Figure 1 large amount of free peritoneal air and free fluid alongside with evidence o metastatic liver disease. Jan, 2019 serous cystadenoma of pancreas is an uncommon benign tumor of the pancreas that forms as a cyst. In all, 106 patients diagnosed with serous cystadenoma were identified. Serous cystadenoma of pancreas is a benign tumor of pancreas. Herein, we report a case of a solidtype serous cystadenoma of the pancreas which is the 16th case reported worldwide and the first ever reported in greece. Differential diagnosis of pancreatic serous cystadenoma. The first large series of pathologically proven serous cystadenoma was first described in 1978 21. Doctors give trusted, helpful answers on causes, diagnosis, symptoms, treatment, and more. Serous cystadenoma sca represents a form of pancreatic cystic neoplasm which accounts for 1015% of pancreatic tumors and is characterized by benign behavior and heterogeneous macroscopic features. Since 1978, 211 cases have been reported in the literature. The full text of this article is available in pdf format.
All but one showed characteristic findings consisting of both cystic and solid components. Dec 16, 2019 mucinous cystadenoma constitutes approximately 23% of all the resected pancreatic cystic lesions, and serous cystadenoma accounts for 16%. Serous cystadenoma of pancreas radiology reference article. Serous cystadenoma of the pancreas libre pathology. It can affect both males and females, though females are affected more 6580% of the cases involve women. Classification of the adnexal masses histopathology results n % benign masses 45 100 serous cystadenoma 15 33. The treatment measures available for benign mucinous cystadenoma of pancreas include the following. Distal pancreatectomy was performed by laparotomy and histological and. Rare presentation of serous cystadenoma as hemorrhagic cyst author. Mar 08, 2012 among this group of lesions, the serous cystadenoma is typically asymptomatic.
Although a lobulated contour is a specific feature of serous cystadenoma, it may be over looked on the initial ct evaluation fig. Commonly, pancreatic serous cystadenomas are considered to be benign neoplasms, whereas mucinous cystadenomas are thought. Pancreatic serous cystadenoma with compression of the main. Serous cystadenoma of pancreas is an uncommon form of cystic tumor of pancreas. Serous cystadenomata scas are benign entities that historically have been described to constitute 1% of neoplasia from the exocrine pancreas.
An oligocystic serous cystadenoma appears as a multicystic or lobulated cystic lesion with septation in the head of the pancreas, whereas mucinous cystic neoplasms have smooth contours with or without septation, and intraductal papillary mucinous neoplasms have either a pleomorphic or a clubbed, fingerlike cystic shape. The most common presentation is with numerous small cysts that give a honeycomb appearance microcystic variant, thin septa, and sometimes with a central scar. Pancreatic serous cystadenoma with signs of compression em. The histopathologic findings, diagnostic strategy, differential diagnosis, and treatment strategy of these generally benign but sometimes symptomatic lesions are discussed. Radiographic imaging is a potent tool with which to diagnose serous cystadenoma of the pancreas, but limitations exist. Serous cystadenoma definition of serous cystadenoma by. Vhl associated cases are sometimes patchy, multifocal pancreas 2012. The prevalence of cancer among serous cystadenomas is reported to be 3% since the first case reported in the literature in 1989. Serous cystadenomas of pancreas are rare benign epithelial neoplasms, which predominantly occur in the pancreatic body and tail of elderly females. The natural history and malignant potential of serous cystadenomas differ significantly from that of other cystic neoplasms. Typical macroscopic characteristics of serous cystadenoma of the pancreas consist of microcystic mass with a spongelike honeycomb aspect or central scar or both. Serous cystadenoma of pancreas occur in adults in the age group of 2590 years, with average age of presentation being 60 years. It is rather clear from the literature that the differentiation between benign and malignant serous cystadenoma both histologically and clinically may be very difficult 911.
In contrast to some of the other cystforming tumors of the pancreas such as the intraductal papillary mucinous neoplasm and the mucinous cystic neoplasm, serous cystic. In fact, once diagnosed correctly through ct scans, mri, eus, fna, serology and blood test studies, observation and routinely reassessment of asymptomatic lesions is indicated thereby avoiding a major operation and resulting morbidity and mortality 1 3. Serous cystadenoma of pancreas is an uncommon benign tumor of the pancreas that forms as a cyst. Serous cystadenoma microcystic and oligocystic is relatively rare among pancreatic neoplasms 1, 2.
Serous cystadenomas scas are benign tumors, and serous. It typically occurs in women most tumors do not cause any signs and symptoms, but in some individuals, there may be abdominal pain, indigestion, and loss of appetite due to serous cystadenoma of pancreas. Pancreatic serous cystadenoma is typically found in women accounting for 74% of cases with a mean age of 58 years 1699 years, and the tumor is usually located at the bodytail of the pancreas. Accounts for almost 50% of pancreatic cystic neoplasms. Serous cystadenoma is more common than mucinous cystic neoplasm, with a ratio of about 2. Serous cystadenocarcinoma of the pancreas and serous. Tell a friend about us, add a link to this page, or visit the webmasters page for free fun content. Serous cystadenocarcinoma of the pancreas is a rare but wellestablished entity.
