Middle segment pancreatectomy for a solid serous cystadenoma diagnosed by MRCP and review of the literature: A case report

Okumura, Yoshitomo; Noda, Takehiro; Eguchi, Hidetoshi; Iwagami, Yoshifumi; Yamada, Daisakuï¿1⁄2; Asaoka, Tadafumi; Kikuchi, Kôichi; Gotoh, Kunihito; Kobayashi, Shogoï¿1⁄2; Umeshita, Koji; Hashimoto, Yasuji; Takeda, Yutaka; Tanemura, Masahiroï¿1⁄2; Shigekawa, Minoru; Morii, Eiichi; Takehara, Tetsuoï¿1⁄2; Mori, Masaki; Doki, Yuichiro

doi:10.3892/mco.2018.1598

Cited by 2 publications

(4 citation statements)

References 34 publications

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“…The preoperative diagnosis of SCNs of the pancreas is usually the result of a multidisciplinary discussion of clinical, radiological, echoendoscopic, and cytological data. [1234] For pathologists, the diagnosis of SCNs of the pancreas in a presurgical setting is challenging because the cytology suffers from low diagnostic accuracy due to the scant cellularity of the samples,[79171819] and no histological material is routinely recruited from these lesions.…”

Section: Discussionmentioning

confidence: 99%

“…[6] Nevertheless, the definitive diagnosis of Sa-SCA, as for all other types of SCN, remains challenging because EUS-FNA cytology usually results in inconclusive hypocellular or acellular, bloody samples. [78910]…”

Section: Introductionmentioning

confidence: 99%

“…To the best of our knowledge, all other reported Sa-SCA cases have resulted in the decision to proceed with surgical resection for the suspicion of a NET or a malignancy, and the definitive diagnosis was always achieved on surgical specimens. [7]…”

Section: Introductionmentioning

confidence: 99%

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Pseudo solid-appearing pancreatic serous microcystic adenomas: Histologic diagnosis with the EUS core biopsy fork-tip needle

Manfrin¹,

Perini²,

Stefano³

et al. 2019

Endosc Ultrasound

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Background and Objectives:Despite rarely, serous cystic adenoma (SCA) can assume a pseudo-solid aspect mimicking other pancreatic neoplasm as neuroendocrine tumor. EUS-FNA cytology has low diagnostic accuracy due to the scant cellularity of the collected samples. Histological diagnosis is usually made after resection. Recently, end-cutting needles for EUS-fine-needle biopsy (EUS-FNB), which obtain tissue cores by penetrating the lesions, have been developed. We aimed to assess the capability of EUS-FNB with SharkCore™ needles in the preoperative diagnosis of serous cystic adenoma pseudo-solid-appearing on imaging (Sa-SCA).Materials and Methods:Between January 2016 and January 2018, data from consecutive adult patients, who were referred for EUS-FNB of a solid pancreatic lesion and were diagnosed with having SCA, were retrieved from a single-center institutional database.Results:Two patients were excluded because of microcystic aspect at EUS. Histological diagnosis of SCA was made by EUS-FNB in the remaining 7 patients (5 females; mean age of 62.5 years). Lesions (mean size of 19.8 mm) were hypervascular on cross-sectional imaging, slightly hyperdense magnetic resonance imaging with T2-weighted images can, and negative at 68Ga-somatostatin receptor positron emission tomography and 18fluoro-deoxyglucose positron emission tomography. EUS-FNB samples were judged adequate for a definitive diagnosis in all cases, achieving specimens suitable for histological evaluation and several ancillary stains. Histochemical positivity for periodic acid-Schiff (PAS) and PAS with diastase digestion was observed in 7/7 cases. Immunohistochemical positivity for α-inhibin (7/7), GLUT1 (6/6), MUC6 (5/5), and negativity for synaptophysin (7/7) and chromogranin A (2/2) favored SCA diagnosis.Conclusions:In the case of preoperative workup suspected for Sa-SCA, a “forward acquiring” needle could improve the rate of preoperative histological diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pseudo solid-appearing pancreatic serous microcystic adenomas: Histologic diagnosis with the EUS core biopsy fork-tip needle

Manfrin¹,

Perini²,

Stefano³

et al. 2019

Endosc Ultrasound

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“…If symptomatic, the presentation is usually non-specific, with abdominal pain, abdominal mass and, rarely, jaundice [43]. As the remaining serous cystadenomas, SSCAs are well-delimited lesions, hypointense in T1WIs and hyperintense in T2WIs [44]. Its most salient feature is an early rapid enhancement followed by isointensity in the portal phase, a fact that frequently leads to a misdiagnosis of pNEN [40,45,46].…”

Section: Solid Serous Cystadenoma (Figurementioning

confidence: 99%

Rare Solid Pancreatic Lesions on Cross-Sectional Imaging

Veron Sanchez,

Santamaria Guinea,

Cayon Somacarrera

et al. 2023

Diagnostics

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Several solid lesions can be found within the pancreas mainly arising from the exocrine and endocrine pancreatic tissue. Among all pancreatic malignancies, the most common subtype is pancreatic ductal adenocarcinoma (PDAC), to a point that pancreatic cancer and PDAC are used interchangeably. But, in addition to PDAC, and to the other most common and well-known solid lesions, either related to benign conditions, such as pancreatitis, or not so benign, such as pancreatic neuroendocrine neoplasms (pNENs), there are solid pancreatic lesions considered rare due to their low incidence. These lesions may originate from a cell line with a differentiation other than exocrine/endocrine, such as from the nerve sheath as for pancreatic schwannoma or from mesenchymal cells as for solitary fibrous tumour. These rare solid pancreatic lesions may show a behaviour that ranges in a benign to highly aggressive malignant spectrum. This review includes cases of an intrapancreatic accessory spleen, pancreatic tuberculosis, solid serous cystadenoma, solid pseudopapillary tumour, pancreatic schwannoma, purely intraductal neuroendocrine tumour, pancreatic fibrous solitary tumour, acinar cell carcinoma, undifferentiated carcinoma with osteoclastic-like giant cells, adenosquamous carcinoma, colloid carcinoma of the pancreas, primary leiomyosarcoma of the pancreas, primary and secondary pancreatic lymphoma and metastases within the pancreas. Therefore, it is important to determine the correct diagnosis to ensure optimal patient management. Because of their rarity, their existence is less well known and, when depicted, in most cases incidentally, the correct diagnosis remains challenging. However, there are some typical imaging features present on cross-sectional imaging modalities that, taken into account with the clinical and biological context, contribute substantially to achieve the correct diagnosis.

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Middle segment pancreatectomy for a solid serous cystadenoma diagnosed by MRCP and review of the literature: A case report

Cited by 2 publications

References 34 publications

Pseudo solid-appearing pancreatic serous microcystic adenomas: Histologic diagnosis with the EUS core biopsy fork-tip needle

Pseudo solid-appearing pancreatic serous microcystic adenomas: Histologic diagnosis with the EUS core biopsy fork-tip needle

Rare Solid Pancreatic Lesions on Cross-Sectional Imaging

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