[Microcystic cystadenoma of the pancreas]

Cystadenoma of the pancreas is a rare tumor. In the surgery unit of the Hospital de la "Santa Cruz y San Pablo", of 18 cases of cephalic duodeno-pancreatectomy in the last nine years, we have only observed one case of cystadenoma. The patient was a 70 year-old woman, hypertensive and very obese, who had few symptoms and was diagnosed as pancreatic tumor by echography. CAT, ERCP and abdominal arteriography confirmed the diagnosis. Needle biopsy guided by echography and CAT was negative for malignant cells. In the operation, needle and trucut biopsy revealed benign cystadenoma. Cephalic duodenopancreatectomy was performed. The postoperative period was difficult, and the patient required reoperation within hours for intraperitoneal hemorrhage and again, eight days later, for dehiscence of the pancreatic suture. Finally she recuperated and was released at 38 days. Of all the types of proliferative pancreatic cysts, microcystic or serous adenoma is benign, as compared to mucinous cyst, of clearly malignant potential. However, needle biopsy rarely provides differential diagnosis. In some cases of high surgical risk, the indication for resection can be dubious if the cyst lies in the region of the pancreatic head and its benign nature can be demonstrated.