Multiple synchronous serous cystadenomas of the pancreas: uncommon CT and MRI findings

Serous cystadenomas (SCAs) of the pancreas are benign cystic tumors. Although still controversial, asymptomatic SCAs, in contrast to their mucinous counterparts, can be treated conservatively. This attitude is mostly defendable for lesions of the pancreas head or multiple lesions distributed throughout the entire pancreas, as their surgical resection is still associated with significant morbidity. Thus, correct diagnosis is essential, and this relies on radiological and biological characteristics. Asymptomatic multiple SCAs are rare. Most cases described in the literature are either symptomatic, degenerated, or both. We present a case of huge (>10 cm), multiple asymptomatic SCAs, not associated with von Hippel-Lindau disease, involving the entire pancreas. The patient has been followed up for 3 years and remains asymptomatic. Tumor markers were within normal ranges. On abdominal computed tomography (CT) and magnetic resonance imaging (MRI), the lesions showed pathognomonic characteristics of SCAs, and their uncommon dimensions and number remained stable over time. 18-Fluorodeoxyglucose positron emission tomography (PET) scan performed at 3-year follow-up did not show hypermetabolic lesions.