B gross pathology photograph illustrates honeycomb pattern of microcysts and central fibrous scar. Evaluation of the cystic masses of the pancreas is a challenge in the routine daily practice. Serous cystadenoma of pancreas radiology reference. Serous cystadenoma of the pancreas is the most common benign pancreatic neoplasm.
Thus, surgical intervention should be proposed in a minority of patients with serous cystadenoma, and only for those who had uncertain diagnosis after systemic examinations or had symptoms 20, 21. The solid variant of serous cystadenoma sc was first described by perezordonez in 1994, and the tumour was defined as a solid tumour with cytological features of serous microcystic adenoma. Pancreatic serous cystadenomas report of 8 cases with a mean follow up of 7. Chronic pancreatitis shounak majumder, suresh t chari chronic pancreatitis describes a wide spectrum of. The preoperative examination results led to a diagnosis of a nonfunctional pancreatic islet cell tumour, and the patient underwent a pyloruspreserving pancreaticoduodenectomy. Pancreatic cystic lesions with increasing advances imaging and asymptomatic cystic tumors of the pancreas has increased than are described prevalence in the.
Ct of serous cystadenoma of the pancreas and mimicking. As a service to our customers we are providing this early version of the. Use of the term chronic pancreatitis without quali. All structured data from the file and property namespaces is available under the creative commons cc0 license. Cystadenomas and cystadenocarcinomas of the pancreas. We present a case of a 46yearold woman who was diagnosed with mixed mucinous cystadenoma with serous cystadenoma of the pancreas. Serous cystadenomas are benign cystic tumors composed of cuboidal epithelium producing serous fluid. A rare case of mixed mucinous cystadenoma with serous. A rare case of mixed mucinous cystadenoma with serous cystadenoma of the pancreas treated by laparoscopic central pancreatectomy. Others oligocystic serous cystadenoma, lymphoepithelial cyst, and cystic islet cell neoplasm. Benign cystic lesions may be managed conservatively, while those with a significant malignant potential need surgical intervention 4.
Pdf serous cystadenoma of the pancreas is a diagnosis being entertained with increasing frequency. Serous cystadenoma prognosis in a series byyg bassi and colleagues y50 patients with sca were treated with definitive surgical resection. A disseminated variant of pancreatic serous cystadenoma. Pancreatic serous cystadenoma is a benign neoplasm composed of glycogenrich epithelial cells that form innumerable small thinwalled cysts that contain serous fluid. Solid serous microcystic adenoma of the pancreas world. Computed tomography and magnetic resonance imaging showed a cystic neoplasm in the. Mixed mucinous cystadenoma with serous cystadenoma of the pancreas is rare. Cystic neoplasms of the pancreas cystic neoplasms of the pancreas. Evidencebased guidelines on the management of pancreatic cystic neoplasms pcn are lacking. Pdf management of serous cystadenoma of the pancreas. Differential diagnosis of pancreatic serous cystadenoma and. A serous cystadenoma of the pancreas showing a invasive growth to lymph node and adipose tissue a case reportyoshio yuasa, shigenobu kado, atushi nakamitu, yuuji imamura, hideyuki nagata, mohei kouyama, naoto hadano and hiroshi daimaru. Any information contained in this pdf file is automatically generated from digital material.
They can be divided into serous and mucinous subtypes, with the former behaving less aggressively and generally considered benign. Histopathological examination revealed that the polyp consisted of multiple microcystic structures similar to those observed in cystadenoma of the pancreas. Case report solid variant of serous cystadenoma of the. Pancreas, serous cystadenoma, computed tomography, pancreatic cysts. Because solid variant sc is very rare, it is difficult to diagnose preoperatively.
The true pancreatic cysts were serous cystadenoma, which was treated by distal pancreatectomy, and mucinous cystadenocarcinoma, which was initially treated by drainage, like a pseudocyst, and then by distal pancreatectomy when its true nature was revealed. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a pdf plugin installed and. Expectant management of serous cystadenoma sca of the pancreas requires an accurate preoperative diagnosis. Get a printable copy pdf file of the complete article 1.
