title: Giant symptomatic pancreatic cyst mimicking a malignant tumor.
abstract: BACKGROUND
  Pancreatic cystic lesions found in the literature are estimated between 2.6-19.6%. These neoplasms are almost exclusively benign tumors, and rarely become malignant. The aim of this paper was to report a feasible total pancreatectomy with portal resection in a giant pancreatic serous cystadenoma mimicking a malignant tumor.
  
  
  METHODS
  A healthy 52-year-old female patient presented to us with a giant pancreatic cyst with unknown preoperative diagnosis and a secondary dilatation of the Wirsung duct, and unclear vascular invasion. The imaging assessment was not conclusive for malignancy. Furthermore, it was decided to perform a total pancreatectomy with portal vein resection and splenectomy. The pathological findings revealed a microcystic serous cystadenoma of 10 cm with abundant myxoid stromal degeneration and focal papillary proliferation without atypia.
  
  
  CONCLUSIONS
  Unless the diagnosis of serous cystadenoma is certain, cystic tumors with inconclusive clinical and imaging features should be radically treated.
authors.affiliation: Liver and Gastrointestinal Transplant Division. , University of São Paulo School of Medicine, Brazil, Brasil.
authors.forename: Lucas
authors.initials: L
authors.lastname: Souto Nacif
authors.affiliation: Cirugia Hepato-Bilio-Pancreática y Trasplante., Hospital Clinic Barcelona, España.
authors.forename: Joana
authors.initials: J
authors.lastname: Ferrer Fábrega
authors.affiliation: Hepato-Bilio-Pancreatic Surgery and Transplant., Hospital Clínic Barcelona, España.
authors.forename: Rocío
authors.initials: R
authors.lastname: García Pérez
authors.affiliation: Hepato-Bilio-Pancreatic Surgery and Transplant, Hospital Clínic Barcelona, España.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: García-Valdecasas
mesh_terms: D018293:Cystadenoma, Serous / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D019160:Endosonography; D005260:Female; D006801:Humans; D008875:Middle Aged; D010180:Pancreatectomy; D010181:Pancreatic Cyst / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed