Cystadenomas of the pancreas

Cystadenomas of the pancreas are rare tumors. They represent about 10% of the pancreatic cystic masses. Several hundred cases seem to have been reported so far. These tumors appear as serous and mucinous. Over 13 years period (1983-1996) we treated 22 patients for cystadenoma of the pancreas. All patients were women. There were 6 serous and 16 mucinous cystadenomas. The average age in the serous group was 31 years (ranging from 23 to 42 years) and 43 years (ranging 17-64) in mucinous group. Two patients had tumor in the head, 20 others in the tail and body of the pancreas. The diameter of these tumors varied from 3.5 to 17.0 cm (average 9.6 cm). The leading symptoms were epigastric or left subcostal pain in 19 patients, palpable mass in 10, weight loss in 5, vomiting in 5, and melena in one patient. Tumor was accidentally found in a women undergoing abdominal operation for enteric fistula after hysterectomy. Serum amylase was moderately elevated in two patients. Diagnosis of pancreatic cystadenoma was proposed preoperatively in 16 patients (72.7%). In other cases, diagnoses of pancreatic cysts in 5 patients or hydatid cyst in 1 patient were made. An ideal operative removal (excision) was done in 7 patients, both excision of the tumor and splenectomy in 2, while distal pancreatectomy and splenectomy were carried out in 13 others. There was no mortality. One female patient developed left subphrenic abscess and left pleural effusion which were successfully treated by drainage and thoracocenthesis. One patient developed transient pancreatic fistula. All patients have been under close follow-up from 6 months to 13 years and all stayed symptom free so far.