A Serous Cystadenocarcinoma of the Pancreas Diagnosed With Lymph Node Metastasis

Abstract

Serous cystic neoplasms of the pancreas account for 10% to 16% of all pancreatic cystic masses. Serous cystic neoplasms were evaluated as benign pancreatic masses. For all that, the first serous cystic neoplasm with malignancy criteria was described by George in 1989. Only 10 cases have been observed until today. A 53-year-old female patient presented with complaints of jaundice and abdominal pain. Her past medical history revealed pancreatic cysts during the examination for abdominal pain. Computed tomography revealed a cystic mass of approximately 8 cm in size with a solid component originating from the head of the pancreas and leading to obstruction in the bile duct. She underwent pylorus-preserving pancreaticoduodenectomy and was discharged on Day 12 due to the absence of any surgical abnormality during the postoperative follow-up. On examination of the surgical specimens, a multiloculated cystic tumor with a serous content was detected. Tumor metastasis which demonstrated a positive reaction with cytokeratin 7 and cytokeratin 19 in the celiac lymph node biopsies was detected. The tumor was found to have a histomorphologically benign appearance and was reported as a serous cystadenocarcinoma based on the desmoplastic stroma and lymph node metastasis. Cystic neoplasms of the pancreas can be followed conservatively. Malignant transformation in pancreatic serous cystadenocarcinoma should be kept in minds such as pancreatitis, bile duct obstruction, and new-onset or increased complaints during follow-up.