Macrocystic serous cystadenoma of the pancreas: a morphologic variant differing from microcystic adenoma

Area of Science:

• Gastroenterology
• Surgical Pathology
• Diagnostic Imaging

Background:

• The term "microcystic adenoma" is widely accepted for a specific pancreatic tumor.
• Macrocystic variants of serous cystadenoma have been poorly documented in existing literature.

Observation:

• This study reports five cases of macrocystic serous cystadenoma, including two unilocular types.
• These tumors displayed macroscopic features distinct from microcystic adenoma, posing diagnostic challenges.
• Computed tomography scans incorrectly suggested mucinous cystic neoplasms or pseudocysts in all cases.

Findings:

• Two out of three cases with intraoperative frozen sections were misclassified.
• Macrocystic and microcystic serous tumors are proposed as morphologic variants of the same benign neoplasm.
• Diagnostic difficulties arose for radiologists and pathologists due to differing macroscopic appearances.

Implications:

• The findings suggest that "serous cystadenoma" should encompass all variants, including macrocystic and microcystic types.
• Accurate classification is crucial for appropriate patient management and treatment strategies.
• Further research into the distinct imaging and pathological features of these variants is warranted.