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Serous cystadenoma of pancreas

Case contributed by Domenico Nicoletti
Diagnosis almost certain

Presentation

Incidental finding in staging stomach cancer.

Patient Data

Age: 75 years
Gender: Female

Pancreatic head hypodense lesion, multicystic aspect with enhancement.

Well demarcated lesion of the pancreatic head, containing multiple microcysts (1-2 cm) filled with fluid and separated by fibrous septa with honeycomb appearance. The septa show enhancement and a small central scar can be appreciated. The lesion is not in communication with the duct of Wirsung.

Case Discussion

The pancreatic serous cystadenoma is an epithelial neoplasm that mostly affects women with a slight predominance in the pancreatic head. The most common presentation is with numerous small cysts that give a "honeycomb" appearance (microcystic variant), thin septa, and sometimes with a central scar. In some cases, the cysts may increase in size of 2 cm or be made up of one or a few voluminous cysts (oligocystic or macrocystic variants) which will likely lead to a differential diagnosis including mucinous neoplasms. The serous cystadenoma is always benign

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