Solid serous microcystic tumor of the pancreas.

Abstract

it is known that pancreatic serous cystic tumors are uncommon pancreatic tumors. Grossly, they are more frequently microcystic or oligocystic [1]. The solid form is rarely described in literature. To our knowledge, only four cases of solid serous neoplasms have been described [2, 3, 4, 5] (Table 1). Herein, we present the fifth case of solid serous cystic neoplasm of the pancreas. She was a 59-year-old woman who was admitted at our institute for abdominal pain in the upper right quadrant. Her past medical history was not significant. Laboratory tests, including pancreatic tumor markers, were normal (CEA: 1.40 ng/mL, reference range: 0-7 ng/mL; CA 19-9: less than 6 U/mL reference range: 0-37 U/L). Abdominal ultrasonography showed a well circumscribed hypoechoic mass, 4 cm in diameter, in the tail of the pancreas. A CT scan confirmed the presence of a well defined solid mass in the tail of the pancreas, contiguous with the splenic vein. The mass showed marked contrast-enhancement in the early phase, it was disomogeneous with an hyperdense capsule (Figure 1). Preoperatively, diagnosis of solid mass of the tail of the pancreas was made. The differential diagnosis included pancreatic neuroendocrine tumor, solid pseudopapillary tumor and metastatic carcinoma. The diagnosis of ductal adenocarcinoma was not considered because this tumor does not show contrastenhancement in the early phase and it does not present tumor capsule. The patient underwent surgery and a distal pancreatectomy with splenectomy was performed. Postoperative course was uneventful and the patient was discharged on postoperative day 12. On gross examination the resection specimen showed a solid, well circumscribed, encapsulate mass, 4 cm in diameter, of the pancreatic tail. The cut surface of the tumor contained a thick fibrous band without necrosis or hemorrhage (Figure 2). The