The issue is the initial diagnosis because if this is a side branch IPMN, I know that any center is just going to monitor it. It is 8mm and all the protocols seem to just be watch it. My concern is making sure the initial dx is well done. I think I will call Yale tomorrow and see if I can get someone to talk to me about how they would approach this because if they aren't going to do any specialized imaging, I can just send them my images for a second opinion. I can always transfer care I guess.