Laparoscopic distal pancreatectomy for a large pancreatic lymphoepithelial cyst: a rare entity

Lymphoepithelial cysts (LECs) of the pancreas are rare true pancreatic cysts. Their cause is not known. The differential diagnosis is broad and includes many benign and malignant cystic lesions of the pancreas and surrounding organs. A combination of imaging modalities and fine needle aspiration might narrow the differential diagnosis. However, the final diagnosis can only be achieved with certainty after resection of the cyst. In this study, we report the largest LEC of the pancreas to have been resected laparoscopically. A 43-year-old man presented with upper abdominal pain, a 7.5 cm mutlioculated cystic mass in the pancreatic body and tail on imaging, and a raised serum cancer antigen-19-9. Laparoscopic distal pancreatectomy and splenectomy was performed. Histologic examination revealed a LEC. This study discusses the diagnostic difficulties and management decisions which face surgeons treating pancreatic cysts.