Skip to main content

Advertisement

SpringerLink
Log in

A case of serous cystic neoplasm with tumor growth acceleration leading to extrapancreatic invasion

  • Case Report
  • Published:
Clinical Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Serous cystic neoplasm (SCN) is a potentially malignant and invasive disease. However, there are no established guidelines regarding the surgical management of SCN. Here, we report a case of SCN with jejunal invasion that ultimately required a distal pancreatectomy with partial resection of the jejunum. The patient was a 65-year-old female who was referred to our department after a diagnosis of SCN in the pancreatic tail. CT and MRI showed a 75-mm multifocal cystic mass with calcifications; the splenic vein and left adrenal vein were entrapped within the tumor. Furthermore, the tumor was in contact with the beginning of the jejunum. Finally, she underwent a posterior radical antegrade modular pancreatosplenectomy with a partial wedge-shaped resection of the jejunum. Histological findings indicated serous cystadenoma. In addition, the tumor cells were found to have infiltrated the jejunal muscularis propria in some areas, suggesting that the tumor had malignant potential. Currently, 14 months have passed since surgery and there is no evidence of metastasis or recurrence. Surveillance and the decision to perform surgical resection should be made based on tumor size and growth rate to avoid malignant transformation as well as to provide SCN patients with organ-sparing, less invasive surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

Data availability

Data will be made available by the corresponding author upon reasonable request.

Abbreviations

SCN:

Serous cystic neoplasm

EUS:

Endoscopic ultrasonography

PAS:

Periodic acid Schiff

d-PAS:

Diastase-periodic acid Schiff

IPMN:

Intraductal papillary mucinous neoplasm

MCN:

Mucinous cystic neoplasm

References

  1. Horvath KD, Chabot JA. An aggressive resectional approach to cystic neoplasms of the pancreas. Am J Surg. 1999;178:269–74.

    Article  CAS  PubMed  Google Scholar 

  2. Wang GX, Wang ZP, Chen HL, et al. Discrimination of serous cystadenoma from mucinous cystic neoplasm and branch duct intraductal papillary mucinous neoplasm in the pancreas with CT. Abdom Radiol (NY). 2020;45:2772–8.

    Article  PubMed  Google Scholar 

  3. Dababneh Y, Mousa OY. Pancreatic serous cystadenoma. Treasure Island (FL): StatPearls Publishing Copyright © 2022, StatPearls Publishing LLC; 2022.

    Google Scholar 

  4. George DH, Murphy F, Michalski R, et al. Serous cystadenocarcinoma of the pancreas: a new entity? Am J Surg Pathol. 1989;13:61–6.

    Article  CAS  PubMed  Google Scholar 

  5. Lee SD, Han SS, Hong EK. Solid serous cystic neoplasm of the pancreas with invasive growth. J Hepatobiliary Pancreat Sci. 2013;20:454–6.

    Article  PubMed  Google Scholar 

  6. Galanis C, Zamani A, Cameron JL, et al. Resected serous cystic neoplasms of the pancreas: a review of 158 patients with recommendations for treatment. J Gastrointest Surg. 2007;11:820–6.

    Article  PubMed  Google Scholar 

  7. Chandwani R, Allen PJ. Cystic neoplasms of the pancreas. Annu Rev Med. 2016;67:45–57.

    Article  CAS  PubMed  Google Scholar 

  8. Slobodkin I, Luu AM, Höhn P, et al. Is surgery for serous cystic neoplasms of the pancreas still indicated? Sixteen years of experience at a high-volume center. Pancreatology. 2021;21:983–9.

    Article  PubMed  Google Scholar 

  9. Reid MD, Choi HJ, Memis B, et al. Serous neoplasms of the pancreas: a clinicopathologic analysis of 193 cases and literature review with new insights on macrocystic and solid variants and critical reappraisal of so-called “serous cystadenocarcinoma.” Am J Surg Pathol. 2015;39:1597–610.

    Article  PubMed  Google Scholar 

  10. Wu W, Li J, Pu N, et al. Surveillance and management for serous cystic neoplasms of the pancreas based on total hazards-a multi-center retrospective study from China. Ann Transl Med. 2019;7:807.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Kimura W, Moriya T, Hirai I, et al. Multicenter study of serous cystic neoplasm of the Japan pancreas society. Pancreas. 2012;41:380–7.

    Article  PubMed  Google Scholar 

  12. Wataru KIMURATW. Diagnosis and treatment of serous cystic neoplasm. Suizo. 2018;33:131–9.

    Article  Google Scholar 

  13. Kimura W, Makuuchi M. Operative indications for cystic lesions of the pancreas with malignant potential–our experience. Hepatogastroenterology. 1999;46:483–91.

    CAS  PubMed  Google Scholar 

  14. Jais B, Rebours V, Malleo G, et al. Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the international association of pancreatology and European pancreatic club (European study group on cystic tumors of the pancreas). Gut. 2016;65:305–12.

    Article  CAS  PubMed  Google Scholar 

  15. Hu F, Hu Y, Wang D, et al. Cystic neoplasms of the pancreas: differential diagnosis and radiology correlation. Front Oncol. 2022;12: 860740.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Huh J, Byun JH, Hong SM, et al. Malignant pancreatic serous cystic neoplasms: systematic review with a new case. BMC Gastroenterol. 2016;16:97.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Sasaki YMH, Uemura K, Hashimoto Y, et al. (2015) Operative indication for serous cystic neoplasm of the pancreas—the evaluation of our 12 resected patients. Suizo. 2015;30:585–91.

    Article  Google Scholar 

  18. Khashab MA, Shin EJ, Amateau S, et al. Tumor size and location correlate with behavior of pancreatic serous cystic neoplasms. Am J Gastroenterol. 2011;106:1521–6.

    Article  PubMed  Google Scholar 

  19. Tseng JF, Warshaw AL, Sahani DV, et al. Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment. Ann Surg. 2005;242:413–9 (discussion 9-21).

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We sincerely thank Shari Joy Berman for professionally editing the English draft of this manuscript.

Funding

Institutional sources only.

Author information

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan

    Keisuke Yamazaki, Taiichi Wakiya, Keinosuke Ishido, Norihisa Kimura, Daichi Ichinohe, Yoshiya Takahashi & Kenichi Hakamada

  2. Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan

    Tadashi Yoshizawa & Hiroshi Kijima

Authors
  1. Keisuke Yamazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Taiichi Wakiya
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Keinosuke Ishido
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Norihisa Kimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Daichi Ichinohe
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yoshiya Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Tadashi Yoshizawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hiroshi Kijima
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kenichi Hakamada
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

KY and TW wrote the first draft of the manuscript. KI and KH contributed to the review, and/or critical revision of the manuscript. All authors have approved the final article. TW, KI, NK, DI, and YT performed the surgical resection and collected the clinical data. TY and HK contributed to the pathological assessment.

Corresponding author

Correspondence to Kenichi Hakamada.

Ethics declarations

Conflict of interest

None of the authors have a conflict of interest with regard to the work in the case report.

Informed consent

With regard to this manuscript, consent to publish was obtained from the patient.

Human rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the 1964 Declaration of Helsinki and its subsequent amendments. The approval for publication of this case study was waived by our IRB.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yamazaki, K., Wakiya, T., Ishido, K. et al. A case of serous cystic neoplasm with tumor growth acceleration leading to extrapancreatic invasion. Clin J Gastroenterol 16, 289–296 (2023). https://doi.org/10.1007/s12328-022-01746-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12328-022-01746-x

Keywords

Search

Navigation