Macrocystic serous cystadenoma of the pancreas: Report of 4 cases. (September 2015)

• Record Type: Journal Article
• Authors: Pravisani, Riccardo; Intini, Sergio Giuseppe; Girometti, Rossano; Avellini, Claudio; Leo, Cosimo Alex; Bugiantella, Walter; Risaliti, Andrea
• Is Part Of: International journal of surgery. Volume 21(2015)Supplement 1
• Page Start: S98
• Page End: S101
• Publication Date: 2015-09
• Subjects: Serous cystadenoma -- Macrocystic -- Cystic pancreatic neoplasm -- Pancreas; SCA Serous Cystadenoma -- MaSCA Macrocystic Serous Cystadenoma -- MCN Mucinous Cystic Neoplasm -- BD-IPMN Branch Duct - Papillary Mucinous Neoplasm -- CT Computed Tomography -- HU Hounsfield Units -- BMI Body Mass Index -- MRI Magnetic Resonance Imaging -- EUS Endoscopic Ultrasonography -- FNA Fine Needle Aspiration -- MRCP Magnetic Resonance Cholangiopancreatography -- MCA Mucinous Cistoadenoma; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2015.04.097
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Background: Macrocystic serous cystadenomas (MaSCA) are rare benign tumor of the pancreas which represent an atypical macroscopic morphologic variant of serous cystadenomas (SCA). They are characterized by a limited number of cysts with a diameter of >2 cm and share imaging features overlapping those of mucinous cystic neoplasm (MCN) and branch-duct intraductal papillary mucinous neoplasm (BD-IPMN), thus frequently making the pre-operative radiologic diagnosis difficult. Materials and methods: Four cases of MaSCA, which were surgically treated in our structure, are reported. Results: Two women (62 and 39 year-old) presented with upper abdominal pain and palpable mass underwent CT with evidence of a lobulated cystic neoformation (98 × 70 and 94 × 75 mm respectively) originating from the body and the tail of the pancreas respectively. They underwent distal pancreatectomy for suspected MCN. A 38 year-old woman underwent laparoscopic distal pancreatectomy because of the incidental finding of an unilocular cystic lesion in the pancreatic tail (23 mm) of indeterminate origin (MCN, SCA or metastasis). In a 40 year-old woman, admitted for acalculous acute pancreatitis, an unilocular cystic lesion in the body of the pancreas (62 mm) was detected and confirmed after 2 months at CT, therefore she underwent distal pancreatectomy for suspected pseudocyst or SCA. In all of the 4 patients the histological examination of the specimens revealed a MaSCA. Conclusion: Imaging techniques have a low diagnostic power in terms of differentiation of MaSCA from malignant lesions (as MCNs and BD-IPMN). In the clinical practise of MaSCA, surgery appears to gain indications that are wider than those correlated to the pathologic outcome, because of the necessity of a correct differential diagnosis from potentially malignant cystic tumors and the frequent symptoms requiring treatment.