Giant Serous Cystadenoma of the Pancreas (⩾10 cm): The Clinical Features and CT Findings

Abstract

Purpose. To report the clinical features and CT manifestations of giant pancreatic serous cystadenoma (≥10 cm). Methods. We retrospectively reviewed the clinical features and CT findings of 6 cases of this entity. Results. All 6 patients were symptomatic. The tumors were 10.2 cm–16.5 cm (median value, 13.0 cm). CT imaging revealed that all 6 cases showed microcystic appearances (n = 5) or mixed microcystic and macrocystic appearances (n = 1). Five patients with tumors at the distal end of the pancreas received distal pancreatectomy. Among these 5 patients, 2 patients underwent partial transverse colon resection or omentum resection due to close adhesion. One patient whose tumor was located in the pancreatic head underwent pancreaticoduodenectomy; however, due to encasement of the portal and superior mesenteric veins, the tumor was incompletely resected. One patient had abundant draining veins on the tumor surface and suffered large blood loss (700 mL). After 6–49 months of follow-up the 6 patients showed no tumor recurrence or signs of malignant transformation. Conclusions. Giant pancreatic serous cystadenoma necessitates surgical resection due to large size, symptoms, uncertain diagnosis, and adjacent organ compression. The relationship between the tumors and the neighboring organs needs to be carefully assessed before operation on CT image.

Serous cystic neoplasm: Do we have to wait till it causes trouble? Season 2

“…However, above-mentioned clinical circumstances are thought to be the same as those of a malignant disease. According to several studies reporting surgical extirpation of symptomatic SCNs [ 5 ], the size of the tumor is relatively large. Combined adjacent organ resection has been frequently reported [ 6 ].…”

A rare case of pancreatic macrocystic serous cystadenoma in an adolescent: a case report and literature review

“…Hence, SCA is also referred to as a “grandmother” tumor. 4 In general, pancreatic cystic lesions are categorized into four types: the microcystic type, macro(oligo)cystic type (such as mucinous tumors), cystic type with a solid component (such as solid pseudopapillary tumors), and diffuse cysts type (such as Von Hippel-Lindau [VHL]-associated mixed tumors). Most SCAs are composed of multiple small cysts (1–2 cm in diameter) separated by thick fibrous septa and covered by cuboid serous epithelial cells, resembling a honeycomb.…”

“…2 Imaging results for MSCs show that they can mimic other pancreatic tumors, and laboratory data show non-specific findings in early stages. 4 Hence, some clinicians have suggested that fine-needle aspiration (FNA) may be helpful for diagnosing SCAs or MSCs. The cytomorphological features of SCA/MSC cyst fluid should include scattered cuboidal cells over a clear background without extracellular mucin or hemosiderin-laden macrophages, but diagnoses that solely rely on judging the cytomorphological features of cystic fluid are also not satisfactory.…”

Unusual Cause of Hematochezia

“…1 However, giant pancreatic serous cystadenomas (GPSC), defined as lesions measuring ≥10 cm, are very rare with only some sporadic cases reported in the literature. 2 Liu et al 2 in a recent review demonstrated that GPSC was more common in women (76%), with a mean age of 65.5 years and slightly more frequent in the head of the pancreas (59%). GPSC tend to adhere, compress, encase, or even infiltrate adjacent structures.…”