Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature
Abstract Background Microcystic pancreatic serous cystadenoma (SCA) can be managed without surgery in selected patients. However, the preoperative diagnosis of microcystic SCA remains challenging, and it is potentially misdiagnosed as other pancreatic cystic neoplasms or solid tumors, especially sma...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Japan Surgical Society
2022-09-01
|
| Series: | Surgical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40792-022-01544-0 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849248211562135552 |
|---|---|
| author | Shinichiro Nakamura Yasuhiro Murata Katsunori Uchida Kenichiro Nishikawa Yusuke Iizawa Takehiro Fujii Akihiro Tanemura Naohisa Kuriyama Masashi Kishiwada Shugo Mizuno |
| author_facet | Shinichiro Nakamura Yasuhiro Murata Katsunori Uchida Kenichiro Nishikawa Yusuke Iizawa Takehiro Fujii Akihiro Tanemura Naohisa Kuriyama Masashi Kishiwada Shugo Mizuno |
| author_sort | Shinichiro Nakamura |
| collection | DOAJ |
| description | Abstract Background Microcystic pancreatic serous cystadenoma (SCA) can be managed without surgery in selected patients. However, the preoperative diagnosis of microcystic SCA remains challenging, and it is potentially misdiagnosed as other pancreatic cystic neoplasms or solid tumors, especially small microcystic SCA. Case presentation This was a case of a 27-year-old male patient with microcystic SCA causing difficulty in the differential diagnosis from pancreatic neuroendocrine neoplasm (pNEN). A pancreatic tail mass was incidentally discovered on abdominal ultrasound (US). A contrast-enhanced computed tomography (CT) scan revealed a solid tumor measuring 13 mm with early enhancement in the arterial phase at the pancreatic tail. The tumor showed low intensity on T1-weighted magnetic resonance image, high intensity on T2-weighted image, and a slightly hyperechoic mass on endoscopic US (EUS). EUS-fine needle aspiration (EUS-FNA) did not lead to a definitive diagnosis. The tumor was clinically diagnosed as a pNEN, and a laparoscopic spleen-preserving distal pancreatectomy using the Warshaw technique was performed. The final histopathological diagnosis was microcystic SCA. Conclusion Small microcystic SCA is difficult to distinguish from a hypervascular pancreatic tumor such as pNEN on imaging studies, and it is necessary to focus on the tumor echogenicity of EUS to differentiate microcystic SCA from pNEN preoperatively. |
| format | Article |
| id | doaj-art-e5ffceb9ef654be98fb230e6eb0180d4 |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2022-09-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-e5ffceb9ef654be98fb230e6eb0180d42025-08-20T03:57:59ZengJapan Surgical SocietySurgical Case Reports2198-77932022-09-01811810.1186/s40792-022-01544-0Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literatureShinichiro Nakamura0Yasuhiro Murata1Katsunori Uchida2Kenichiro Nishikawa3Yusuke Iizawa4Takehiro Fujii5Akihiro Tanemura6Naohisa Kuriyama7Masashi Kishiwada8Shugo Mizuno9Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of MedicineDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of MedicineDepartment of Pathology, Mie University School of MedicineDepartment of Gastroenterology, Matsusaka Municipal HospitalDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of MedicineDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of MedicineDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of MedicineDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of MedicineDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of MedicineDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of MedicineAbstract Background Microcystic pancreatic serous cystadenoma (SCA) can be managed without surgery in selected patients. However, the preoperative diagnosis of microcystic SCA remains challenging, and it is potentially misdiagnosed as other pancreatic cystic neoplasms or solid tumors, especially small microcystic SCA. Case presentation This was a case of a 27-year-old