Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. But diagnostic difficulties may be encountered in the macrocystic oligocystic form of serous cystadenoma seen in 10% to 30% of cases 4, 5. Most serous cystadenomas are microcystic, forming an honeycomblike appearance, but macrocystic variants have been described. Jul 14, 2017 serous cystadenoma of pancreas is a benign tumor of pancreas. Wgo practice guidelines world gastroenterology organisation. 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. An extremely rare solid variant of serous microcystic adenoma lacking secretory capability.
These are uncommon tumors and constitute about 12% of all pancreatic tumors. T1 cystadenoma and cystadenocarcinoma of the pancreas. Pancreas, serous cystadenoma, computed tomography, pancreatic cysts. Serous cystadenoma is more common than mucinous cystic neoplasm, with a ratio of about 2. The sectioned surface of the pancreas revealed a circumscribed, whitish gray ovoid. Example of a transverse ct image obtained in a patient with mucinous cystadenoma was shown in the additional file 1. Serous cystadenoma of pancreas is mainly present in women, especially over the age of 60 years.
Management of serous cystic adenoma of the pancreas medscape. Fibrous central scar with calcification arrow is a classic feature of serous cystadenoma. Any information contained in this pdf file is automatically generated from digital. Of the serous neoplasms, serous microcystic adenoma is the most common. The similarities stem from the bland architecture of the lesions, and noncommunicating cysts of different sizes compressing the surrounding benign pancreatic stroma. Apr 06, 2017 cystic neoplasms of the pancreas are less common, accounting for about 1015% of all cystic pancreatic lesions. 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. If you have problems viewing pdf files, download the latest version of adobe reader. However, the tumor showed marked hyperintensity similar to that of hepatic cyst on mr cholangiopancreatography, indicating not a solid but rather a. 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. A 77yearold female with a microcystic serous cystadenoma. The natural history and malignant potential of serous cystadenomas differ significantly from that of other cystic neoplasms. Frequently, pancreatic tumors are difficult to detectdiagnose in the early stages. Cystic neoplasms of the pancreas are less common than solid tumors, and portend a better prognosis.
Computed tomographic and magnetic resonance mr images showed a hypervascular solid tumor that was difficult to differentiate from endocrine tumor of the pancreas. Differential diagnosis of pancreatic serous cystadenoma and. Nowadays, the current management of serous cystadenomas of the pancreas is essentially conservative. Mucinous cystadenomas mcn of the pancreas are a type of mucinous cystic neoplasm of the pancreas. Serous cystadenoma has 2 main morphologic patterns. Pancreatic serous cystadenoma with compression of the main. Magnetic resonance imaging showed a hypervascular mass in the tail of the pancreas of a 72yearold female who presented with mild abdominal pain. We report a 47yearold woman with macrocystic serous cystadenoma of the pancreas. Serous cystadenomas are the most common type of cystic neoplasm of the pancreas 5. Comptonmacrocystic serous cystadenoma of the pancreas.
Jan, 2019 serous cystadenoma of pancreas is an uncommon benign tumor of the pancreas that forms as a cyst. Pancreatic serous cystadenoma is a benign tumour of pancreas. Serous cystadenocarcinoma of the pancreas presenting with liver. Spontaneous rupture of mucinous cystadenoma of the pancreas. Management of pancreatic serous cystadenomas advances in. Mucinous cystadenoma of the pancreas radiology reference. Malignant serous cystic neoplasm is a rare clinical entity. It accounts for approximately 1% of all types of pancreatic tumor. Serous microcystic adenoma of the pancreas surgical. Rapid shrinkage of a pancreatic serous cystadenoma with. Macrocystic serous cystadenoma of the pancreas springerlink. Vhl associated cases are sometimes patchy, multifocal pancreas 2012. Serous cystadenoma is a common benign neoplasm that can be managed without surgery in asymptomatic patients provided that the diagnosis is certain.
In fact, once diagnosed correctly through ct scans, mri, eus, fna, serology and blood test studies, observation and routinely reassessment of asymptomatic lesions is indicated thereby avoiding a major operation and resulting morbidity and mortality 1 3. The histogenesis of mixed tumors within the pancreas. A 29yearold woman who presented with epigastric pain and jaundice underwent computed tomography, which showed a 6cm monolocular cystic tumor in the pancreatic head. Cysts are larger, less well defined, and fewer in number, can be as few as one locule unilocular variant. However, the tumor showed marked hyperintensity similar to that of hepatic cyst on mr cholangiopancreatography, indicating not a solid but rather a cystic nature. Serous cystic neoplasms of the pancreas are usually benign.
