The Diagnosis And Treatment Of Serous Cystadenoma Of Pancreas: A Report Of 23 Cases

Objective To summarize the experience of diagnosis and treatment in serous cystadenoma of pancreas(SCA).Method Retrospectively analyzed the clinical and pathological data of 23 patients with SCA who were treated in Fujian medical university Union Hospital from 2004 December to 2014 August.Results there are 23 patients with SCA,including 8 men and 15 women.the average age was 52.17±16.50 years(22-79years).The first symptoms were abdominal pain in 11 patients(47.83%), Physical examination found in 12 cases(52.17%).The lesions were located in the head of pancreas in 9 patients,in the neck in 3 patients,in the body-tail in 11 patients. Ultrasound of a serous microcystic adenoma typically displays a well-circumscribed, lobulated lesion with decreased through-transmission. The lesions showed low density on CT, After administration of iodinated contrast material, the fibrous portions of the lesion enhance. On T2-weighted images, the cystic fluid-filled components are hyperintense relative to adjacent pancreatic parenchyma, and the fibrous components are hypointense. The cystic portions are classically hypointense on T1-weighted imaging,but may have areas of hyperintensity if there has been previous intracystic hemorrhage. Of the 23 patients, nine underwent pancreaticoduodenectomy,one underwent enucleation, two underwent central pancreatectomy,eight underwent distal pancreatectomy include splenectomy, three underwent distal pancreatectomy. The most common major complication was pancreatic leak or fistula in ten patients. Gastrointestinal anastomotic bleeding in one patient. After conservative treatment, were both recovery.The mean follow-up period was 43 months,two patients died of cerebral hemorrhage, one patient died of kidney malignant tumor.The others were no evidence of recurrence or metastasis were found.Conclusions Classified as a benign neoplasm, serous cystic neoplasm(SCN) of the pancreas is the most common primary cystic. SCNs constitute 30% of all cystic masses of the pancreas and 1% of all pancreatic neoplasms. This most common single type of cystic tumor is largely predominant in women. SCNs are typically unifocal and present as large, well-demarcated, often honeycombed cystic masses, which size can be from a few millimeters to a few centimeters. Diffuse or multifocal disease is uncommon. The average 3-5 cm in diameter. The preferred noninvasive test, Such as computer tomography, magnetic resonance imaging and ultrasound.Nowadays,we believe that asymptomatic of SCA can be follow-up.The tumor diameter less than 4 centimeter,we suggest the patients shuould checkup once every 2 years.If the tumor diameter greater than 4 cm, the patients shuould checkup once every 1 year. If the tumor increased or symptoms,that should be under surgery. Surgery should be based on the principles of benign tumors.In addition, only a few cases of serous cystadenocarcinomas of the pancreas have been reported. There have since been multiple case reports of malignant SCA histologically indistinguishable from benign SCA of the pancreas. This malignant variant is defined by the presence of metastases to extrapancreatic organs, tissues,Vascular or perineural invasion.If there is not any surgical contraindication,the tumor should be resection.