title: Left-sided portal hypertension caused by serous cystadenoma of the pancreas: report of a case.
abstract: We report a case of serous cystadenoma of pancreas causing left-sided portal hypertension and gastric varices. A 68-year-old man was admitted for treatment of a pancreatic body tumor. Contrast-enhanced computed tomography (CT) showed a honeycombed cystic mass. A celiac angiogram showed a hypervascular tumor supplied mainly by a dilated splenic artery and dorsal pancreatic artery. In the venous phase, the patent splenic vein had a large hepatopetal collateral vein via the coronary gastric vein. Upper gastrointestinal endoscopy showed isolated varices of the gastric fundus. We made a preoperative diagnosis of a serous cystic tumor of the pancreas with left-sided portal hypertension and performed distal pancreatectomy with splenectomy. The resected tumor was 8 cm in diameter and had a typical honeycombed microcystic pattern with central stellate scarring. The spleen was not enlarged. Histopathological examination confirmed a diagnosis of serous cystadenoma without any sign of malignancy. Postoperative endoscopy showed disappearance of the gastric varices.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Tokyo Medical and Dental University, Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Ito
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kudo
authors.forename: Noriaki
authors.initials: N
authors.lastname: Nakamura
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Kenichi
authors.initials: K
authors.lastname: Teramoto
authors.forename: Shigeki
authors.initials: S
authors.lastname: Arii
mesh_terms: D000368:Aged; D018293:Cystadenoma, Serous / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D004932:Esophageal and Gastric Varices / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology*; D008297:Male; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery