A case of serous cystadenoma of the pancreas communicating with a pancreatic duct

Abstract

A 63-year-old woman seen for right back pain was found in enhanced computed tomography (CT) to have a multilocular cystic lesion 3cm in diameter in the pancreatic head and body border. Endoscopic retrograde cholangiopancreatography showed communication between the cyst and the pancreatic duct, which was not dilated. Pancreatic juice cytology indicated no malignancy. Endoscopic ultrasonography (EUS) showed an intramural nodule in the cystic lesion. Based on a tentative diagnosis of intraductal papillary mucinous neoplasm branch subtype (adenoma or adenocarcinoma) of the pancreas, we recommended surgery, but the woman desired follow-up. Ten months later, EUS showed that intramural nodules in the cystic lesion had grown, so we conducted pylorus preserving pancreaticoduodenectomy. The cut tumor surface was multilocular and 26 × 15 mm. Histological examination showed multiple cysts lined with single-layered cuboidal cells. Immunohisto-chemically, tumor cells were positive for PAS. Macroscopically, a brown structure was seen inside of the cyst, but cells were not seen histologically. The definitive pathological diagnosis was serous cystic tumor macrocys-tic type. © 2010 The Japanese Society of Gastroenterological Surgery.