Pancreatic serous cystic neoplasm mimicking intraductal papillary mucinous neoplasm: Two case reports and literature review

Abstract

Rationale: Serous cystic neoplasms (SCNs) are treated as benign lesions. It is widely known that SCN rarely have a connection with the main pancreatic duct (MPD), which helps differentiate them from other cystic lesions, such as intraductal papillary mucinous neoplasm (IPMN). However, very rare cases where the SCN appears connected to the MPD cause diagnostic confusion. Patient concerns: We present 2 patients with SCN (1 male, 54, and 1 female, 42). Both patients were asymptomatic, without abnormal laboratory results. Diagnosis: In both cases, abdominopelvic computed tomography and pancreatic magnetic resonance imaging scans revealed a multilobulated cystic lesion in communication with the MPD. Since the size of each patient’s lesion was >3 cm and there was connectivity with the MPD, it was strongly suspected to be a branch duct-type IPMN with worrisome features rather than SCN and surgical intervention was considered. Interventions: Both neoplasms were misdiagnosed as IPMN due to appearing connected with the MPD on radiologic imaging. Surgery was performed. Outcomes: A final diagnosis of microcystic serous cystadenoma of the pancreas without connectivity of MPD was confirmed in both patients. Lessons: An unnecessary surgery was performed due to atypical radiologic features in which the pancreatic duct seems to be connected to the pancreatic cystic lesion on magnetic resonance imaging, leading to misdiagnosis of SCN as IPMN. Particular attention should be paid to interpretation of clinicoradiologic findings of pancreatic cystic lesions, especially to the decision of surgical intervention. Also, awareness of presence of the atypical radiologic features of SCN may broaden the knowledge base of radiologists. Lessons: An unnecessary surgery was performed due to atypical radiologic features in which the pancreatic duct seems to be connected to the pancreatic cystic lesion on magnetic resonance imaging, leading to misdiagnosis of SCN as IPMN. Particular attention should be paid to interpretation of clinicoradiologic findings of pancreatic cystic lesions, especially to the decision of surgical intervention. Also, awareness of presence of the atypical radiologic features of SCN may broaden the knowledge base of radiologists.

A bibliometric and visualization analysis of global research on postherpetic neuralgia from 2000 to 2022: A review

“…We have consulted analogous scholarly works and restricted the range of document genres to solely encompass articles and reviews. [ 28 , 29 ] The search criteria were defined as TS = (PHN) or (neuralgia, postherpetic) or (post-herpetic neuralgia) AND DT = (Article OR Review). In total, 3505 papers were retrieved, consisting of 2677 articles and 828 reviews.…”

Preconditions for radiomics-based approach in differential diagnosis of pancreatic cystic lesions: critical evaluation of meta-analyses and international guidelines

“…Компрессионный эффект и ассоциированная эктазия протоков дистальнее образования могут приводить к формированию эрозии и истинного сообщения образования с ГПП [34]. Кистозное образование, ассоциированное с дистальным расширением ГПП, не исключает наличия серозной цистаденомы и ВПМО 2-го типа [30,35].…”