male patient with microcystic SCA causing difficulty in the differential diagnosis from pancreatic neuroendocrine neoplasm (pNEN). A pancreatic tail mass was incidentally discovered on abdominal ultrasound (US). A contrast-enhanced computed tomography (CT) scan revealed a solid tumor measuring 13 mm with early enhancement in the arterial phase at the pancreatic tail. The tumor showed low intensity on T1-weighted magnetic resonance image, high intensity on T2-weighted image, and a slightly hyperechoic mass on endoscopic US (EUS). EUS-fine needle aspiration (EUS-FNA) did not lead to a definitive diagnosis. The tumor was clinically diagnosed as a pNEN, and a laparoscopic spleen-preserving distal pancreatectomy using the Warshaw technique was performed. The final histopathological diagnosis was microcystic SCA. Conclusion Small microcystic SCA is difficult to distinguish from a hypervascular pancreatic tumor such as pNEN on imaging studies, and it is necessary to focus on the tumor echogenicity of EUS to differentiate microcystic SCA from pNEN preoperatively.https://doi.org/10.1186/s40792-022-01544-0Pancreatic serous cystadenomaSCAMicrocystic serous cystadenomaLaparoscopic spleen-preserving distal pancreatectomy |
| spellingShingle | Shinichiro Nakamura Yasuhiro Murata Katsunori Uchida Kenichiro Nishikawa Yusuke Iizawa Takehiro Fujii Akihiro Tanemura Naohisa Kuriyama Masashi Kishiwada Shugo Mizuno Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature Surgical Case Reports Pancreatic serous cystadenoma SCA Microcystic serous cystadenoma Laparoscopic spleen-preserving distal pancreatectomy |
| title | Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature |
| title_full | Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature |
| title_fullStr | Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature |
| title_full_unstemmed | Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature |
| title_short | Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature |
| title_sort | microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm report of a resected case with preoperative diagnostic difficulty and review of the literature |
| topic | Pancreatic serous cystadenoma SCA Microcystic serous cystadenoma Laparoscopic spleen-preserving distal pancreatectomy |
| url | https://doi.org/10.1186/s40792-022-01544-0 |
| work_keys_str_mv | AT shinichironakamura microcysticserouscystadenomamimickingpancreaticneuroendocrineneoplasmreportofaresectedcasewithpreoperativediagnosticdifficultyandreviewoftheliterature AT yasuhiromurata microcysticserouscystadenomamimickingpancreaticneuroendocrineneoplasmreportofaresectedcasewithpreoperativediagnosticdifficultyandreviewoftheliterature AT katsunoriuchida microcysticserouscystadenomamimickingpancreaticneuroendocrineneoplasmreportofaresectedcasewithpreoperativediagnosticdifficultyandreviewoftheliterature AT kenichironishikawa microcysticserouscystadenomamimickingpancreaticneuroendocrineneoplasmreportofaresectedcasewithpreoperativediagnosticdifficultyandreviewoftheliterature AT yusukeiizawa microcysticserouscystadenomamimickingpancreaticneuroendocrineneoplasmreportofaresectedcasewithpreoperativediagnosticdifficultyandreviewoftheliterature AT takehirofujii microcysticserouscystadenomamimickingpancreaticneuroendocrineneoplasmreportofaresectedcasewithpreoperativediagnosticdifficultyandreviewoftheliterature AT akihirotanemura microcysticserouscystadenomamimickingpancreaticneuroendocrineneoplasmreportofaresectedcasewithpreoperativediagnosticdifficultyandreviewoftheliterature AT naohisakuriyama microcysticserouscystadenomamimickingpancreaticneuroendocrineneoplasmreportofaresectedcasewithpreoperativediagnosticdifficultyandreviewoftheliterature AT masashikishiwada microcysticserouscystadenomamimickingpancreaticneuroendocrineneoplasmreportofaresectedcasewithpreoperativediagnosticdifficultyandreviewoftheliterature AT shugomizuno microcysticserouscystadenomamimickingpancreaticneuroendocrineneoplasmreportofaresectedcasewithpreoperativediagnosticdifficultyandreviewoftheliterature |