Serous cystic neoplasms of the pancreas are rare in children and adults, are more often observed in females, and are found mainly in the body and tail of the pancreas. This was managed safely by excision and resection with a distal pancreatectomy that was avoided. Serous cystadenomas are benign cystic tumors composed of cuboidal epithelium producing serous fluid. In contrast to some of the other cystforming tumors of the pancreas such as the intraductal papillary mucinous neoplasm and the mucinous cystic.
Methods fiftythree patients with pancreatic serous cystadenoma and 25 patients with pancreatic mucinous cystadenoma were included. Serous cystadenoma of the pancreas with papillary features. There are a number of different types of pancreatic cancer. Neoplastic cysts of pancreas include serous cystic neoplasms scns and mucinous cystic neoplasms. Zincker diverticulum, patient asymptomatic in dec 2018 case 4. Herein, we report a rare presentation of a serous cystadenoma of the pancreas causing obstructive jaundice in a vhl patient, which was managed with a total pancreatectomy. A patients guide to pancreatic cysts 2012 university of michigan comprehensive cancer center 2 what does the pancreas do. The chart showing pdf series, word series, html series, scan qr codes.
Serous cystadenoma of the pancreas communicating with a. The cytomorphologic structure of pancreatic serous cystadenoma has been rarely described, and, to our knowledge, such papillary morphologic structure has never been reported on fineneedle aspiration cytologic examination. Serous cystadenomas of pancreas are rare benign epithelial. Management of pancreatic serous cystadenomas management of serous cystadenomas depends on patients age and comorbidities, tumor size and location, presence or absence of symptoms, local practice patterns, and surgeon preferences. Serous pancreatic cystic neoplasms are infrequent neoplasms of. We present a 31yearold woman with a 3year history of an enlarging symptomatic benign pancreatic mucinous cystadenoma, which was misdiagnosed radiologically as a pancreatic serous cystadenoma or a mesenteric cyst. To report the clinicopathological features of patients with serous cystadenomas of the pancreas. 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. Molecular characteristics of pancreatic serous microcystic adenomas. It is a benign tumor, more common in females in middleage and elderly, usually between 7080 years old. These lesions occur in patients raging from 20 to 90 years of age, most commonly around 60 years. Serous cystadenoma of the pancreas, also referred as microcystic adenoma, is an uncommon type of benign cystic pancreatic neoplasm. This type of cyst is usually located in the body or tail of the pancreas and occurs most often in middleaged women. Atypical manifestations of serous cystadenoma can include giant tumors with ductal dilatation, intratumoral hemorrhages, solid variants, unilocular cystic tumors, interval growth, and a disseminated form.
Preoperative diagnosis of a solidtype serous cystadenoma of the pancreas is difficult, and, due to its benign nature, simple excision of the tumor is the recommended treatment. 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. Intraductal papillary mucinous neoplasm ipmn, serous. Describe the appearance of serous cystadenoma, cystic pancreatic neuroendocrine.
Previous studies have reported many cases of pancreatic serous cystadenoma table 3 the results of receiver operating characteristic analysis characteristics area under the curve 95% ci p value. Thinfibrousseptawere found to separatethecystsinto multiloculatedcompartmentsfig 3. Serous cystadenomas are typically encountered in the head of pancreas, varying from 2 cm to a maximum of 25 cm. Discrimination of pancreatic serous cystadenomas from. Current perspectives on pancreatic serous cystic neoplasms. These unusual proliferative pancreatic cysts have a slow growth rate and are frequently large when they are symptomatic. There is a recognized strong female predilection m. Pancreatic serous cystadenoma, also known as serous cystadenoma of the pancreas and serous microcystic adenoma, a benign tumour of pancreas. Muhammad usman tariq an external file that holds a picture.
Furthermore, scant cellular yield on fineneedle aspiration. Mucinous cystic neoplasms should be resected because of the risk of malignant progression. In the differential diagnosis of pancreatic serous and mucinous. If the diagnosis of serous cystadenoma can be made based on. These findings are not diagnostic of a pancreatic cystadenoma. The diagnosis of serous cystadenoma sca, a rare benign pancreatic neoplasm, can alter the management of patients with pancreatic masses. Typically, a serous cystadenoma is morphologically classified as having either a polycystic, honeycomb, or oligocystic pattern. Serous cystadenomas occur most frequently in middleaged women and become cancerous only rarely. Differential diagnosis of pancreatic serous cystadenoma. Pdf preliminary study of computed tomography texture. We report the case of an 87yearold woman with a serous microcystic neoplasm in the tail of the pancreas that behaved in a. Cystadenomas and cystadenocarcinomas of the pancreas ncbi. Cle probes allow the visualization of a superficial vascular network in the cyst walls of serous cystadenomas, a sign that is. Although surgical resection is the treatment of choice, the relative surgical risk should be.
Serous cystic neoplasms scns of the pancreas are almost always benign, and are among the common primary pancreatic cystic neoplasms. Mixed serousneuroendocrine neoplasm of the pancreas. Pancreatic serous cystadenomas report of 8 cases with a mean follow up of 7. Cystic and intraductal pancreatic and biliary lesions 1. Serous cystadenoma of pancreas pancreas case studies. The vast majority of serous cystic neoplasms of the pancreas are benign, and small, asymptomatic lesions, which are. Common bile duct headtail body pancreatic duct figure 3. Pancreatic cystic neoplasm, serous cystic neoplasm, diagnosis. Management of pancreatic serous cystadenomas advances in. Serous cystadenoma of the pancreas causing obstructive. Pdf serous adenomas represent 12% of pancreatic neoplasms and typically are asymptomatic not requiring any treatment and simple observation is the. Pancreatic serous cystadenoma is a benign tumour of pancreas. Pancreatic serous cystadenoma is the most common benign lesion of the pancreas.
