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Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature

BACKGROUND: Microcystic pancreatic serous cystadenoma (SCA) can be managed without surgery in selected patients. However, the preoperative diagnosis of microcystic SCA remains challenging, and it is potentially misdiagnosed as other pancreatic cystic neoplasms or solid tumors, especially small micro...

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Autores principales: Nakamura, Shinichiro, Murata, Yasuhiro, Uchida, Katsunori, Nishikawa, Kenichiro, Iizawa, Yusuke, Fujii, Takehiro, Tanemura, Akihiro, Kuriyama, Naohisa, Kishiwada, Masashi, Mizuno, Shugo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9525490/
https://www.ncbi.nlm.nih.gov/pubmed/36178634
http://dx.doi.org/10.1186/s40792-022-01544-0
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author Nakamura, Shinichiro
Murata, Yasuhiro
Uchida, Katsunori
Nishikawa, Kenichiro
Iizawa, Yusuke
Fujii, Takehiro
Tanemura, Akihiro
Kuriyama, Naohisa
Kishiwada, Masashi
Mizuno, Shugo
author_facet Nakamura, Shinichiro
Murata, Yasuhiro
Uchida, Katsunori
Nishikawa, Kenichiro
Iizawa, Yusuke
Fujii, Takehiro
Tanemura, Akihiro
Kuriyama, Naohisa
Kishiwada, Masashi
Mizuno, Shugo
author_sort Nakamura, Shinichiro
collection PubMed
description BACKGROUND: Microcystic pancreatic serous cystadenoma (SCA) can be managed without surgery in selected patients. However, the preoperative diagnosis of microcystic SCA remains challenging, and it is potentially misdiagnosed as other pancreatic cystic neoplasms or solid tumors, especially small microcystic SCA. CASE PRESENTATION: This was a case of a 27-year-old male patient with microcystic SCA causing difficulty in the differential diagnosis from pancreatic neuroendocrine neoplasm (pNEN). A pancreatic tail mass was incidentally discovered on abdominal ultrasound (US). A contrast-enhanced computed tomography (CT) scan revealed a solid tumor measuring 13 mm with early enhancement in the arterial phase at the pancreatic tail. The tumor showed low intensity on T1-weighted magnetic resonance image, high intensity on T2-weighted image, and a slightly hyperechoic mass on endoscopic US (EUS). EUS-fine needle aspiration (EUS-FNA) did not lead to a definitive diagnosis. The tumor was clinically diagnosed as a pNEN, and a laparoscopic spleen-preserving distal pancreatectomy using the Warshaw technique was performed. The final histopathological diagnosis was microcystic SCA. CONCLUSION: Small microcystic SCA is difficult to distinguish from a hypervascular pancreatic tumor such as pNEN on imaging studies, and it is necessary to focus on the tumor echogenicity of EUS to differentiate microcystic SCA from pNEN preoperatively.
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spelling pubmed-95254902022-10-21 Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature Nakamura, Shinichiro Murata, Yasuhiro Uchida, Katsunori Nishikawa, Kenichiro Iizawa, Yusuke Fujii, Takehiro Tanemura, Akihiro Kuriyama, Naohisa Kishiwada, Masashi Mizuno, Shugo Surg Case Rep Case Report BACKGROUND: Microcystic pancreatic serous cystadenoma (SCA) can be managed without surgery in selected patients. However, the preoperative diagnosis of microcystic SCA remains challenging, and it is potentially misdiagnosed as other pancreatic cystic neoplasms or solid tumors, especially small microcystic SCA. CASE PRESENTATION: This was a case of a 27-year-old male patient with microcystic SCA causing difficulty in the differential diagnosis from pancreatic neuroendocrine neoplasm (pNEN). A pancreatic tail mass was incidentally discovered on abdominal ultrasound (US). A contrast-enhanced computed tomography (CT) scan revealed a solid tumor measuring 13 mm with early enhancement in the arterial phase at the pancreatic tail. The tumor showed low intensity on T1-weighted magnetic resonance image, high intensity on T2-weighted image, and a slightly hyperechoic mass on endoscopic US (EUS). EUS-fine needle aspiration (EUS-FNA) did not lead to a definitive diagnosis. The tumor was clinically diagnosed as a pNEN, and a laparoscopic spleen-preserving distal pancreatectomy using the Warshaw technique was performed. The final histopathological diagnosis was microcystic SCA. CONCLUSION: Small microcystic SCA is difficult to distinguish from a hypervascular pancreatic tumor such as pNEN on imaging studies, and it is necessary to focus on the tumor echogenicity of EUS to differentiate microcystic SCA from pNEN preoperatively. Springer Berlin Heidelberg 2022-09-30 /pmc/articles/PMC9525490/ /pubmed/36178634 http://dx.doi.org/10.1186/s40792-022-01544-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Case Report
Nakamura, Shinichiro
Murata, Yasuhiro
Uchida, Katsunori
Nishikawa, Kenichiro
Iizawa, Yusuke
Fujii, Takehiro
Tanemura, Akihiro
Kuriyama, Naohisa
Kishiwada, Masashi
Mizuno, Shugo
Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature
title Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature
title_full Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature
title_fullStr Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature
title_full_unstemmed Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature
title_short Microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature
title_sort microcystic serous cystadenoma mimicking pancreatic neuroendocrine neoplasm: report of a resected case with preoperative diagnostic difficulty and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9525490/
https://www.ncbi.nlm.nih.gov/pubmed/36178634
http://dx.doi.org/10.1186/s40792-022-01544-0
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