Pancreatic cysts are abnormal, saclike pockets of fluid within your pancreas. Serous cystadenoma has 2 main morphologic patterns. A 51yearold female presented with a pancreatic mass incidentally found on the abdominal computed tomography. Clinical features and natural history of serous cystic neoplasm of. These are uncommon tumors and constitute about 12% of all pancreatic tumors. Innumerable small cysts producing a honeycomb appearance were. Case report we report the case of a 52yearold woman admitted to our hospital who had suffered from epigastric pain, nausea and vomiting for 4 months. Computed tomography of cystadenoma and cystadenocarcinoma. Mass has many internal locules with septa black arrow. Cystic lesions of the pancreas are being identified in increasing numbers, both because of the frequent use of radiography and advances in imaging techniques.
In the differential diagnosis of pancreatic serous and mucinous. Imaging of mucinous cystic neoplasms of the pancreas. Macrocystic serous cystadenoma of the pancreas springerlink. Also known as oligocystic serous cystadenoma, serous oligocystic and illdemarcated adenoma. Differential diagnosis of pancreatic serous cystadenoma and. Mucinous cystic neoplasm mcn of the pancreas is basically cystic epithelial neoplasm, unilocular or multilocular, occurring almost exclusively in women. Serous cystadenoma of the pancreas libre pathology.
Laparoscopic resection of a pancreatic serous cystadenoma. An extremely rare solid variant of serous microcystic adenoma lacking secretory capability. Though it may be alarming to learn you have a pancreatic cyst, the good news is that most pancreatic cysts arent cancerous and many dont even cause symptoms. Pdf management of serous cystadenoma of the pancreas. We present a case of a 79yearold greek woman with symptomatic cholelithiasis and a serous pancreatic cystadenoma located at the neck of the pancreas. Jul 16, 2009 pancreatic serous cystadenomas are rare benign cystic neoplasms. Contrastenhanced ct scan obtained during pancreatic phase shows smooth cyst mass in tail of pancreas white arrow. Cystic neoplasms of the pancreas are less common, accounting for about 1015% of all cystic pancreatic lesions.
Cystic degeneration of ductal adenocarcinoma of the pancreatic tail. The similarities stem from the bland architecture of the lesions, and noncommunicating cysts of different sizes compressing the surrounding benign pancreatic stroma. Serous cystadenoma definition of serous cystadenoma by. Cystic neoplasms of the pancreas are less common than solid tumors, and portend a better prognosis. Fibrous central scar with calcification arrow is a classic feature of serous cystadenoma. N2 during the period 1987 to 1994, 14 patients with cystic neoplasms of the pancreas were surgically treated.
Right axial cect in a 35yearold woman demonstrates a large complex cystic mass arising from the pancreatic tail with multiple internal cystic locules and septations, some of which are thick. The sectioned surface of the pancreas revealed a circumscribed, whitish gray ovoid. Spontaneous rupture of a mucinous cystadenoma mca is an exceptionally rare clinical entity. The purpose of our study was to determine useful ct criteria for differentiating serous oligocystic adenomas of the pancreas from other similarly presenting neoplasms, such as mucinous cystadenoma and intraductal papillary mucinous tumor of the branch duct type. Management of serous cystic adenoma of the pancreas medscape. Laparoscopic pancreatic procedures are under evaluation. Management of serous cystic adenoma of the pancreas. Serous cystadenoma of pancreas is an uncommon benign tumor of the pancreas that forms as a cyst. Serous cystadenoma is a benign pancreatic cystic neoplasm. Although extremely rare, serous cystic neoplasms of the pancreas that involve lymph nodes and the liver have been reported 104,115116117118119120 121 122. Distal pancreatectomy was performed by laparotomy and histological and. On magnetic resonance imaging, the cyst showed heterogeneous signal intensity on t1weighted images, and was. Epidemiology previously believed to occur exclusively in middle age females 5, it has occasionally been described in males 6,7. Hepatoid carcinoma of the pancreas combined with serous.
