Abstract
A 57-yr-old female patient was referred to our hospital with a cystic lesion of the head of the pancreas that had been noted on abdominal computed tomography (CT). Endoscopic ultrasonography (EUS) showed a 3.0 cm rounded mass in the head of the pancreas. EUS images showed that the tumor had a solid component consisting of multiple microcysts separated by septae and a cystic component consisting of a macrocystic lesion. Thus, the tumor was suspected of being a serous cystadenoma (SCA). However, the histopathological diagnosis based on endoscopic ultrasound- guided fine-needle-aspiration biopsy (EUS-FNAB) was that of a pancreatic endocrine neoplasm (PEN). Surgical resection was performed. Despite having very similar macroscopic findings to SCA, microscopic examination revealed that the patient’s tumor was definitely a PEN. This case suggests that it is very difficult to distinguish PENs from SCAs based solely on imaging methods. EUS-FNAB is essential for determining the appropriate therapeutic strategy, as it provides the histopathological diagnosis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Eriksson B, Oberg K, Skogseid B. Neuroendocrine pancreatic tumors. Clinical findings in a prospective study of 84 patients. Acta Oncol 1989;28:373–377.
Buchanan KD, Johnston CF, O’Hare MM, et al. Neuroendocrine tumors. A European view. Am J Med 1986;81:14–22.
Heitz PU, Kasper M, Polak JM, Kloppel G, et al. Pancreatic endocrine tumors. Hum Pathol 1982;13:263–271.
Thompson NW, Eckhauser FE, Vinik AI, et al. Cystic neuroendocrine neoplasms of the pancreas and liver. Ann Surg 1984;199:158–164.
Eckhauser FE, Cheung PS, Vinik AI, et al. Nonfunctioning malignant neuroendocrine tumors of the pancreas. Surgery 1986;100:978–988.
Buetow PC, Parrino TV, Buck JL, et al. Islet cell tumors of the pancreas; pathologie-imaging correlation among size, necrosis and cysts, calcification, malignant behavior, and functional status. Am J Roentgenol 1995;165:1175–1179.
Ligneau B, Lombard-Bohas C, Partensky C, et al. Cystic endocrine tumors of the pancreas: clinical, radiologic, and histopathologic features in 13 cases. Am J Surg Pathol 2001;25:752–760.
Kehagias D, Smyrniotis V, Gouliamos A, Vlahos L. Cystic pancreatic neoplasms: computed tomography and magnetic resonance imaging findings. Int J Pancreatol 2000;28:223–230.
Kehagias D, Smyrniotis V, Kalovidouris A, et al. Cystic tumors of the pancreas: preoperative imaging, diagnosis, and treatment. Int Surg 2002;87:171–174.
Turnage RH, Eckhauser FE, Vinik AI, et al. Diagnostic dilemmas in patients with cystic neoplasms of the pancreas. Int J Pancreatol 1988;3:477–489.
Sedlack R, Affi A, Vazquez-Sequeiros E, Norton ID, Clain JE, Wiersema MJ. Utility of EUS in the evaluation of cystic pancreatic lesions. Gastrointest Endosc 2002;56:543–547.
Abe H, Kubota K, Mori M, et al. Serous cystadenoma of the pancreas with invasive growth: benign or malignant? Am J Gastroenterol 1998;93:1963–1966.
George DH, Murphy F, Michalski R, Ulmer BG. Serous cystadenocarcinoma of the pancreas: a new entity? Am J Surg Pathol 1989;13:61–66.
Kamei K, Funabiki T, Ochiai M, Amano H, Kasahara M, Sakamoto T. Multifocal pancreatic serous cystadenoma with atypical cells and focal perineural invasion. Int J Pancreatol 1991;10:161–172.
Siech M, Tripp K, Schmidt-Rohlfing B, et al. Cystic tumors of the pancreas: diagnostic accuracy, pathologic observations and surgical consequences. Langenbecks Arch Surg 1998;383:56–61.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Imaoka, H., Yamao, K., Salem, A.A.S. et al. Pancreatic endocrine neoplasm can mimic serous cystadenoma. Int J Gastrointest Canc 35, 217–220 (2005). https://doi.org/10.1385/IJGC:35:3:217
Issue Date:
DOI: https://doi.org/10.1385/IJGC:35:3:217