:
- MRI MRCP - Cyst (IPMN) - Newbie https://connect.mayoclinic.org/discussion/mri-mrcp-cyst-newbie/

I did this so you can read previous posts and connect with other members like @susanpmadigan @lvtexas @chasenkw @stageivsurvivor @frances007 @ileneb @sb4ca who have also received news that they have a intraductal papillary mucinous neoplasm (IPMN). As you know an IPMN is a benign pancreatic cyst in the ducts of your pancreas that can become malignant, or cancerous.

In this discussion @victoriadukes explains that she will be having surgery to remove her cyst:
- IPMN 2 cm mass head of pancreas caught EARLY....... https://connect.mayoclinic.org/discussion/ipmn-2-cm-mass-head-of-pancreas-caught-early/

You may also be interested in @mariouk journey with IPMN in this discussion:
- Benign or Malignant IPMN? What to do next? https://connect.mayoclinic.org/discussion/six-non-invasive-ipmns/

What questions are you preparing for your upcoming meeting with the radiologist? Can we help you prepare the list of questions?

Hi, I read your story with interest. I had an MRCP in August that shows both liver and pancreatic ducts enlarged, like yours. Also found two small cysts, one in the head and one in the tail. It was ordered at UCLA by their head of hepatology dept. (not sure we can name names here). He told me the cysts were like "pimples" and nothing to worry about. However, I'm still very concerned because it results in something called the double duct sign which is scary when you read about it. I'm in Orange County. Last weekend the LA times featured an article about a comedian who beat pancreatic cancer and she brought up a program at UCSF. I looked up the study and it's a registry for people with pancreatic cysts. I contacted one of the directors there and heard from her right away. Now I wonder if you and I are talking to the same person. My contact is Dr. Kim Kirkwood at UCSF. She said I can get the appropriate imaging down here and she can see patients throughout CA. She also offered me a second opinion session with her which I'm setting up today. These IPMN's at less than 1 cm are put on a watch protocol just like you brought up. She commented that the dilated MPD may call for more testing. My report had the suggested follow-up protocols in these cases, which is an MRI pancreas. My hepatologist never even brought that up. Funny, I have had abnormal liver enzymes since 2013 when I had my gall bladder removed. About 4 years ago I had a liver biopsy at UCLA which wasn't conclusive. They thought it was either drug induced or primary sclerosing cholangitis. Now they want to repeat it. Have you been told anything about your liver directly? I'm having problems separating the two in my mind. Lately, I've been having stomach problems that are worse after eating. So of course I didn't really want to eat and since last Fall I have lost 7 lbs and I'm tiny to begin with. That loss puts me in a lower size jeans than normal. Honestly, if I could get into Mayo I'd likely go for it. I've been in the Arizona facility before. When you have complicated issues (and I have more than the biliary tree issues, such as a poly radiculopathy/neuropathy of unknown cause), they do a fantastic job of referring you immediately to specialists that you can see almost like the next day. It's very intense and highly condensed. If your insurance covers it, I'd advise it. Let me know your thoughts, especially if you're going to see Dr. Kirkwoood (via zoom).

My experience with MRI has been that it's more accurate than ultrasound. My IPMN-MD was resected last July, after a year of surveillance, because, although the IPMN had only grown from 2 cm to 2.1 cm, the duct was dilated more than had previously been observed. Evidence of cancer was found in the resected pancreas tail. I am stage 1b, undergoing chemo now. Doctors speculated that the IPMN may have played a role in the development of cancer. Hope this is somewhat helpful.

Where was your Whipple surgery done? Thanks and God Bless

Actually, the IPMN was located in the tail of the pancreas, so I had a distal pancreatectomy (half of pancreas resected and all of the spleen). It was done at Hartford Hospital in Connecticut. Take care.

Thank you so much. So how do the GI check on the cysts?

I appreciate it!

What did the doctor do to test for the cysts ?

I recently reconnected with my former Rheumatologist who offered me some sage advice about my liver/pancreatic condition. She had been my clinician for about 25 years and when she retired she gave me her address/contact information as we had become friends.
In any event, while discussing my liver/pancreatic condition this week, as well as discussing autoimmune disorders that she had previously diagnosed me with, I had forgotten about the Raynaud's syndrome as well as Sjogren's and the ulcerative colitis. Her suggestion was that I get on the waiting list to see a rheumatologist, and I have asked for a referral to the same. While she agreed that seeing a liver specialist at UC Davis is important , I also need the help of a rheumatologist as all of my conditions could be related to some kind of autoimmune process. I have only a layman's understanding of autoimmune disorders, but understand now that everything I am experiencing could be related to various underlying conditions. I have recently asked for and received a referral to an opthamologist because I had noticed some vision changes as well as that feeling as if there is sand in my eyes, Lubricated eye drops have been helpful, as are the lozenges for dry mouth. Naturally, all of this is overwhelming, and with my recent experience of losing my therapist has only added to my distress over my current medical condition(s). I recently reached out to a therapist I saw over 25 years ago, and I anticipate a response from her soon. For what it is worth, the company which employed my tele-therapist has opened an internal investigation into her termination therapy with me, as well as the misinformation she gave to me about the company's platform and services. This too has added to my distress because it was never my intention to have this therapist face any punitive consequences; however, I see now that she did me a great disservice, especially by telling me that "video" or "FaceTime" visits were not available, when in fact they were. She also kept advising me I needed to be in a group because of my good coping skills and things of that nature, but because of my hearing impairment and the fact that I read lips would have created communication barriers. She did not understand anything about living with a hearing impairment, so I suggested she go on YOUTUBE and watch a video, POWER OF SILENCE, which I saw during the summer at my local public television studio along with my hearing aid dispenser who is also a close friend. In fact, I highly recommend this documentary to anyone who is deaf or hearing impaired or to anyone who wants to gain better insight to those with hearing impairments. My hearing aid dispenser is in this documentary and is a kind and compassionate human being. I am continuing to lose weight and have now developed other symptoms related to the dilation of my bile and pancreatic ducts. The itching is awful as is the chronic diarrhea which is now bright orange, telling me that the bile from my liver is not flowing as it should. While I remain patient until my referral to a UC Davis hepatologist is accepted, the waiting period to see a specialist of any kind is having an enormous effect on my anxiety/stress. All of this causes me to wonder how best to cope during the waiting period while my body undergoes tremendous changes that I have no control over at this point. It is no wonder to me that so many people with chronic medical conditions begin to lose hope, as I am beginning to experience. While I understand the changes in our medical system as a result of Covid-19, knowing this does not make the wait any easier.