Serous microcystic adenoma (glycogen‐rich cystadenoma) of the pancreas: Study of 11 cases showing clinicopathological and immunohistochemical correlations

Abstract

Serous microcystic adenoma of the pancreas, also known as microcystic adenoma, glycogen-rich cystadenoma or serous cystadenoma, is an uncommon benign tumor. We have studied 11 cases involving eight women and three men. The average age at diagnosis was 61.7 years. Four tumors were discovered incidentally. Tumors varied from 1.2 to 20 cm in maximum diameter and all were multicystic. Within the pancreas, three were located in the pancreas head, one involved the head and body, one was located in the body, five were in the tail, and one occupied the whole pancreas. Central stellate scar was seen in five (45%) cases. Histologically, all tumors were composed of microglandular cysts lined by clear epithelial cells rich in glycogen, which were separated by fibrocollagenous stroma. The expression of keratin in clear epithelial cells resembled that in ductal and/or centroacinar cells, but not acinar cells. alpha-Smooth muscle actin (SMA)-positive myoepithelial cells and stromal amyloid deposits were not detected. Ultrastructurally, fibrocollagenous stroma was composed of alpha-SMA-positive myofibroblasts and endothelial cells embedded in thick collagen bundles. Regardless of female propensity, estrogen and progesterone receptors were not detected. Therefore, female predominance in this tumor remains to be elucidated.

A case of serous cystadenoma of the pancreas with a central stellate scar detected on contrast-enhanced ultrasound with perflubutane

“…This accounts for the honeycomb appearance in the tumor interior on contrast CT. Moreover, in 45% of cases of pancreatic serous cystadenoma, small septal nodules and a central stellate scar are present [8]. In the present patient, histopathologic examination showed a spongy tumor with a central stellate scar, and tissue staining with antibodies to blood vessels revealed rich vascularity of the septa, including the central stellate scar.…”

Microcystic Serous Cystadenoma of the Pancreas With Subtotal Cystic Degeneration

“…They share immunolabeling for EMA, inhibin, MART-1, and MUC6 with centroacinar cells, whereas ductal mucin markers such as B72.3, CEA, and CA19-9 are typically negative. 16,31,32 Data regarding the pathogenesis of serous cystadenomas are limited, but a recent investigation revealed frequent immunoexpression of hypoxia-induced molecules VEGF, GLUT1, CAIX, and HIF1a, which are implicated in the development of other hypervascular clear cell neoplasms, such as renal cell carcinoma and capillary hemangioblastoma. The characteristic subepithelial capillary network of MSCA is also shared by other members of this group.…”

Serous Cystic Neoplasms of the Whole Pancreas in a Patient with von Hippel-Lindau Disease

“…Though a growing number of SCNs of the pancreas are being identified because of the frequent use of radiography and advances in imaging techniques (17), SCNs of the whole pancreas are very rare (22)(23)(24)(25)(26)(27)(28)(29)(30)(31). In the present case, there were solid components in the head and body of the pancreas, and histological examination showed that this tumor was a solid variant of SCNs.…”