Furthermore, scant cellular yield on fineneedle aspiration. Pancreatic serous cystadenoma is a benign tumour of pancreas. Serous neoplasms of the pancreas archives of pathology. Pancreatic serous cystadenoma with compression of the main pancreatic duct. A 73yearold man initially presented with epigastric abdominal pain and was diagnosed with sca involving the whole pancreas. Mucinous cysts have malignant potential whereas nonmucinous cysts do not. Of the serous neoplasms, serous microcystic adenoma is the most common. Pancreatic cystic neoplasm, serous cystic neoplasm. Although characteristic imaging findings and fluid chemical analysis have been described, scas are not always recognized preoperatively. Differential diagnosis of pancreatic serous cystadenoma.
Introduction cystic tumors of the pancreas ctp have recently gained attention from surgeons and gastroenterologists due to progress in. Cystic neoplasms of the pancreas are less common than solid tumors, and portend a better prognosis. Cystic tumors of the pancreas, serous cystadenoma, mucinous cystadenoma, intraductal papillary tumors, cystic papillary tumors. Pancreatic pseudocyst or a cystic tumor of the pancreas. This type of tumor is very rare in the esophagus, and is suggested to originate from esophageal glands or remnants from the embryonal state. Radiologically, cystadenomas of the liver resemble cystadenomas of the ovary and pancreas and usually appear as large, multilobular cystic lesions 10, 11. Pancreatic cysts are being increasingly identified in patients. Differentiation of mucinous from nonmucinous pancreatic.
It has a very superficial resemblance to the most common type of ovarian cancer serous carcinoma of the ovary under the microscope. Typical and atypical manifestations of serous cystadenoma of. We report a case, which, according to our best knowledge is the 27th case reported in the literature. In contrast to some of the other cystforming tumors of the pancreas, serous cystic neoplasms are almost always entirely benign. All the patients were women, and their ages ranged from to 90 years. The results of this paper have been presented in partial form at the 45th annual pancreas club meeting, chicago, illinois, usa, may 67, 2011. Previously published cytologic diagnostic sensitivities have ranged widely, from 10% to 100%. Ovarian serous cystadenoma, also less precisely known as serous cystadenoma, is the most common ovarian neoplasm, representing 20% of ovarian neoplasms, and is benign. There is no visible communication between the cysts and the pancreatic duct. Apart from true pancreatic cysts, so called pseudocysts, which are defined by the absence of cystlining cells, may develop in the context of pancreatitis and. This study was undertaken to determine whether cyst fluid mucin glycoprotein analysis could differentiate mucinous.
These cysts do not have mucin and have little to no risk of becoming cancerous. Diagnostic criteria, potential for growth or malignancy, and outcomes. The full text of this article is available in pdf format. Types of pancreatic cysts gastroenterology jama jama. Radiographic imaging is a potent tool with which to diagnose serous cystadenoma of the pancreas, but limitations exist. In addition, serous cystic neoplasms slowly grow, and if they grow large enough they can press on. A 86year old patient known to have a serous cystadenoma of the pancreas treated conservatively through a close clinical and radiological follow up which was unattended for 4 years ending up to. Growth pattern of serous cystic neoplasms of the pancreas. Cytologic analysis of cyst fluids was of limited value in differentiating pseudocysts from serous cystadenoma, but in seven of eight mucinous tumors provided useful diagnostic information and correctly classified three of five malignant tumors. Fineneedle aspirations of pancreatic serous cystadenomas. The diagnosis of serous cystadenoma sca, a rare benign pancreatic neoplasm, can alter the management of patients with pancreatic masses.
As regards the diffuse pancreatic calcifications, these indicate that there is a signifcant lesion. Distinguishing potentially malignant cysts from harmless ones by the characterization of cyst fluid contents remains a difficult problem. Clinical features of cystic lesions of the pancreas. Download supplementary data pdf manuscript file of format pdf footnotes. Although, they carry a realistic risk of malignancy despite the general view that they never become malignant.
