Lucas Souto Nacif1, Joana Ferrer Fábrega2, Rocío García Pérez3, Juan Carlos García-Valdecasas4. 1. Liver and Gastrointestinal Transplant Division. , University of São Paulo School of Medicine, Brazil, Brasil. 2. Cirugia Hepato-Bilio-Pancreática y Trasplante., Hospital Clinic Barcelona, España. 3. Hepato-Bilio-Pancreatic Surgery and Transplant., Hospital Clínic Barcelona, España. 4. Hepato-Bilio-Pancreatic Surgery and Transplant, Hospital Clínic Barcelona, España.
Abstract
BACKGROUND: Pancreatic cystic lesions found in the literature are estimated between 2.6-19.6%. These neoplasms are almost exclusively benign tumors, and rarely become malignant. The aim of this paper was to report a feasible total pancreatectomy with portal resection in a giant pancreatic serous cystadenoma mimicking a malignant tumor. CASE PRESENTATION: A healthy 52-year-old female patient presented to us with a giant pancreatic cyst with unknown preoperative diagnosis and a secondary dilatation of the Wirsung duct, and unclear vascular invasion. The imaging assessment was not conclusive for malignancy. Furthermore, it was decided to perform a total pancreatectomy with portal vein resection and splenectomy. The pathological findings revealed a microcystic serous cystadenoma of 10 cm with abundant myxoid stromal degeneration and focal papillary proliferation without atypia. CONCLUSION: Unless the diagnosis of serous cystadenoma is certain, cystic tumors with inconclusive clinical and imaging features should be radically treated.
BACKGROUND:Pancreatic cystic lesions found in the literature are estimated between 2.6-19.6%. These neoplasms are almost exclusively benign tumors, and rarely become malignant. The aim of this paper was to report a feasible total pancreatectomy with portal resection in a giant pancreatic serous cystadenoma mimicking a malignant tumor. CASE PRESENTATION: A healthy 52-year-old female patient presented to us with a giant pancreatic cyst with unknown preoperative diagnosis and a secondary dilatation of the Wirsung duct, and unclear vascular invasion. The imaging assessment was not conclusive for malignancy. Furthermore, it was decided to perform a total pancreatectomy with portal vein resection and splenectomy. The pathological findings revealed a microcystic serous cystadenoma of 10 cm with abundant myxoid stromal degeneration and focal papillary proliferation without atypia. CONCLUSION: Unless the diagnosis of serous cystadenoma is certain, cystic tumors with inconclusive clinical and imaging features should be radically treated.
Authors: Giuseppe Evola; Francesco Ferrara; Mario Scravaglieri; Ezio Trusso Zirna; Salvatore Sarvà; Luigi Piazza Journal: Int J Surg Case Rep Date: 2021-03-26