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. 2011:2011:574378.
doi: 10.1155/2011/574378. Epub 2011 Mar 14.

Pancreatic serous cystadenoma with compression of the main pancreatic duct: an unusual entity

Stéphanie Truant  1 , D Izgarevic, Vincent Maunoury, David Buob, Philippe Bulois, Olivier Ernst, Guillemette Huet, Philippe Zerbib, François-René Pruvot
Affiliations

Pancreatic serous cystadenoma with compression of the main pancreatic duct: an unusual entity

Stéphanie Truant et al. HPB Surg. 2011.

Abstract

Serous cystadenoma is a common benign neoplasm that can be managed without surgery in asymptomatic patients provided that the diagnosis is certain. We describe a patient, whose pancreatic cyst exhibited a radiological appearance distinct from that of typical serous cystadenoma, resulting in diagnostic difficulties. CT and MRI showed a 10 cm-polycystic tumor with upstream dilatation of the main pancreatic duct (MPD), suggestive of intraductal papillary mucinous tumor (IPMT). Ultrasonographic aspect and EUS-guided fine-needle aspiration gave arguments for serous cystadenoma. ERCP showed a communication between cysts and the dilated MPD, compatible with IPMT. The patient underwent left pancreatectomy with splenectomy. Pathological examination concluded in a serous cystadenoma, with only a ductal obstruction causing proximal dilatation.

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Figures

Figure 1
Figure 1
Preoperative computed tomography: presence of a well-defined multiloculated cystic mass in the body and tail of the pancreas with central calcifications.
Figure 2
Figure 2
Magnetic resonance cholangiopancreatography: polycystic mass of the left pancreas with upstream dilatation of the main pancreatic duct (arrow). The pancreatic head shows no abnormality and no dilatation of the MPD.
Figure 3
Figure 3
Endoscopic retrograde cholangiopancreatography: cystic dilatation of the pancreatic branches communicating with the dilated MPD suggestive of an IPMT.
Figure 4
Figure 4
Macroscopic appearance of the pancreatic cystic mass. The lesion, which measures 10 cm in greatest dimension, is made of a combination of large cysts with several small cysts and replaces the entire body and tail of the pancreas.
Figure 5
Figure 5
Microscopic appearance of the pancreatic cystic tumor. Low-power microscopic view shows the simple cuboidal epithelial cells with clear cytoplasm.
Figure 6
Figure 6
Diagnostic and management algorithm for cystic lesion of the pancreas.
See this image and copyright information in PMC

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