Dermoid cyst of the pancreas: presentation and management

Abstract

Background: Dermoid cyst of the pancreas is a benign, well-differentiated, extremely rare germ cell neoplasm. Published data indicate that differential diagnosis of cystic lesions of the pancreas is challenging and although ultrasonography, computed tomography and magnetic resonance may be useful, radiological findings are often inconclusive and the diagnosis is intraoperative. We report a case of a dermoid cyst of the tail of the pancreas intraoperatively diagnosed and successfully treated with left pancreatectomy. Further, characteristics, preoperative detection and differential diagnosis of this rare pathology are also discussed.

Dermoid cyst of the pancreas: a case report

“…The most common signs and symptoms are palpable mass in the upper quadrant of the abdomen, abdominal pain, back pain, nausea, vomits, anorexia, weight loss, fatigue and fever. However, there are some cases with no symptoms (18.3%) (6) , only incidentally discovered at diagnostic imaging (3,4,8,12,13,15) , as it happened in our study.…”

“…There is also report of the conduction of endoscopic ultrasound-guided FNA (8) , but there are no pathognomonic data to recognize a dermoyd cyst, and many times preoperative diagnosis is inconclusive (9,11,13) , as well as in this case, in which the pancreatic dermoyd cyst was not a differential diagnosis according to the surgery team.…”

“…The dermoid cyst of the pancreas, also called mature cystic teratoma of the pancreas, is an uncommon mesenchymal neoplasm, firstly described in 1918 (4,5,(10)(11)(12)(13) , with 35 cases reported in the world literature (7) . This is the 36 th reported case up to now, according to a bibliographic survey.…”

“…Tumor markers CEA and CA19-9 are generally lower than those in other pancreatic cystic neoplasms (13) , but no consensus exists and further studying is necessary. In the present case, the patient presented normal levels of these and other markers, as previously cited.…”

“…The clinical picture is non-specific (3,4,7,8,12,13,15) , and the preoperative diagnosis is difficult. Many times it is suggested by imaging studies, but only confirmed by histological evaluation (9) .…”