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CC BY-NC-ND 4.0 · Journal of Gastrointestinal and Abdominal Radiology 2021; 04(01): 077-082
DOI: 10.1055/s-0040-1721293
Case Report

The Elusive Appearance of Hyperenhancing Solid Serous Cystadenoma of the Pancreas—Radio-Pathological Correlation

Supraja Laguduva Mohan
1   Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
,
Sunitha Vellathussery Chakkalakkoombil
1   Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
,
Sunil Kumar Devaraj
1   Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
,
Ravindar Kashyap
1   Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
,
Rajesh Nachiappa Ganesh
2   Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Abstract

Serous cystadenomas account for ~10 to 29% of pancreatic cystic tumors. Solid serous cystadenoma (SSCA) is a rare variant, first described in 1996, with imaging characteristics different from the classical serous cystadenoma of the pancreas and can cause a diagnostic dilemma due to its resemblance to other solid tumors of the pancreas. To the best of our knowledge, only 22 cases of SSCA of pancreas have been reported till date.

A 50-year-old female patient underwent contrast-enhanced computed tomography (CECT) of the abdomen for a hypoechoic lesion detected in the body of the pancreas during ultrasound (US) examination. Due to the hyperenhancement of the well-circumscribed lesion in the arterial phase, a provisional diagnosis of neuroendocrine tumor was considered. Gallium 68-labeled somatostatin-analog (Ga 68-DOTANOC) positron emission tomography CT scan did not show any uptake within the lesion and endoscopic US (EUS)-guided fine-needle aspiration cytology (FNAC) was also inconclusive. She underwent laparotomy and the lesion was enucleated and it was proven to be a serous microcystadenoma on postoperative histopathologic examination.

A diagnosis of SSCA should be considered for solid-appearing pancreatic lesions with characteristic CECT features such as arterial phase hyperenhancement, and immediate washout, along with negative results on DOTANOC scan and EUS-guided FNAC. Malignant transformation of SSCA has not been reported till date, and hence these can be safely followed up, instead of invasive surgery.

Keywords

solid serous cystadenoma - hyperenhancing pancreatic lesion - solid appearing pancreatic lesion


Publication History

Article published online:
01 February 2021

© 2021. Indian Society of Gastrointestinal and Abdominal Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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