While serous cystadenoma is the most common of them all, they rarely grow to large sizes unless. Differential diagnosis of pancreatic serous cystadenoma and. Pdf serous adenomas represent 12% of pancreatic neoplasms and typically are. Microcystic serous cystadenoma of the pancreas is an uncommon pancreatic exocrine neoplasm that morphologically resembles conventional clear cell rcc, in so far as both tumors are characterized. Serous cystadenoma of pancreas is a rare benign cystic neoplasm constituting 12% of all exocrine pancreatic tumors and isnt it 1015% of all cystic pancreatic neoplasms. Serous cystic neoplasms of the pancreas although they carry a realistic risk of malignancy, the predominant view is that they never become malignant. Nowadays, the current management of serous cystadenomas of the pancreas is essentially conservative. A 65yearold woman was admitted to our hospital for evaluation of a palpable, elastic, hard mass measuring 6 cm in diameter in the right upper quadrant of the abdomen. A patient with a history of a large pancreatic serous cystadenoma sca presented to the emergency department with abdominal pain and haemodynamic shock. Distal pancreatectomy was performed by laparotomy and histological and immunohistochemical.
The risk of malignant transformation seems to be low even in the longterm course 1. It is also known as serous microcystic adenoma, 1 and pancreatic serous cystadenoma. Mcn, serous cystic neoplasm, rare cysts, neoadjuvant treatment, and. Three cases of pancreatic serous cystadenoma and endocrine. Serous cystadenoma article about serous cystadenoma by. European evidencebased guidelines on pancreatic cystic. Majority of these tumors have microcystic appearance. Serous cystadenoma sca of pancreas accounts for more than half of cystforming neoplasms and has been increasingly recognized with advancement of clinical imaging evaluations. Serous cystadenomas are the most common type of cystic neoplasm of the pancreas 5. Resection is generally carried out for symptoms, large size, or the inability to distinguish a serous cystic neoplasm from a mucinous lesion, which has greater. Discussion serous cystadenoma of pancreas is a rare benign cystic neoplasm constituting 12% of all exocrine pancreatic tumors. Between january 1986 and october 1998 25 patients with serous cystic neoplasms of the pancreas were operated at our institution.
Cystic lesions of the pancreas are being identified in increasing numbers, both because of the frequent use of radiography and advances in imaging techniques. Mucinous cystadenoma has considerable malignant potential, estimated to be between 10 and 50%. Magnetic resonance imaging showed a hypervascular mass in the tail of the pancreas of a 72yearold female who presented with mild abdominal pain. Serous cystadenoma of the pancreas belsley 2008 cancer. Causes of ovarian serous cystadenoma answers on healthtap. Serous cystadenoma of the pancreas is commonly considered to be a benign.
Wed like to understand how you use our websites in order to improve them. May 11, 2018 how is benign mucinous cystadenoma of pancreas treated. Ten cases of cystadenoma or cystadenocarcinoma of the pancreas were examined by computed tomography ct. Diseasefree survival was defined as the length of time. There is a recognized strong female predilection m.
Mixed serous cystadenoma with mucinous cystadenoma of the. Diagnostic criteria, potential for growth or malignancy, and outcomes are not well defined. Pancreas is an important gland which produces digestive juices as well as insulin and glucagon hormone needed for maintaining optimum level of sugar in the blood. Serous cystadenoma of the pancreas is a benign cystic lesion of the pancreas. Serous cystadenoma of pancreas is mainly present in women, especially over the age of 60 years. Serous cystadenoma of the pancreas is commonly consid ered to be a benign. Jul 14, 2017 serous cystadenoma of pancreas is a benign tumor of pancreas. Complete blood count, liver function test, amylase level, ca 199, cea levels were within normal limits. How is benign mucinous cystadenoma of pancreas treated. Serous cystadenoma sca represents a form of pancreatic cystic neoplasm which accounts for 1015% of pancreatic tumors and is characterized by benign behavior and heterogeneous macroscopic features, although the microscopic structure of pancreatic sca is uniform, the macroscopic feature shows a wide heterogeneity. Innumerable small cysts producing a honeycomb appearance were. Serous microcystic cystadenocarcinoma of the pancreas with. If there are no signs and symptoms, then a wait and watch approach has been recommended by some experts, since it is a benign condition.