These tumors consist predominantly of small cysts microcystic adenomas. Imaging findings of a pancreatic head lesion are compatible with pancreatic serous cystadenoma microcystic adenoma. From this pool we gathered 27 cases of pancreatic neuroendocrine tumors, 25 serous adenomas, 2 intrapancreatic splenules and 4 pancreatic hypervascular metastases table 1 on page 3. Evaluation of pancreatic lesions in vivo microscopy ivm applies light directly to living tissues to produce images that may be interpreted by a trained pathologist. Pancreatic cancer mortality has been gradually increasing despite the decreasing death rates of most major cancers, including lung, colorectum, female breast, and prostate cancers. Figure 2 microcystic pancreatic serous cystic neoplasm presentation on. Ethics documents guidelines for the manuscript publishing process. Serous cystadenoma of pancreas radiology reference. Serous cystadenoma of pancreas is an uncommon benign tumor of the pancreas that forms as a cyst. Overview of treatment of cystic lesions of the pancreas classification of pancreatic cysts nonneoplastic cysts pseudocyst true cyst lymphoepithelial cyst neoplastic cysts serous cystadenoma.
Malignant serous cystic neoplasm of the pancreas is a rare clinical entity. Serous cystadenoma sca of the pancreas, encompassing serous microcystic adenoma sma and serous oligocystic adenoma soa, accounts for 1% to 2% of exocrine pancreatic tumors. Learning opportunities will be focused in the domains of benign and malignant diseases of the liver, pancreas, biliary tract, duodenumperiampullary lesions, and. Serous cystadenoma of the pancreas pubmed central pmc. Typical microcystic adenoma showing multiple small cysts. Cystadenomas and cystadenocarcinomas of the pancreas.
However, there are occasional reported cases of serous cystic tumors that behaved in a malignant fashion. Excision of benign mucinous cystadenoma of the pancreas. Conclusion to differentiate serous cystadenoma from other cystic lesions communicating with the pancreatic duct, careful radiological examination is necessary. Differential diagnosis of pancreatic serous cystadenoma and. Objectives this study was designed to estimate the performance of textural features derived from contrastenhanced ct in the differential diagnosis of pancreatic serous cystadenomas and pancreatic mucinous cystadenomas. Computeraided diagnosis for distinguishing pancreatic. The mucinous cystadenoma has to be considered as potentially malignant. Serous cystadenoma of the pancreas is an uncommon neoplasm that occasionally exhibits papillary differentiation.
Pathological features of proliferative cystic lesions of the pancreas permit distinction of three different tumours. Typical and atypical manifestations of serous cystadenoma. The full text of this article is available in pdf format. Cystic lesions of the pancreas are being identified in increasing numbers, both because of the frequent use of radiography and advances in imaging techniques. Current case serous cystadenoma of pancreas diagnosis hidden 4,716. Nonmucinous minimally mucinous intraductal iopn itpn scopd others serous spn degenerativepdacacinar cell carcinomanens outline. Clinical features and natural history of serous cystic neoplasm of. Although different histologic types of cystic pancreatic neoplasms have been reported in the literature, serous cystadenomas, mucinous cystic neoplasms, and intraductal papillary mucinous neoplasms ipmns account for 90% of all primary cystic pancreatic neoplasms 5.
The disease can affect the main pancreatic duct or a branch of the main pancreatic duct figure 5 and have the potential to turn into cancer. In general, serous cystic neoplasms of the pancreas are thought to be benign. Evaluation of pancreatic lesions that may be interpreted. Although characteristic imaging findings and fluid chemical analysis have been described, scas are not always recognized preoperatively. Teaching files with ct medical imaging and case studies on anatomical regions including adrenal, colon, cardiac, stomach, pediatric, spleen, vascular, kidney, small bowel, liver, chest ctisus. A determination will be made at eus whether the cysts can be safely monitored or if a surgery will be required. Mixed serous neuroendocrine neoplasm of the pancreas. Excision of mucinous cystadenoma of pancreas is safe and.
Diagnostic criteria, potential for growth or malignancy, and outcomes are not well defined. Macrocystic serous cystadenoma msc of the pancreas is a rare benign neoplasm with varied imaging appearances. Due to the variability inherent to tissue samples and histologic methodology, most of the tissue microarray sections will not contain all. Serous cystadenomas are thought to arise from the centroacinar cells found at the junction of the ductal system and the pancreatic acini 14 x 14 moore, p. We describe an intriguing case of a surgically resected and histologically proven. Curvilinear array, echoendoscopic image of a pancreatic body tumor. Its precancerous and may already be cancerous when discovered. Serous cystadenoma of the pancreas is the most common benign pancreatic neoplasm. Resection is generally carried out for symptoms, large size, or the inability to distinguish a serous cystic neoplasm from a mucinous lesion, which has greater. Epidemiology, diagnosis, and management of cystic lesions of the pancreas epidemiology, diagnosis, and management of cystic lesions of the pancreas.
The microcysticcystadenomaswere composedof serous cystsofvaryingsizeandshape. Biopsy with a moray forceps of a cystic lesion the tail of the pancreas. Evaluation and management of cystic lesions of the pancreas. As a result, management for patients with serous cystadenomas varies widely in current practice. Pancreas, serous cystadenoma, computed tomography, pancreatic cysts. Pancreatic cystic lesion typical of serous cystadenoma.
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