Pancreatic endocrine neoplasm can mimic serous cystadenoma.
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.
Imaoka
Hiroshi
H
Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden Chikusa-ku, Nagoya, Japan. Hiroshi.Imaoka@ma9.seikyou.ne.jp
Yamao
Kenji
K
Salem
Ahmed A S
AA
Sawaki
Akira
A
Takahashi
Kuniyuki
K
Mizuno
Nobumasa
N
Kawai
Hiroki
H
Tajika
Masahiro
M
Isaka
Toshifumi
T
Okamoto
Yasuyuki
Y
Shimizu
Yasuhiro
Y
Yanagisawa
Akio
A
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*