These are uncommon tumors and constitute about 12% of all pancreatic tumors. Rare presentation of serous cystadenoma as hemorrhagic cyst. Serous cystadenoma of the pancreas is the most common benign pancreatic neoplasm. Serous pancreatic cystadenomas are benign tumours and most cases are detected incidentally. Serous cystadenoma of the pancreas pubmed central pmc. The pancreatic serous cystadenoma is an epithelial neoplasm that mostly affects women with a slight predominance in the pancreatic head. In contrast, serous cystadenoma is considered benign and are typically found incidentally. Typical and atypical manifestations of serous cystadenoma. Cystadenomas and cystadenocarcinomas of the pancreas. Although a lobulated contour is a specific feature of serous cystadenoma, it may be over. Computed tomography of cystadenoma and cystadenocarcinoma. Case report open access serous cystadenocarcinoma of. Serous cystadenoma of the pancreas, also referred as microcystic adenoma, is an uncommon type of benign cystic pancreatic neoplasm. Large amount of free peritoneal air and free fluid alongside with.
After haemodynamic stabilisation, an urgent abdominal ct scan revealed a large. Additionally the presenting symptoms are not characteristic. Three of the 25 tumours 12% showed a malignant behaviour on histological assessment, whereas two patients with serous cystadenoma 8% revealed an association with ductal adenocarcinoma. Abstract background the preoperative diagnosis of pancreatic serous cystadenoma sca is important because as a typically benign tumor. Mucinous cystadenoma constitutes approximately 23% of all the resected pancreatic cystic lesions, and serous cystadenoma accounts for 16%.
Benign ovarian cysts are one of the most common gynecological conditions occurring in the adolescent and reproductive age group. Cystadenomas and cystadenocarcinomas of the pancreas ncbi. Pancreatic serous cystadenoma is a benign tumour of pancreas. These tumors are very similar to benign serous cystic neoplasms scns of the pancreas, except that they tend to be larger, are locally invasive, and present distant metastasis. The most widely applicable radiographic test at the current time is helical ct scanning with thin cuts through the pancreas, which often can provide assistance in the differentiation between serous and mucinous neoplasms. Thus, surgical intervention should be proposed in a minority of patients with serous cystadenoma, and only for those who had uncertain diagnosis after systemic examinations or had symptoms 20, 21. Serous cystadenoma sca of the pancreas, encompassing serous microcystic adenoma sma and serous oligocystic adenoma soa, accounts for 1% to 2% of exocrine pancreatic tumors. Macrocystic and solid variants have also been described. Pancreas, serous cystadenoma, computed tomography, pancreatic cysts. Serous cystadenoma of the pancreas is a rare lesion thought to be almost invariably benign. Ct of serous cystadenoma of the pancreas and mimicking.
Serous cystadenoma article about serous cystadenoma by the. Serous cystadenoma of pancreas is mainly present in women, especially over the age of. Aug 25, 2017 serous cystadenoma of pancreas is a benign tumor of pancreas. Once thought to be rare, cystic neoplasms of the pancreas are being diagnosed with increased frequency because of improvements in pancreatic imaging 14. Cystic neoplasms of pancreas are relatively rare tumours that can be divided into serous and mucinous category. Cystic neoplasms of the pancreas are less common, accounting for about 1015% of all cystic pancreatic lesions.
Resected serous cystic neoplasms of the pancreas jefferson. Ovarian serous cystadenoma, also less precisely known as serous cystadenoma, is the most common ovarian neoplasm, representing 20% of ovarian neoplasms, and is benign it has a very superficial resemblance to the most common type of ovarian cancer serous carcinoma of the ovary under the microscope. Cystadenomas represented 76% of all primary pancreatic cystic tumors 398522. We report a case of serous cystadenoma of the pancreas mixed with mucinous cystadenoma. Mixed serous cystadenoma with mucinous cystadenoma of the pa. The origin and evolution of this disorder remain unclear, but even metastatic cases have an excellent prognosis. This is a common benign ovarian tumor diagnosed by microscopic examination. Serous cystadenoma of the pancreas is a diagnosis being entertained with increasing frequency. This cystic neoplasm is made up of several small cysts spread into a honeycomb like appearance. Serous cystadenoma of pancreas radiology reference. Management of pancreatic serous cystadenomas advances in. Its clinical and pathological recognition as a separate entity from the mucinous cystic neoplasms has been characterised by compagno and oertel 3, 4.
This article is brought to you for free and open access by the jefferson digital commons. Apr 06, 2017 cystic neoplasms of the pancreas are less common, accounting for about 1015% of all cystic pancreatic lesions. The two most common cystic neoplasms of the pancreas are serous cystadenoma and mucinous cystic neoplasms. Ct of serous cystadenoma of the pancreas and mimicking masses. Typical and atypical manifestations of serous cystadenoma of. A 86year old patient known to have a serous cystadenoma of the pancreas treated conservatively.