What symptoms or changes in a patient's condition should prompt immediate re-evaluation of a pancreatic cyst?

Symptoms or changes in a patient's condition that should prompt immediate re-evaluation of a pancreatic cyst include:

• Development of obstructive jaundice, especially if associated with cystic lesions in the head of the pancreas.
• Appearance of an enhancing solid component within the cyst on imaging.
• An increase in the diameter of the main pancreatic duct to 10 mm or larger.
• New or worsening symptoms such as pain, vomiting, or weight loss that may indicate cyst complications or malignancy.
• Suspicion of infection or risk of rupture in cystic lesions.

These features are considered high-risk and warrant urgent further investigation, including pancreatic protocol CT, MRI/MRCP, and possibly endoscopic ultrasound (EUS) with guided tissue sampling to assess malignancy risk and guide management decisions.

Referral for surgical resection should be considered if any high-risk features are present.

Close monitoring and re-evaluation are essential to detect malignant transformation or complications early.

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