Benign or Malignant IPMN? What to do next
Hi all,
I’m 27M and pretty anxious about what I’ve experienced earlier. Due to a slight upper abdominal pain, I went to visit my GP and had several blood tests and MRI with contrast done. My CA19-9, CEA and pancreatic enzymes all came out normal.
CA19-9: 2.3
CEA: 1.96
But the MRI with contrast result came out saying it detected a non-enhancing lesion seen on my pancreas tail, around 0.8cm. Suggested IPMN, or other pancreatic neoplasm.
Than I went to visit 2 hepatobiliary surgery doctor, both suggest me to do a PET-CT scan. 2 days later my PET-Ct report came out:
A pancreatic tail 8mm hypodense lesion shows homogeneous fat density and sharp border without F-FDG avidity on both early and delayed imaging, metabolic assessment indicates a benign pancreatic lesion such as pancreatic lipoma. And my doctor told me it is benign and just need a followed up annually with MRI.
Due to my anxiety, I went to visit 2 other hepatobiliary surgery specialists, and both said it most Likely benign, and need to be follow up annually. Although all 4 doctors recommend no surgery since it’ll be overtreatment, but than one of the 4 doctors said a very tiny white dot is seen on the cyst, which could be mural nodule. This has driven me back to the huge anxiety again. I can’t stop myself on thinking about what if it’ll became cancerous later on (Although all doctors said surgery will be totally fine if it gets bigger in a year and won’t affect my survival rate).
Please give me advice on what to do next.
I understand how much anxiety can be brought on by tests that indicate that something is going on with your body. It appears as if you have been extremely thorough in following up on the test findings with several doctors. In circumstances like this, I've learned I have to trust in my doctor's opinion and advice, even if it gives me pause. The suggestion to monitor the lipoma and follow up yearly is reasonable, and you don't want to jump into a surgery you don't need. In circumstances like this, I've just remained in contact with my doctors and monitored how I feel and what I experience due to my particular issue. If the anxiety this is causing you continues to impact your life and thoughts, I would suggest getting that aspect addressed by a doctor so that they can provide you with tools to cope with it. I hope this helps you a bit, but ultimately you will have to find a way to navigate this finding within yourself and with the help of your doctors. I'll be praying for you. Warmly, Cheryl migraine.com team 
I'm sorry to hear you are experiencing increased anxiety about this particular health issue. We can't give medical advice, but as Cheryl suggested, it's important to stay in contact with your doctors.
We are a migraine/headache disorder site, not a general health site. Wishing you luck with all this, Nancy Harris Bonk, Patient Leader/Moderator Migraine.com Team