Pancreatic pseudocysts, serous cystadenomas, mucinous cystadenomas, intraductal papillary mucinous neoplasms ipmns and solid. Background the diagnosis of serous cystadenoma sca, a rare benign pancreatic neoplasm, can alter the management of patients with pancreatic masses. Serous cystadenoma of the pancreas pubmed central pmc. Solid serous cystadenoma sca of the pancreas is a rare type of pancreatic solid tumors. The many faces of pancreatic serous cystadenoma em consulte. Pancreatic serous cystadenoma with compression of the main. Flowchart chart 2 specifying the management of incidental pancreatic cysts 1. Pancreatic ductal adenocarcinoma, the most common form of. Serous cystadenoma of pancreas is an uncommon benign tumor of the pancreas that forms as a cyst. Cystadenoma and cystadenocarcinoma of the pancreas. Serous cystadenoma is a common benign neoplasm that can be managed without surgery in asymptomatic patients provided that the diagnosis is certain. Intraductal papillary mucinous neoplasm ipmn, serous. Serous cystadenomas usually appear as a cluster of small cysts within the pancreas. Pancreatic cysts involve a wide spectrum of pathologies from postinflammatory cysts to malignant neoplasms.
Among cystic tumors, serous cystadenomas of the pancreas have characteristic imaging and histologic features that may differentiate them from other potentially. Serous adenomas represent 12% of pancreatic neoplasms and typically are asymptomatic not requiring any treatment and simple observation is the option of choice. Solid variant of 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. There have been only two previous case reports in the englishlanguage literature. European evidencebased guidelines on pancreatic cystic. Current perspectives on pancreatic serous cystic neoplasms.
The differential diagnosis between cystic tumors serous cystadenoma,mucinous cystadenoma,mucinous cystadenocarcinoma and ipmn, pseudocysts and cystic masses in solid pancreatic tumors. Communication with the pan creatic duct, pancreatic duct dilatation, and a pleomorphic cystic. To date, only approximately 30 cases of serous cystadenocarcinoma are. Postoperative pathological evaluation is of particular importance for distinguishing solid sca of the pancreas from other pancreatic solid tumors.
Microcystic adenoma or serous cystadenoma sca is an uncommon tumor type, accounting for only 12% of pancreatic exocrine neoplasms. Mucinous cystadenoma constitutes approximately 23% of all the resected pancreatic cystic lesions, and serous cystadenoma accounts for 16%. Serous cystadenoma of pancreas old female microcysticadenoma i. Microscopically, the single layer of cuboidal or flattened cells lining the small cysts have. Files are available under licenses specified on their description page. This guideline is a joint initiative of the european study group on cystic tumours of the pancreas, united european gastroenterology, european pancreatic club, europeanafrican hepatopancreatobiliary association, european digestive surgery, and the european society of.
They are found more commonly in women older than 50 years. In contrast, serous cystadenoma is considered benign and are typically found incidentally. Ascites have been reported as a presentation of cystadenoma caused by compression of the vena cava and the hepatic veins by the cyst 9. We describe a case of a solid variant of serous cystadenoma of the pancreas. Mucinous cystic neoplasms are mucinproducing and cystforming epithelial neoplasia of the pancreas with distinctive ovariantype stroma. Mucinous cystadenoma has considerable malignant potential, estimated to be between 10 and 50%. Computeraided diagnosis for distinguishing pancreatic. In the differential diagnosis of pancreatic serous and mucinous cystadenomas, the combination of morphological characteristics and textural. We describe a patient, whose pancreatic cyst exhibited a radiological appearance distinct from that of typical serous cystadenoma, resulting in diagnostic difficulties. This is a pdf file of an unedited manuscript that has been accepted for publication.
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. The most widely applicable radiographic test at the current time is helical ct scanning with thin cuts through the pancreas, which often can provide assistance in the differentiation between serous and mucinous neoplasms. Usually unifocal, scas present as single, large, welldemarcated, multiloculated, cystic tumors, 125 cm in size. The pathological findings in 14 cases of cystadenoma and three cases of cystadenocarcinoma of the pancreas have been studied in relation to the clinical effects. By renchao zhang, xiaowu xu, yucheng zhou, di wu, harsha ajoodhea, ke chen and yiping mou. These neoplasms have been variably referred to as cystadenoma with ovarianlike stroma, cystadenoma with mesenchymal stroma, papillary cystadenofibroma of epididymis and. Epithelial tumors having ovariantype stroma are well known to occur in various organs outside the female genital tract, including the kidney,, pancreas, biliary tract, and retroperitoneum. An extremely rare solid variant of serous microcystic adenoma lacking secretory. Epidemiology, diagnosis, and management of cystic lesions of the pancreas epidemiology, diagnosis, and management of cystic lesions of the pancreas. Read serous cystadenoma of the pancreas associated with obstructive jaundice, journal of gastroenterology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips.