source of the following text: radiopaedia.org
A serous cystadenoma of the pancreas (microcystic adenoma) is an uncommon type of benign cystic pancreatic neoplasm.
Typically large lesion at presentation ( ~ 5 cm) and characterised by innumerable glycogen rich flat or cuboidal epithelial lined cysts seperated by fibrous septa. There can be signifcant variation in locule size (1 – 2cm) 2-4. Three morphological patterns have been described 1
- polycystic : 70 %
- honeycomb : 20 %
- oligocystic (macrocystic variant) : < 10 % (cysts can be larger than 2 cm)
Demographics and clinical presentation
There is a recognised strong female predilection (M : F ~ 1 : 4 and usually presents in the middle age to elderly ( > 60 years of age).
Many patients are asymptomatic. Some may present with pain, weight loss jaundice or a mass 4,6.
- von Hippel Lindau (vHL) disease : can be multiple or diffuse and present at a younger age.
- can be normal
- may demonstrate amorphous central calcification overlying the pancreas
- typically shows an echogenic mass in the pancreatic head region due to the nature of microcysts (the oligocystic sub type may individually identify cysts 6)
- typically demonstrates a multicystic, lobulated mass in the pancreatic head region.
- a characteristic enhancing central scar may be present which can show associated stellate calcification (present in ~ 20 % of cases)
- T1 : typically low signal
- T2 : the central fibrous scar (if present) is low signal while cystic components themselves are high signal
- may show enhancement due to hypervascular components 4
Treatment and prognosis
Most lesions are observed 6. They are benign lesions and do not recur once resected 4.
- pancreatic pseudocyst
- mucinous cystic neoplasm of pancreas (e.g mucinous cystadenoma)
- Intraductal papillary mucinous tumour (IPMN) of pancreas : communicated with pancreatic ducts
- cystic lesions of the pancreas for general differential