title: Pancreatic endocrine neoplasm can mimic serous cystadenoma.
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.
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, Nagoya, Japan. Hiroshi.Imaoka@ma9.seikyou.ne.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imaoka
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamao
authors.forename: Ahmed A S
authors.initials: AA
authors.lastname: Salem
authors.forename: Akira
authors.initials: A
authors.lastname: Sawaki
authors.forename: Kuniyuki
authors.initials: K
authors.lastname: Takahashi
authors.forename: Nobumasa
authors.initials: N
authors.lastname: Mizuno
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kawai
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tajika
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Isaka
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Akio
authors.initials: A
authors.lastname: Yanagisawa
mesh_terms: D001707:Biopsy, Needle; D018293:Cystadenoma, Serous / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004701:Endocrine Gland Neoplasms / Q000175:diagnosis*; D019160:Endosonography; D005260:Female; D006801:Humans; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis*