Three cases of serous oligocystic adenomas of the pancreas; evaluation of cyst wall thickness for preoperative differentiation from mucinous cystic neoplasms.
BACKGROUND
Serous oligocystic adenoma (SOA), a rare pancreatic neoplasm, is generally a benign lesion without the necessity of surgery. Preoperatively, it is difficult to discriminate SOA from mucinous cystic neoplasm (MCN), which essentially needs surgical treatment. The purpose of this study was to evaluate the cyst wall thickness of SOAs and MCNs for preoperative differential diagnosis.


METHODS
We experienced three cases of SOAs with typical histopathological features. The cyst wall thickness of the SOAs was evaluated in the area protruding out of the pancreas and was compared with that of 13 MCNs histopathologically. The same evaluation and comparison were conducted on preoperative computed tomography (CT) images retrospectively.


RESULTS
The SOAs had a uniformly thin cyst wall measuring less than 1 mm. In contrast, the largest area of a cyst wall in MCNs ranged from 2.5 to 10.0 mm. On CT images, all but one of the MCNs showed a detectable cyst wall, while the cyst walls were hardly recognizable in two of the three SOAs.


CONCLUSIONS
For preoperative differentiation between SOAs and MCNs, the evaluation of cyst wall thickness may be an important tool and may contribute to the decision of treatment strategy.
Yamaguchi
Hiroshi
H
Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. hyamag@saitama-med.ac.jp
Ishigami
Kousei
K
Inoue
Takahiro
T
Eguchi
Takashi
T
Nagata
Shigenori
S
Kuroda
Yosuke
Y
Nishihara
Yunosuke
Y
Yamaguchi
Koji
K
Tanaka
Masao
M
Tsuneyoshi
Masazumi
M
D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology*; D000368:Aged; D003560:Cysts / Q000000981:diagnostic imaging / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D011300:Preoperative Care; D014057:Tomography, X-Ray Computed