Squamoid cyst of pancreatic ducts: A case report

Abstract

The term squamoid cyst of pancreatic ducts (SCOP) has been proposed recently, and it is a very rare benign lesion. We report a case of SCOP in a patient who underwent laparoscopic distal pancreatectomy. A 51-year-old woman presented with a pancreatic cystic lesion (3.3 cm) as an incidental finding on abdominal ultrasonography. A computed tomography scan showed a well-defined cystic lesion in the body of the pancreas with peripheral nodular calcification. Histology showed a unilocular cyst with a thin, fibrotic wall, and it was surrounded by normal-appearing pancreatic tissue. The lining of the cyst was composed of stratified non-keratinized squamous epithelium without significant nuclear atypia. Immunohistochemistry showed positive nuclear p63 expression in the cyst lining. The final diagnosis of SCOP was established. It is important to distinguish SCOPs from mucinous pancreatic cysts that have malignant potential. Preoperative diagnosis of SCOP is still difficult, and further studies are needed to identify specific preoperative characteristics that can accurately distinguish this lesion.

Keywords: Cysts; Pancreas; Pancreatic neoplasms.

Fig. 1

Abdominal US showed a well-demarcated cyst lesion with a smooth surface (A). CT scan showed a 4-cm sized cystic lesion in the body of the pan-creas, with well-defined margin and peripheral nodular calcifi-cation (B).

Fig. 2

Unilocular cyst surrounded by pancreatic tissue. The cyst is well-circumscribed with fibrotic wall ((A) Hematoxylin-eosin, ×10). The cyst lining is composed of stratified squamous epithelium without keratinization ((B) HE ×20; (C) HE ×400).

Fig. 3

Immunohistochemstrical staining for p63 shows nuclear staining in cyst lining cells ((A) ×20; (B) ×400).