Successful Cystic Fenestration for a Macrocystic Serous Cystadenoma of the Pancreas Causing Obstructive Jaundice: Report of a Case

Watanabe, Hiroyuki; Ohtsubo, Koushiro; Yamaguchi, Yasushi; Mouri, Hisatsugu; Motoo, Yoshiharu; Noto, Masahiro; Kitagawa, Hirohisa; Kayahara, Masato; Ohta, Tetsuo; Gabata, Toshifumi; Sakamoto, Shigeo; Sawabu, Norio

doi:10.1007/s00595-005-3079-3

Cited by 10 publications

(5 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11 Despite the benign nature of SCAs, huge tumors tend to compress or involve the surrounding structures, and sometimes obstruct the bile duct or involve the splenic vein. [12][13][14] Serous cystadenomas are generally resected to relieve symptoms, because they have grown to a large size, or if it is impossible to distinguish a serous cystic neoplasm from a mucinous lesion, which has greater malignant potential. Some authors have recommended resection for all cystic neoplasms of the pancreas, [15][16][17] whereas others insist on a more selective approach.…”

Section: Discussionmentioning

confidence: 99%

Left-sided portal hypertension caused by serous cystadenoma of the pancreas: Report of a case

et al. 2008

View full text Add to dashboard Cite

We report a case of serous cystadenoma of pancreas causing left-sided portal hypertension and gastric varices. A 68-year-old man was admitted for treatment of a pancreatic body tumor. Contrast-enhanced computed tomography (CT) showed a honeycombed cystic mass. A celiac angiogram showed a hypervascular tumor supplied mainly by a dilated splenic artery and dorsal pancreatic artery. In the venous phase, the patent splenic vein had a large hepatopetal collateral vein via the coronary gastric vein. Upper gastrointestinal endoscopy showed isolated varices of the gastric fundus. We made a preoperative diagnosis of a serous cystic tumor of the pancreas with left-sided portal hypertension and performed distal pancreatectomy with splenectomy. The resected tumor was 8 cm in diameter and had a typical honeycombed microcystic pattern with central stellate scarring. The spleen was not enlarged. Histopathological examination confirmed a diagnosis of serous cystadenoma without any sign of malignancy. Postoperative endoscopy showed disappearance of the gastric varices.

show abstract

Section: Discussionmentioning

confidence: 99%

Left-sided portal hypertension caused by serous cystadenoma of the pancreas: Report of a case

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Only one case using an open approach of fenestration indicated for jaundice was published, and had an excellent long-term result [18] . This small series suggests that laparoscopic fenestration of large symptomatic SC is safe and effective.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic fenestration of pancreatic serous cystadenoma: Minimally invasive approach for symptomatic benign disease

Dokmak

Aussilhou

Rasoaherinomenjanahary

et al. 2015

WJG

View full text Add to dashboard Cite

Serous cystadenoma (SC) is a benign pancreatic cystic tumor. Surgical resection is recommended for symptomatic forms, but laparoscopic fenestration of large symptomatic macrocystic SC was not yet described in the literature. In this study, 3 female patients underwent laparoscopic fenestration for macrocystic SC (12-14 cm). Diagnosis was established via magnetic resonance imaging and endoscopic ultrasound, with intra-cystic dosage of tumors markers (ACE and CA19-9) in 2 patients. All patients were symptomatic and operated on 15-60 mo after diagnosis. Radiological evaluation showed constant cyst growth. Patients were informed about this new surgical modality that can avoid pancreatic resection. The mean operative time was 103 min (70-150 min) with one conversion. The post-operative course was marked by a grade A pancreatic fistula in one patient and was uneventful in the other two. The hospital stay was 3, 10, and 18 d, respectively. The diagnosis of macrocystic SC was histologically-confirmed in all cases. At the last followup (13-26 mo), all patients were symptom-free, and radiological evaluation showed complete disappearance of the cyst. Laparoscopic fenestration, as opposed to resection, should be considered for large symptomatic macrocystic SC, thereby avoiding pancreatic resection morbidity and mortality.

show abstract

“…This malignant variant is defined by the presence of metastases in extrapancreatic organs or tissues [ 5 ]. In addition, the presence of invasion to the adjacent organs is considered a characteristic of malignancy [ 6 ]. SCAs predominate in females in their sixth decade of life [ 7 ] and are asymptomatic in 33% of cases [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Symptoms are frequently non-specific, with abdominal pain being the most common, occurring in 50–60% of all cases [ 7 ]. The tumors rarely cause obstructive jaundice [ 6 , 8 – 12 ] and are usually unifocal, situated in the body and tail of the pancreas, and are multiloculated and cystic in appearance. The present case can be classified as one of a multicentric serous tumor involving the entire pancreas with almost complete obliteration of pancreatic acini and ducts.…”

Section: Discussionmentioning

confidence: 99%

A disseminated variant of pancreatic serous cystadenoma causing obstructive jaundice, a very rare entity: a case report and review of the literature

2014

View full text Add to dashboard Cite

BackgroundMicrocystic adenoma or serous cystadenoma (SCA) is an uncommon tumor type, accounting for only 1–2% of pancreatic exocrine neoplasms. Usually unifocal, SCAs present as single, large, well-demarcated, multiloculated, cystic tumors, 1–25 cm in size.Case presentationA 73-year-old man initially presented with epigastric abdominal pain and was diagnosed with SCA involving the whole pancreas. Eleven months later, he presented with obstructive jaundice, and total pancreatectomy was performed. The removed tissue allowed histological verification of pancreatic SCA. Histopathological examination showed both microcysts and macrocysts, lined by cuboidal epithelium, with optically clear cytoplasm and the absence of detectable mitosis or necrosis.ConclusionsThus, although relatively rare, pancreatic SCA is one of the differential diagnoses of epigastric abdominal pain; we recommend early surgical intervention for symptomatic pancreatic SCA.

show abstract

Successful Cystic Fenestration for a Macrocystic Serous Cystadenoma of the Pancreas Causing Obstructive Jaundice: Report of a Case

Cited by 10 publications

References 11 publications

Left-sided portal hypertension caused by serous cystadenoma of the pancreas: Report of a case

Left-sided portal hypertension caused by serous cystadenoma of the pancreas: Report of a case

Laparoscopic fenestration of pancreatic serous cystadenoma: Minimally invasive approach for symptomatic benign disease

A disseminated variant of pancreatic serous cystadenoma causing obstructive jaundice, a very rare entity: a case report and review of the literature

Contact Info

Product

Resources

About