Fact-sheet: Serous cystadenoma of pancreas
Updated on 04/19/2018 at 4:18 PM
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Definition
Tumor developing from the acinar cells of the pancreas. Benign lesion with an exceptional risk of malignant transformation. Pathology: cluster of microcysts separated by a central scar. Fibrous septa and central calcification. 3 forms: - microcystic 75% - macrocystic 25% - solid, rare (5%), with arterial enhancement corresponding to the summation of the septa
Clinical features
Middle-aged and older women (median age 65 years).
VHL: multiple (associated with true cysts and neuroendocrine tumors).
Asymptomatic +++.
Otherwise, pain, mass, weight loss, jaundice, and diabetes.
Ultrasound
Echogenic mass +/- anechoic cysts (if > 2 mm) +/- central calcification.
CT
Well-defined lesion, with polylobulated contours, multicystic with fine central calcification (15%).
May mimic a neuroendocrine tumor if the cysts are very small (rare).
Enhancement of the cyst walls reveals the pseudocysts (key to diagnosis), with a more solid portion showing calcification (microcystic form).
No enhancement of the walls in the unilocular macrocystic form.
MRI
Lobulated lesion with hypoT1 and markedly hyperT2+++ signal.
Management
Most often no treatment required.
No specific surveillance needed.
Differential diagnosis
Mucinous cystic neoplasm