Pancreatic lymphangioma in an adolescent male managed without surgery: a rare case report

Pancreatic lymphangiomas are extremely rare benign cystic lesions of the pancreas, with fewer than 100 cases reported in the literature. They can mimic other cystic pancreatic neoplasms, posing a diagnostic challenge. This case adds to the limited literature and supports conservative management as a safe option in selected patients. A 15-year-old South Asian male presented with right-sided upper abdominal pain persisting for 5 months. Imaging revealed a large, multiloculated cystic lesion involving the neck and body of the pancreas. Aspiration cytology and cyst fluid analysis (low carcinoembryonic antigen, elevated amylase, lymphocytes) were suggestive of pancreatic lymphangioma. The patient became asymptomatic and was managed conservatively with close monitoring. No surgical intervention was performed. This case demonstrates that conservative management of pancreatic lymphangiomas may be appropriate in asymptomatic or minimally symptomatic adolescents with benign imaging and biochemical features. It reinforces the importance of individualized treatment to avoid unnecessary surgery.