Request pdf incidentally detected microcystic serous cystadenoma of the pancreas with splenic invasion. It can affect both males and females, though females are affected more 6580% of the cases involve women. Once thought to be rare, cystic neoplasms of the pancreas are being diagnosed with increased frequency because of improvements in pancreatic imaging 14. We report a case of incidentally detected pancreatic hc combined with a serous microcystic cystadenoma, in a 47. Pancreatic serous cystadenoma wellcircumscribed, lobulated cystic mass most often occurring in pancreatic head classic appearance microcystic or sponge lesion. Cystadenoma definition of cystadenoma by medical dictionary. Since the pancreas is located in the peritoneum, behind many organs, there is a lot of space for the tumor to grow often unnoticed. Incidentally detected microcystic serous cystadenoma of the. More frequent use of radiography and advances in imaging techniques have led to larger numbers of cystic lesions being identified. Differentiation of cystic lesions of the pancreas is difficult, as they can be benign serous cystadenomas, inflammatory pseudocyst of the pancreas, or malignant. Ultrasonography and computed tomography revealed a unilocular cyst in the body of the pancreas.
Majority occurs in the body and tail, although 30% of the time they are seen in the head. The signs and symptoms can be very similar to other conditions. Hepatoid carcinoma of the pancreas combined with serous. Also known as oligocystic serous cystadenoma, serous oligocystic and illdemarcated adenoma. In fact most pancreatic cysts arent technically cysts at all. Distal pancreatectomy was performed by laparotomy and histological and.
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. Microcystic adenoma serous cystadenoma of the pancreas. Serous cystadenocarcinoma of the pancreas request pdf. Background serous cystadenomas of pancreas are rare benign epithelial neoplasms, which predominantly occur in the pancreatic body and tail of elderly females. 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.
Distal pancreatectomy was performed by laparotomy and histological and immunohistochemical. A 51yearold female presented with a pancreatic mass incidentally found on the abdominal computed tomography. Imaging of mucinous cystic neoplasms of the pancreas. Pdf management of serous cystadenoma of the pancreas. 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. Jul 16, 2009 pancreatic serous cystadenomas are rare benign cystic neoplasms. Cystic neoplastic lesion that is a precursor to pancreatic adenocarcinoma.
Serous cystadenoma of pancreas radiology reference. How is benign mucinous cystadenoma of pancreas diagnosed. Both males and females can be affected with this tumor. Serous cystadenoma of pancreas radiology reference article. N2 during the period 1987 to 1994, 14 patients with cystic neoplasms of the pancreas were surgically treated. The treatment measures available for benign mucinous cystadenoma of pancreas include the following. This cystic neoplasm is made up of several small cysts spread into a honeycomb like appearance. There is no visible communication between the cysts and the pancreatic duct. Mucinous cystic neoplasms mcns of the pancreas are uncommon, and their diagnosis, treatment, and prognosis have yet to be uniformly determined in full. Combined serous cystadenoma and pancreatic endocrine. Serous cystadenoma of pancreas is an uncommon benign tumor of the pancreas that forms as a cyst. 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. The cystic spaces are separated by fibrous septa that can coalesce into a central scar that may calcify.
Cystic neoplasms of the pancreas are increasingly diagnosed in the modern era. Serous cystic neoplasms of the pancreas are benign lesions with little chance for malignant degeneration. Serous cystadenomas usually appear as a cluster of small cysts within the pancreas. 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. Mucinous cystic neoplasm mcn of the pancreas is basically cystic epithelial neoplasm, unilocular or multilocular, occurring almost exclusively in women. Mucinous cystadenoma of the pancreas with predominant stroma. Serous cystadenoma of the pancreas, also referred as microcystic adenoma, is an uncommon type of benign cystic pancreatic neoplasm. Oct 01, 2018 if you have problems viewing pdf files, download the latest version of adobe reader. Extended operations are unnecessary for serous cystadenomas and minimally invasive surgery should be performed.
Cystic neoplasms of the pancreas are less common, accounting for about 1015% of all cystic pancreatic lesions. We report a rare case of pancreatic serous cystadenoma. We report a case of solid type serous cystadenoma 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. Innumerable small cysts producing a honeycomb appearance were. Diffuse pancreatic serous cystadenoma associated with. We report a rare case of pancreatic serous cystadenoma, which shrank remarkably from 6 to 1. It may be difficult to differentiate the oligocystic variant from mucinous cystic neoplasms or sidebranch intraductal papillary mucinous neoplasms ipmns. The sectioned surface of the pancreas revealed a circumscribed, whitish gray ovoid firm mass. Pancreatic adenoma genetic and rare diseases information.
