**1. Introduction**

In the face of this new "epidemic of pancreatic cysts," it is clear that we need to be on top of newly emerging changes in our current daily practice. Pancreatic cancer has a fateful prognosis, despite recent improvements in surgery and chemotherapy. However, most cases of intraductal papillary mucinous neoplasms (IPMNs) are considered as premalignant lesions, thus making them a target for diagnosis and prompt treatment. On the other hand, we should never forget the short- and long-term risks of surgery. This is precisely why it is so challenging to adequately manage this pathology.

Biomarkers represent an interesting opportunity, but until they can be used on a regular clinical basis, we are obliged to say knowledgeable on new insights involving radiologic characteristics and potential malignancy prior to deciding, which is the best available individualized option for each patient.
