Solid serous microcystic adenoma of the pancreas.
BACKGROUND
Cystic neoplasms of the pancreas are less common than solid tumors, and portend a better prognosis. They can be divided into serous and mucinous subtypes, with the former behaving less aggressively and generally considered benign. Of the serous neoplasms, serous microcystic adenoma is the most common. An extremely rare solid variant of serous microcystic adenoma lacking secretory capability has been described. Herein, we present the fourth described case of this solid variant and review the literature.


METHODS
We present a case of a 62 year-old man with a history of abdominal pain, who on CT scan was found to have a solid mass at the junction of the head and body of the pancreas. The patient was offered resection for diagnosis and treatment, and subsequently underwent distal pancreatectomy and splenectomy. Based on gross pathology, histology and immunohistochemistry, the mass was determined to be a solid serous microcystic adenoma.


CONCLUSIONS
Solid serous microcystic adenoma shows similar histologic and immunohistologic features to its classic cystic counterpart, but lacks any secretory functionality. It appears to behave in a benign manner, and as such, surgical resection is curative for patients with this tumor. Furthermore, until more cases of solid SMA are identified to further elucidate its natural history and improve the reliability of preoperative diagnosis, surgical resection of this solid pancreatic tumor should be considered standard therapy in order to exclude malignancy.
Stern
Jordan R
JR
Department of Surgery, The Ohio State University, 410 W 10th Ave, N924 Doan, Columbus, OH 43210, USA. jordan.stern@osumc.edu
Frankel
Wendy L
WL
Ellison
E Christopher
EC
Bloomston
Mark
M
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D001707:Biopsy, Needle; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D035583:Rare Diseases; D018570:Risk Assessment; D013156:Splenectomy / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome