A Case of Serous Cystic Adenoma Coexistent with Pancreas Head Carcinoma

Sadanobu Izumi, Yuji Onoda and Kunihiko Shiota

Department of Surgery, Kagawa Prefectural Central Hospital

A 72 year old man found in abdominal US to have a 3 cm mass in the pancreas head was also found in abdominal computed tomography (CT), MRCP, and ERCP to have a hypervascular microcystic tumor having no communication with the main pancreatic duct (MPD), and thus diagnosed as a serous cystic tumor (SCT). MRCP showed stenosis of the MPD above the SCT, but the cytology of pancreatic juice at ERCP was class II. Abdominal dynamic CT showed a 2×1 cm lesion of the pancreatic head and body located at the MPD stenosis showing a low-density area at the early phase and slight enhancement at the late phase, suggesting coexistence of pancreatic cancer. PET/CT showed no significant accumulation in the MPD stenosis and slight accumulation in the SCT, but maximum standardized uptake -early uptake of 2.93 and late uptake of 2.21- was benign. We conducted pancreatoduodenectomy. Pathological findings showed serous cystic adenoma coexisting with 1.5 cm pancreatic carcinoma at the same place showed in the abdominal CT. To our knowledge, this case is very rare and the first reported in Japan.

Key words
serous cystic adenoma, pancreatic carcinoma, PET/CT

Reprint requests
Sadanobu Izumi Department of Surgery, Kagawa Prefectural Central Hospital
5-4-16 Bancho, Takamatsu, 760-8557 JAPAN

Accepted
April 23, 2008

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