Cystic neoplastic lesion that is a precursor to pancreatic adenocarcinoma. Giant pancreatic serous cystadenoma necessitates surgical resection due to large size, symptoms, uncertain diagnosis, and adjacent organ. It is also known as serous microcystic adenoma, and pancreatic serous cystadenoma. For language access assistance, contact the ncats public information officer. Pancreatic serous cystadenoma is a benign tumour of pancreas. The treatment measures available for benign mucinous cystadenoma of pancreas include the following. The many faces of pancreatic serous cystadenoma epos. Since the pancreas is located in the peritoneum, behind many organs, there is a lot of space for the tumor to grow often unnoticed. However, the tumor showed marked hyperintensity similar to that of hepatic cyst on mr cholangiopancreatography, indicating not a solid but rather a. We present a case of a 79yearold greek woman with symptomatic cholelithiasis and a serous pancreatic cystadenoma located at the neck of. We report a case of solid type serous cystadenoma of the pancreas. Differentiation of cystic lesions of the pancreas is difficult, as they can be benign serous cystadenomas, inflammatory pseudocyst of the pancreas, or malignant.
This cystic neoplasm is made up of several small cysts spread into a honeycomb like appearance. Wgo practice guidelines world gastroenterology organisation. Majority occurs in the body and tail, although 30% of the time they are seen in the head. Serous cystadenoma of pancreas radiology reference article. Diffuse pancreatic serous cystadenoma associated with. In contrast to some of the other cystforming tumors of the pancreas such as the intraductal papillary mucinous neoplasm and the mucinous cystic neoplasm, serous cystic neoplasms are almost always entirely benign.
In this paper, we present the rare case of a serous cystadenoma of the pancreas causing obstruction and upstream dilatation of the main pancreatic duct, making difficult the differential diagnosis with ipmt. Serous cystadenocarcinoma of the pancreas request pdf. Distal pancreatectomy was performed by laparotomy and histological and immunohistochemical. Context the presence of a combined serous cystadenoma and pancreatic endocrine neoplasm is a distinct clinicopathological entity rather than the incidental concurrence of two separate entities. Computed tomographic and magnetic resonance mr images showed a hypervascular solid tumor that was difficult to differentiate from endocrine tumor of the pancreas. Cystadenoma definition of cystadenoma by medical dictionary.
Serous cystadenoma sca represents a form of pancreatic cystic neoplasm which accounts for 1015% of pancreatic tumors and is characterized by benign behavior and heterogeneous macroscopic features, although the microscopic structure of pancreatic sca is uniform, the macroscopic feature shows a wide heterogeneity. Once thought to be rare, cystic neoplasms of the pancreas are being diagnosed with increased frequency because of improvements in pancreatic imaging 14. Ultrasonography and computed tomography revealed a unilocular cyst in the body of the pancreas. On magnetic resonance imaging, the cyst showed heterogeneous signal intensity on t1weighted images, and was homogeneously hyperintense and. Pancreatic ductal adenocarcinoma is the most common pancreatic malignancy, and is. There is no visible communication between the cysts and the pancreatic duct. Combined serous cystadenoma and pancreatic endocrine. Many small cysts separated by thin septa and with central scar demonstrating calcification. Serous microcystic adenoma of the pancreas surgical. May 11, 2018 how is benign mucinous cystadenoma of pancreas treated. Incidentally detected microcystic serous cystadenoma of the.
