A case of pancreatic macrocystic serous cystadenoma associated with acute pancreatitis

Abstract

We report a case of pancreatic macrocystic serous cyst adenoma associated with acute pancreatitis. A 47-year-old woman seen for upper abdominal pain and hospitalized elsewhere showed increased serum CRP and amylase and an increased white blood cell count in laboratory data. Computed tomography (CT) showed severe pancreatic body and tail edema with abdominal and left thoracic and abdominal effusion, diagnosed as acute pancreatitis and treated conservatively. CT on admission also showed a cystic pancreas-head lesion. After acute pancreatitis subsided, she was hospitalized for us to diagnose and treat the cystic lesion. The main pancreatic and common bile ducts showed no dilation, and endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography (MRCP) were negative for the cystic lesion. MRCP showed the same findings. The cystic lesion was recognized as a multilocular tumor similar to intraductal papillary mucinous neoplasm (IPMN) or mucinous systic neoplasm (MCN). The preoperative clinical diagnosis was pancreatic cystic neoplasm (IPMN> MCN>SCN), necessitating pancreaticoduodenectomy. The resected specimen was pathologically diagnosed as pancreatic macrocystic serous cyst adenoma, a rare neoplasm leaving us unable to discriminate it from IPMN or MCN. © 2011 The Japanese Society of Gastroenterological Surgery.