Macrocystic Neoplasms of the Pancreas: CT Differentiation of Serous Oligocystic Adenoma from Mucinous Cystadenoma and Intraductal Papillary Mucinous Tumor

Abstract

Serous oligocystic adenoma of the pancreas has characteristic CT findings that differentiate it from other cystic tumors. It appears as a multicystic or lobulated cystic lesion with septation.

Predictive value of multi-detector computed tomography for accurate diagnosis of serous cystadenoma: Radiologic-pathologic correlation

“…The shape of the cysts was defined as either smooth, simple lobulated or complex lobulated. Simple lobulation was defined as the shape of a simple closed curve with bosselated surface whose borders could not be described within the same circle [10] . A complex lobulated shape was defined as one containing a conglomeration of two or more cysts either round, oval or tubular (pleomorphic in shape) [10] .…”

“…However, there is some overlap in imaging appearance among cystic pancreatic lesions, and it can be difficult to differentiate SCAs from other types of pancreatic cysts, such as pseudocysts, mucinous cystic neoplasms (MCNs) and intraductal papillary mucinous neoplasms (IPMNs). Thus the diagnosis of serous cystadenomas assumes particular significance because they need to be differentiated from other cystic neoplasms like MCNs, which are known to be premalignant or malignant [10] . The differentiation is vital to avoid unnecessary pancreatic surgery, which although increasingly safe in experienced hands continues to cause significant postoperative morbidity [6] .…”

The Role of Volume Perfusion CT in the Diagnosis of Pathologies of the Pancreas

“…They are mainly located in the head of the pancreas. The periphery does not show any contrast agent enhancement while late enhancement was described in the septa [27]. The oligocystic variant is comprised of only a few large cysts while the variant associated with Von Hippel-Lindau consists of multiple cysts distributed across the entire pancreas.…”

“…However, the lesions are rounded without lobulation and possibly with very fine septa. Solid mural tumor nodules, cyst size > 6 cm, and calcifications are considered signs of malignancy [27]. Papillary tumor segments can be better detected via multiphase CT or VPCT due to the enhancement.…”

“…They share papillary differentiation with mucinous secretion. In contrast to other cystic pancreatic lesions, the individual lesions of an IPMN have an irregular configuration [27]. Main duct IPMNs consist of diffuse dilation of the pancreatic duct (> 1 cm) with cystic formations.…”