The natural history and malignant potential of serous cystadenomas differ significantly from that of other cystic neoplasms. Serous cystadenocarcinoma of the pancreas presenting with liver. Serous cystadenoma of pancreas is mainly present in women, especially over the age of 60 years. It typically occurs in women most tumors do not cause any signs and symptoms, but in some individuals, there may be abdominal pain, indigestion, and loss of appetite due to serous cystadenoma of pancreas. The histogenesis of mixed tumors within the pancreas. Serous cystic neoplasms of the pancreas are usually benign. She had no past history of abdominal surgery, instrumentation, or trauma. Pancreatic hepatoid carcinoma hc is an extremely uncommon neoplasm of pancreas that resembles hepatocellular carcinoma hcc. Serous cystadenoma of pancreas occur in adults in the age group of 2590 years, with average age of presentation being 60 years. More frequent use of radiography and advances in imaging techniques have led to larger numbers of cystic lesions being identified. We report a case of incidentally detected pancreatic hc combined with a serous microcystic cystadenoma, in a 47yearold man, while he was being evaluated for renal calculi. Serous cystadenoma is more common than mucinous cystic neoplasm, with a ratio of about 2. Serous cystadenoma of the pancreas is a benign cystic lesion of the pancreas. Serous cystadenoma of pancreas is an uncommon form of cystic tumor of pancreas.
Comptonmacrocystic serous cystadenoma of the pancreas. Management of pancreatic serous cystadenomas advances in. Microcystic adenoma serous cystadenoma of the pancreas. Serous microcystic adenomas are benign tumors of the pancreas and constitute approximately 12% of all exocrine pancreatic tumors. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. Oct 01, 2018 if you have problems viewing pdf files, download the latest version of adobe reader. Spontaneous rupture of mucinous cystadenoma of the pancreas. We report a rare case of pancreatic serous cystadenoma. Solid serous microcystic adenoma of the pancreas world.
Serous cystadenoma of the pancreas, also referred as microcystic adenoma, is an uncommon type of benign cystic pancreatic neoplasm. Any information contained in this pdf file is automatically generated from digital. There is a recognized strong female predilection m. C25 malignant neoplasm of pancreas if malignant icd10.
Rapid shrinkage of a pancreatic serous cystadenoma with. However, the tumor showed marked hyperintensity similar to that of hepatic cyst on mr cholangiopancreatography, indicating not a solid but rather a cystic nature. A 77yearold female with a microcystic serous cystadenoma. Frequently, pancreatic tumors are difficult to detectdiagnose in the early stages. It may be difficult to differentiate the oligocystic variant from mucinous cystic neoplasms or sidebranch intraductal papillary mucinous neoplasms ipmns.
The full text of this article is available in pdf format. Pancreas, serous cystadenoma, computed tomography, pancreatic cysts. How is benign mucinous cystadenoma of pancreas diagnosed. Serous cystadenoma is a common benign neoplasm that can be managed without surgery in asymptomatic patients provided that the diagnosis is certain. T1 cystadenoma and cystadenocarcinoma of the pancreas. In fact most pancreatic cysts arent technically cysts at all. Cysts are larger, less well defined, and fewer in number, can be as few as one locule unilocular variant.
Vhl associated cases are sometimes patchy, multifocal pancreas 2012. Most serous cystadenomas are microcystic, forming an honeycomblike appearance, but macrocystic variants have been described. Serous cystadenoma of pancreas is a rare benign cystic neoplasm constituting 12% of all exocrine pancreatic tumors and isnt it 1015% of all cystic pancreatic neoplasms. Herein, we report a case of a solidtype serous cystadenoma of the pancreas which is the 16th case reported worldwide and the first ever reported in greece. Jan, 2019 serous cystadenoma of pancreas is an uncommon benign tumor of the pancreas that forms as a cyst. Mucinous cystadenoma of the pancreas radiology reference. All but one showed characteristic findings consisting of both cystic and solid components. Cystic neoplasms of the pancreas are increasingly diagnosed in the modern era. The sectioned surface of the pancreas revealed a circumscribed, whitish gray ovoid firm mass. Extended operations are unnecessary for serous cystadenomas and minimally invasive surgery should be performed.
