Serous Cystadenoma of the Pancreas With Complex Florid Papillary Architecture: A Case Report and Review of the Literature

Jessica Tracht, Michelle D. Reid, Erika Hissong, Aarti Sekhar, Juan Sarmiento, Alyssa Krasinskas, Yue Xue*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Serous cystadenoma (SCA) is a relatively rare benign pancreatic neoplasm. It has a very distinctive gross and microscopic appearance including pure and mixed microcystic and macrocystic patterns as well as rare solid architectural pattern. In this article, we present a rare case of SCA with a complex florid papillary architecture. A 40-year-old man was diagnosed with a 3.5 cm SCA of the uncinate process of the pancreas based on abdominal computed tomography scan. The tumor was monitored radiographically until recent magnetic resonance imaging showed a new 1.0-cm eccentric mural nodule within the tumor with multiple arterial enhancing septations and features suspicious for a neuroendocrine tumor. A pylorus-preserving Whipple procedure was subsequently performed and the mass was resected. Gross examination confirmed the radiological findings of a well-demarcated, 3.5 cm multicystic pancreatic lesion with a 1.0 cm circumscribed, tan solid nodule at its periphery. Microscopic evaluation revealed a predominantly microcystic pattern classical of SCA with occasional macrocysts. The 1.0 cm discrete nodule was also a SCA, but showed unusually exuberant complex papillary growth. To our knowledge, this is the first reported case describing this morphologic variant. Recognition of this rare and unusual pattern is important to avoid misdiagnosis, especially on small biopsy specimens.

Original languageEnglish (US)
Pages (from-to)907-911
Number of pages5
JournalInternational Journal of Surgical Pathology
Volume27
Issue number8
DOIs
StatePublished - Dec 1 2019

Keywords

  • cystic neoplasm
  • morphologic variant
  • neuroendocrine tumor
  • pancreas
  • serous cystadenoma

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

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