A Case of Pancreatic Endometrial Cyst

Abstract

Pancreatic endometrial cyst is an extremely rare instance of ectopic endometriosis that was first described by Marchevsky in 19841). A 21-yr-old woman with a history of epigastric pain and weight loss was found to have a cystic lesion in the pancreas on CT-scan. Under the tentative diagnosis of a pancreatic cystic neoplasm, partial pancreatectomy was performed. Histopathological examination of the specimen revealed cystic endometriosis. The clinicopathological features of the lesion are discussed and literature concerning this extremely rare lesion is reviewed.

Pancreatic endometrial cyst: Report of a case

“…5,6 No patient had dysmenorrhea or an irregular 10.0 cm, the mean size was 6.1 cm, and the location was the pancreatic tail in fi ve cases 3,4,6,8 and the pancreatic body in two cases. 5,7 There were descriptions in one case about the fl uid within the cyst, which was a yellowish serous fl uid. 3 In the current case, a white opaque serous fl uid was observed, so the fl uid within endometrial cysts is not always bloody.…”

“…In reviewing the published data on PubMed, only six cases have so far been reported in English since Marchevsky et al reported the fi rst case of a pancreatic endometrial cyst in 1984. [3][4][5][6][7][8] The current case is therefore the seventh case of a pancreatic endometrial cyst. All reported cases were females ranging from 21 to 47 years of age, with a mean age of 34.4 years.…”

“…9 The histopathological fi ndings of a pancreatic endometrial cyst include a well-encapsulated cyst lined by an endometrium, consisting of a single layer of cuboidal or columnar epithelial cells surrounding a mesenchymal or ovarian-like stroma with fi brosis and hemosiderin accumulation. [3][4][5][6][7][8] Despite being one of the most frequently encountered gynecologic diseases, the exact cause and pathogenesis of endometriosis remains unclear. 10 The fi rst widely considered theory of histogenesis is that of coelomic metaplasia.…”

A rare case of pancreatic endometriosis in a postmenopausal woman and review of the literature

“…Common factors seem to be a genetic predisposition, estrogen dependence, progesterone resistance, and inflammation (16). Most cases of extragenital endometriosis seem to occur in premenopausal patients, but cases affecting postmenopausal women have been reported (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Typical imaging features of pelvic endometriosis with hemorrhage are hyperintense foci on T1-weighted (T1W) images with or without fat saturation, or in the absence of bleeding hypointense on T1W and T2weighted (T2W) images.…”

“…A search on PubMed found eight case reports, with most of the patients within the pre-menopausal or perimenopausal age range. There are some more cases reported concerning hepatic endometriosis, with some of the patients being postmenopausal women (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Patients with pancreatic endometriosis presented with a history of abdominal pain, acute pancreatitis, weight loss, or acute abdomen.…”