Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Mar 8;2024(3):rjae105.
doi: 10.1093/jscr/rjae105. eCollection 2024 Mar.

Microcystic serous cystadenoma of the pancreas causing biliary obstruction: a case report and review of the literature

Sydney Bland  1 , William Thompson Iii  2
Affiliations
Case Reports

Microcystic serous cystadenoma of the pancreas causing biliary obstruction: a case report and review of the literature

Sydney Bland et al. J Surg Case Rep. .

Abstract

Cystic tumors account for 15% of pancreatic tumors. Of these, serous microcystic adenomas represent 1-2% of pancreatic exocrine neoplasms. While typically benign, a small percentage possess malignant potential. Given imaging improvements, serous cystadenomas are being identified more frequently. A 63-year-old female was admitted with complaints of jaundice and unintentional weight loss. Abdominal computed tomography scan showed a 16 cm obstructive pancreatic mass near the porta hepatis region. Endoscopic ultrasonography and fine needle aspiration biopsy indicated a large pancreatic head cystic mass favoring serous microcystadenoma causing biliary and some pyloric obstruction. Malignant potential could not be ruled out because of size and symptoms. A pylorus-preserving pancreaticoduodenectomy revealed a cystic tumor invading the pancreatic duct and adhering to the duodenum of the pancreatic head. Pathology confirmed a 15 cm benign pancreatic serous cystadenoma. Although most serous cystadenomas are benign, surgical resection was prudent given the size, symptoms, and adjacent organ involvement.

Keywords: Whipple surgery; biliary obstruction; microcystic serous cystadenoma.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Abdominal US showing a nonspecific mass in RUQ with numerous microcysts.
Figure 2
Figure 2
Coronal CT showing a large heterogeneous mass in the pancreatic head with typical honeycomb feature.
Figure 3
Figure 3
Mass effect to abdominal viscera from the 14 × 10 × 13 cm pancreatic head mass.
Figure 4
Figure 4
Effacement of SMV (arrow).
Figure 5
Figure 5
Histopathological features reveal the cysts lined by a single layer of cuboidal cells with clear, glycogen-rich cytoplasm, without atypia.
Figure 6
Figure 6
Diagnostic and management algorithm for pancreatic serous cystadenomas.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Dikmen K, Bostanci H, Yildirim AC, et al.Giant serous microcystic pancreas adenoma. Rare Tumors 2012;4:181–3. 10.4081/rt.2012.e56. - DOI - PMC - PubMed
    1. Tajima H, Ohta T, Kitagawa H, et al.Giant serous microcystic adenoma of the pancreas safely resected after preoperative arterial embolization. Oncol Lett 2010;1:841–4. 10.3892/ol_00000148. - DOI - PMC - PubMed
    1. Mandvekar AS, Amarapurkar AD, Shenoy AS, Balsarkar DJ. Serous microcystic adenoma of pancreas. Indian J Gastroenterol 2011;30:183–4. 10.1007/s12664-011-0114-8. - DOI - PubMed
    1. Tseng JF, Warshaw AL, Sahani DV, et al.Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment. Ann Surg 2005;242:413–21. 10.1097/01.sla.0000179651.21193.2c. - DOI - PMC - PubMed
    1. Compagno J, Oertel JE. Microcystic adenomas of the pancreas (glycogen-rich cystadenomas): a clinicopathologic study of 34 cases. Am J Clin Pathol 1978;69:289–98. 10.1093/ajcp/69.1.289. - DOI - PubMed

Publication types