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Solid serous adenoma of the pancreas mimicking a solid pseudopapillary neoplasm: A case report
Sohui Jin1, Jisun Lee2, Bum Sang Cho1
1Department of Radiology, Chungbuk National University Hospital, Cheongju, Chungcheongbuk-do, Republic of Korea.
Rationale:
Serous cystic neoplasms of the pancreas are benign epithelial tumors that typically present as microcystic lesions. However, a rare solid variant, known as solid serous adenoma, may appear as a solid hypervascular mass and mimic other solid pancreatic tumors.
Patient Concerns:
An asymptomatic woman in her early 50s was referred for evaluation of an incidentally detected pancreatic tail mass.
Diagnoses:
Computed tomography and magnetic resonance imaging demonstrated heterogeneous peripheral enhancement with progressive centripetal fill-in and a persistent hypoenhancing area. Based on these findings, a solid pseudopapillary neoplasm was initially suspected.
Interventions:
Because malignancy could not be excluded on imaging, the patient underwent distal pancreatectomy.
Outcomes:
Histopathological examination confirmed solid serous adenoma composed of glycogen-rich cuboidal epithelium forming numerous microcystic spaces. The imaging findings correlated with regional differences in stromal composition. The postoperative course was uneventful, and follow-up imaging showed no evidence of recurrence or residual disease.
Lessons:
Solid serous adenomas can exhibit variable imaging appearances and mimic other solid pancreatic tumors. Recognition of this entity is clinically important, as it may improve diagnostic accuracy and help prevent unnecessary surgical resection of benign pancreatic lesions.
