Pancreatic Serous Cystadenoma with Compression of the Main Pancreatic Duct: An Unusual Entity

Stéphanie Truant,Guillemette Huet,D Izgarevic,François-René Pruvot,Vincent Maunoury,Philippe Bulois,Olivier Ernst,Philippe Zerbib,David Buob

doi:10.1155/2011/574378

Stéphanie Truant, Guillemette Huet + Show 7 more

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https://doi.org/10.1155/2011/574378

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Abstract

Serous cystadenoma is a common benign neoplasm that can be managed without surgery in asymptomatic patients provided that the diagnosis is certain. We describe a patient, whose pancreatic cyst exhibited a radiological appearance distinct from that of typical serous cystadenoma, resulting in diagnostic difficulties. CT and MRI showed a 10 cm-polycystic tumor with upstream dilatation of the main pancreatic duct (MPD), suggestive of intraductal papillary mucinous tumor (IPMT). Ultrasonographic aspect and EUS-guided fine-needle aspiration gave arguments for serous cystadenoma. ERCP showed a communication between cysts and the dilated MPD, compatible with IPMT. The patient underwent left pancreatectomy with splenectomy. Pathological examination concluded in a serous cystadenoma, with only a ductal obstruction causing proximal dilatation.

Highlights

Typical macroscopic characteristics of serous cystadenoma of the pancreas consist of microcystic mass with a spongelike honeycomb aspect or central scar or both
Most authors advise that patients who are asymptomatic can be closely followed provided that differential diagnosis can be definitively made with other potentially malignant cystic tumors, mainly mucinous cystadenoma or intraductal papillary mucinous tumor (IPMT) [2, 3]
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

Summary

Introduction

Typical macroscopic characteristics of serous cystadenoma of the pancreas consist of microcystic mass with a spongelike honeycomb aspect or central scar or both. Most authors advise that patients who are asymptomatic can be closely followed provided that differential diagnosis can be definitively made with other potentially malignant cystic tumors, mainly mucinous cystadenoma or intraductal papillary mucinous tumor (IPMT) [2, 3]. Diagnostic difficulties may be encountered in the macrocystic oligocystic form of serous cystadenoma seen in 10% to 30% of cases [4, 5]. 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

Case Report

Findings

Discussion

Conclusion