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. Solid serous microcystic adenoma of the pancreas world. Ten cases of cystadenoma or cystadenocarcinoma of the pancreas were examined by computed tomography ct. Serous cystadenoma of the pancreas libre pathology. Many small cysts separated by thin septa and with central scar demonstrating calcification.
Contrastenhanced ct scan obtained during pancreatic phase shows smooth cyst mass in tail of pancreas white arrow. Serous cystadenoma of pancreas occur in adults in the age group of 2590 years, with average age of presentation being 60 years. Clinical features and natural history of serous cystic neoplasm of. On magnetic resonance imaging, the cyst showed heterogeneous signal intensity on t1weighted images, and was. Computed tomography of cystadenoma and cystadenocarcinoma. These neoplasms are almost exclusively benign tumors, and rarely become malignant. Serous cystadenoma of the pancreas is a benign cystic lesion of the pancreas. For language access assistance, contact the ncats public information officer. It is composed of fewer but larger 2 cm cysts and lacks the central stellate scar. Serous cystadenoma of pancreas is an uncommon form of cystic tumor of pancreas. In the differential diagnosis of pancreatic serous and mucinous.
Management of serous cystic adenoma of the pancreas. Computed tomography of cystadenoma and cystadenocarcinoma of. 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. The full text of this article is available in pdf format. They can be divided into serous and mucinous subtypes, with the former behaving less aggressively and generally considered benign. Benign pancreatic neoplasm composed of innumerable small cysts lined by bland clear cells. 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. Serous microcystic adenomas are benign tumors of the pancreas and constitute approximately 12% of all exocrine pancreatic tumors. Laparoscopic pancreatic procedures are under evaluation. Microcystic adenomas of the pancreas glycogenrich cystadenomas. Pancreatic cysts are abnormal, saclike pockets of fluid within your pancreas.
The many faces of pancreatic serous cystadenoma epos. May 11, 2018 how is benign mucinous cystadenoma of pancreas treated. On magnetic resonance imaging, the cyst showed heterogeneous signal intensity on t1weighted images, and was homogeneously hyperintense and. 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. The two most common cystic neoplasms of the pancreas are serous cystadenoma and mucinous cystic neoplasms. Accounts for almost 50% of pancreatic cystic neoplasms. Mucinous cystadenoma of the pancreas with predominant. All but one showed characteristic findings consisting of both cystic and solid components. Three cases of pancreatic serous cystadenoma and endocrine. We present a case of a 79yearold greek woman with symptomatic cholelithiasis and a serous pancreatic cystadenoma located at the neck of the pancreas. Pancreatic hepatoid carcinoma hc is an extremely uncommon neoplasm of pancreas that resembles hepatocellular carcinoma hcc.
She had no past history of abdominal surgery, instrumentation, or trauma. We describe a patient, whose pancreatic cyst exhibited a radiological appearance distinct from that of typical serous cystadenoma, resulting in diagnostic difficulties. Epidemiology previously believed to occur exclusively in middle age females 5, it has occasionally been described in males 6,7. 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. Spontaneous rupture of a mucinous cystadenoma mca is an exceptionally rare clinical entity. Cystadenoma and cystadenocarcinoma of the pancreas.
Pancreatic serous cystadenomas are rare benign cystic neoplasms. Although extremely rare, serous cystic neoplasms of the pancreas that involve lymph nodes and the liver have been reported 104,115116117118119120 121 122. C25 malignant neoplasm of pancreas if malignant icd10. Cystic degeneration of ductal adenocarcinoma of the pancreatic tail. There is a recognized strong female predilection m. The oligocystic pattern also known as the macrocystic pattern is seen in less than 10% of cases. Cystic lesions of the pancreas are being identified in increasing numbers, both because of the frequent use of radiography and advances in imaging techniques. Innumerable small cysts producing a honeycomb appearance were noticed in serous cystadenomas. Pancreatic ductal adenocarcinoma is the most common pancreatic malignancy, and is. An extremely rare solid variant of serous microcystic adenoma lacking secretory. Serous cystadenoma definition of serous cystadenoma by. Serous cystadenoma is a benign pancreatic cystic neoplasm. Laparoscopic resection of a pancreatic serous cystadenoma. We present a case of a 79yearold greek woman with symptomatic cholelithiasis and a serous pancreatic cystadenoma located at the neck of.