They can be divided into serous and mucinous subtypes, with the former behaving less aggressively and generally considered benign. Nowadays, the current management of serous cystadenomas of the pancreas is essentially conservative. Request pdf incidentally detected microcystic serous cystadenoma of the pancreas with splenic invasion. Innumerable small cysts producing a honeycomb appearance were noticed in serous cystadenomas. Microcystic adenomas of the pancreas glycogenrich cystadenomas. Pancreatic serous cystadenoma wellcircumscribed, lobulated cystic mass most often occurring in pancreatic head classic appearance microcystic or sponge lesion. We report a case of incidentally detected pancreatic hc combined with a serous microcystic cystadenoma, in a 47. Pancreatic serous cystadenomas are rare benign cystic neoplasms. We describe a patient, whose pancreatic cyst exhibited a radiological appearance distinct from that of typical serous cystadenoma, resulting in diagnostic difficulties. Mucinous cystic neoplasms mcns of the pancreas are uncommon, and their diagnosis, treatment, and prognosis have yet to be uniformly determined in full. Pancreatic serous cystadenoma with compression of the main. Mucinous cystadenomas mcn of the pancreas are a type of mucinous cystic neoplasm of the pancreas. Serous cystadenomas are the most common type of cystic neoplasm of the pancreas 5.
Serous cystic neoplasms of the pancreas are benign lesions with little chance for malignant degeneration. A 29yearold woman who presented with epigastric pain and jaundice underwent computed tomography, which showed a 6cm monolocular cystic tumor in the pancreatic head. Ct and mri showed a 10 cmpolycystic tumor with upstream dilatation of the. Background serous cystadenomas of pancreas are rare benign epithelial neoplasms, which predominantly occur in the pancreatic body and tail of elderly females. But diagnostic difficulties may be encountered in the macrocystic oligocystic form of serous cystadenoma seen in 10% to 30% of cases 4, 5. We report a 47yearold woman with macrocystic serous cystadenoma of the pancreas. If there are no signs and symptoms, then a wait and watch approach has been recommended by some experts, since it is a benign condition.
Malignant serous cystic neoplasm is a rare clinical entity. Serous cystadenomas usually appear as a cluster of small cysts within the pancreas. The signs and symptoms can be very similar to other conditions. The cystic spaces are separated by fibrous septa that can coalesce into a central scar that may calcify. An extremely rare solid variant of serous microcystic adenoma lacking secretory. It accounts for approximately 1% of all types of pancreatic tumor. Ten cases of cystadenoma or cystadenocarcinoma of the pancreas were examined by computed tomography ct. We report a rare case of pancreatic serous cystadenoma, which shrank remarkably from 6 to 1. Accounts for almost 50% of pancreatic cystic neoplasms.
Serous cystadenoma of pancreas radiology reference. It is composed of fewer but larger 2 cm cysts and lacks the central stellate scar. The two most common cystic neoplasms of the pancreas are serous cystadenoma and mucinous cystic neoplasms. Computed tomography of cystadenoma and cystadenocarcinoma of. Mucinous cystadenoma of the pancreas with predominant stroma. Both males and females can be affected with this tumor.
Of the serous neoplasms, serous microcystic adenoma is the most common. Example of a transverse ct image obtained in a patient with mucinous cystadenoma was shown in the additional file 1. Magnetic resonance imaging showed a hypervascular mass in the tail of the pancreas of a 72yearold female who presented with mild abdominal pain. Cystadenoma and cystadenocarcinoma of the pancreas. It can affect both males and females, though females are affected more 6580% of the cases involve women. Apr 06, 2017 cystic neoplasms of the pancreas are less common, accounting for about 1015% of all cystic pancreatic lesions. Mucinous cystadenoma of the pancreas with predominant. Pancreatic adenoma genetic and rare diseases information. These neoplasms are almost exclusively benign tumors, and rarely become malignant. Benign pancreatic neoplasm composed of innumerable small cysts lined by bland clear cells. If you have problems viewing pdf files, download the latest version of adobe reader.
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