A Case of Pancreatic Serous Cystadnoma Combined with Pancreatic Endocrine Tumor

Kim, Soo Joong; Chang, Young Woon; Dong, Seok Ho; Kim, Hyo Jong; Kim, Byung Ho; Lee, Joung Il; Chang, Rin

Abstract

Pancreatic serous cystadenoma (microcystic adenoma) is a rare and mostly benign tumor. Occasio nally, it is associated with other pancreatic or extrapancreatic tumor. We report a case of pancreatic serous cystadenoma combined with pancreatic endocrine tumor observed in a 69 year-old woman. She presented intermittent melena for 6 months. Gastroduodenoscopic finding showed 4 cm-sized submucosal mass which was protruding into the second portion of duodenum. Abdominal ultrasonography and computed tomography showed chronic pancreatitis with calcification and multiple cysts in whole pancreas. Whipple's operation and total pancreatectomy with splenectomy were performed under the impression of a pancreatic serous cystadenoma with duodenal invasion. Grossly, the pancreas was enlarged and entirely replaced by spongy-like tiny cysts. Also a gray white solid area at the head portion was encountered and extended to the duodenum. Histologically, the cysts were lined by a single layer of periodic acid Schiff positive cuboidal cells. Moreover, the conpact area was composed of solid and acinar structures of tumor cells which showed a positive reaction for chromogranin A and neuron specific enolase, markers of neuroendocrine tumor. To the best of our knowledge, this is the first report published with immunohistochemical studies to deal with diffuse serous .cystadenoma combined with pancreatic endocrine tumor in Korea.