Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature

Microcystic serous cystadenoma of the pancreas causing biliary obstruction: a case report and review of the literature

Cystic tumors account for 15% of pancreatic tumors. Of these, serous microcystic adenomas represent 1-2% of pancreatic exocrine neoplasms. While typically benign, a small percentage possess malignant potential. Given imaging improvements, serous cystadenomas are being identified more frequently. A 63-year-old female was admitted with complaints of jaundice and unintentional weight loss. Abdominal computed tomography scan showed a 16 cm obstructive pancreatic mass near the porta hepatis region. Endoscopic ultrasonography and fine needle aspiration biopsy indicated a large pancreatic head cystic mass favoring serous microcystadenoma causing biliary and some pyloric obstruction. Malignant potential could not be ruled out because of size and symptoms. A pylorus-preserving pancreaticoduodenectomy revealed a cystic tumor invading the pancreatic duct and adhering to the duodenum of the pancreatic head. Pathology confirmed a 15 cm benign pancreatic serous cystadenoma. Although most serous cystadenomas are benign, surgical resection was prudent given the size, symptoms, and adjacent organ involvement.

Microcystic Serous Cystadenoma Masquerading as Pancreatic Neuroendocrine Tumor on 99m Tc-HYNIC-TOC SPECT/CT

ABSTRACT

We present 99m Tc-HYNIC-TOC SPECT/CT findings in a case of microcystic serous cystadenoma of the pancreatic head. The pancreatic tumor showed intense 99m Tc-HYNIC-TOC uptake mimicking neuroendocrine tumor on SPECT/CT. This case indicates that microcystic serous cystadenoma should be included in the differential diagnosis of 99m Tc-HYNIC-TOC-avid pancreatic masses.