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Pancreatic endocrine neoplasm can mimic serous cystadenoma

  • Hiroshi Imaoka
  • Kenji Yamao
  • Ahmed A. S. Salem
  • Akira Sawaki
  • Kuniyuki Takahashi
  • Nobumasa Mizuno
  • Hiroki Kawai
  • Masahiro Tajika
  • Toshifumi Isaka
  • Yasuyuki Okamoto
  • Yasuhiro Shimizu
  • Akio Yanagisawa
Case Report

Abstract

A 57-yr-old female patient was referred to our hospital with a cystic lesion of the head of the pancreas that had been noted on abdominal computed tomography (CT). Endoscopic ultrasonography (EUS) showed a 3.0 cm rounded mass in the head of the pancreas. EUS images showed that the tumor had a solid component consisting of multiple microcysts separated by septae and a cystic component consisting of a macrocystic lesion. Thus, the tumor was suspected of being a serous cystadenoma (SCA). However, the histopathological diagnosis based on endoscopic ultrasound- guided fine-needle-aspiration biopsy (EUS-FNAB) was that of a pancreatic endocrine neoplasm (PEN). Surgical resection was performed. Despite having very similar macroscopic findings to SCA, microscopic examination revealed that the patient’s tumor was definitely a PEN. This case suggests that it is very difficult to distinguish PENs from SCAs based solely on imaging methods. EUS-FNAB is essential for determining the appropriate therapeutic strategy, as it provides the histopathological diagnosis.

Key Words

Endoscopic ultrasonography serous cystadenoma pancreatic endocrine neoplasm endoscopic ultrasound-guided fine-needle-aspiration biopsy (EUS-FNAB) cystic pancreatic lesion 

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Copyright information

© Humana Press Inc 2005

Authors and Affiliations

  • Hiroshi Imaoka
    • 1
  • Kenji Yamao
    • 1
  • Ahmed A. S. Salem
    • 1
  • Akira Sawaki
    • 1
  • Kuniyuki Takahashi
    • 1
  • Nobumasa Mizuno
    • 1
  • Hiroki Kawai
    • 1
  • Masahiro Tajika
    • 1
  • Toshifumi Isaka
    • 1
  • Yasuyuki Okamoto
    • 1
  • Yasuhiro Shimizu
    • 2
  • Akio Yanagisawa
    • 3
  1. 1.Department of GastroenterologyAichi Cancer Center HospitalNagoyaJapan
  2. 2.Department of SurgeryAichi Cancer Center HospitalNagoyaJapan
  3. 3.Department of PathologyKyoto Prefectural University of MedicineKyotoJapan

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