Research Article

Giant Serous Cystadenoma of the Pancreas (10 cm): The Clinical Features and CT Findings

Table 1

Clinical and CT manifestations of giant pancreatic serous cystadenoma.

AuthorsGender/age (y)SymptomsSize (cm)LocationMorphological patternsCalcificationCTA or DSARelationship with neighboring organsSurgical procedureFollow-up and outcome

Sakata et al. [3]F/71No13.9HeadOligocystic typeNoStretching of the adjacent vessels NADome resection with chemocautery using 100 mg minocycline hydrochlorideNo postoperative complications and survived after 12 months of follow-up

Schulz et al. [4]F/70Abdominal discomfort with vomiting and lost weight17.0HeadMicrocystic typeYesNACompression of the vena cava, the aorta, left liver lobe, and transverse colon. Involvement of the SMV and PV leading to severe portal hypertensionRight-sided hemicolectomy without tumor resectionAlive after 13 years of follow-up, symptoms are worsening and tumor is growing larger

Salemis and Tsohataridis [5]F/83General fatigue, epigastric pain, and weight loss23.0HeadMacrocystic typeNoNANARoux-en-Y cystojejunostomyAlive after 13 years of follow-up, asymptomatic

Vernadakis et al. [6]F/66No26.0HeadMicrocystic typeNoNASurrounding the right colonic vessels and compressing the IVCPylorus-preserving pancreaticoduodenectomy with a right hemicolectomyAlive without postoperative complications

Tajima et al. [7]F/72No13.0HeadMicrocystic typeNoFeeding arteries including GDA, RGA, SA, DPA, and IPDA Enlarged draining veins on the surface (drainage into the PV and SMV)Tightly adherent to the SMV and PVPreoperative embolization of the tumor-feeding arteries, pancreaticoduodenectomy; the SMV-PV was resected and reconstructedAlive without postoperative complications

Charalampoudis et al. [8]M/74No12.7Body-tailMicrocystic typeNoNAAttached to the splenic porta and the transverse mesocolonDistal pancreatectomy with splenectomyAlive without postoperative complications

Dikmen et al. [9]F/64Abdominal pain15.5HeadMicrocystic typeNoNACompression of the right and left PV, inferior vena cava, left PV, and SMAWhipple procedureAlive without postoperative complications

Kawaguchi et al. [10]F/58Abdominal bloating20.0BodyMacrocystic typeNoNACompression of the middle part of the gastric body and main pancreatic duct in the tail of the pancreasDistal pancreatectomy with splenectomyNA

Dokmak et al. [11]F/33–66Pain and fullness in the right subcostal area (), palpable mass (), signs of gastric outlet obstruction (), and cholestasis without jaundice12.0, 13.0, and 14.0Head ()Macrocystic type ()NA ()NA ()NA ()Laparoscopic fenestration (), and one patient needed pancreatectomyBile duct injury in one patient, pancreatic fistula in another patient At the last follow-up (13, 21, and 26 months), all 3 patients were symptom-free

Liu et al.F/65Abdominal bloating and vomiting15.3Body-tailMicrocystic typeYesLack of abundant feeding arteries (SA and DPA) and draining veins (drainage into the SV)Encasement or compression of the left RV, the SA and, SV and adherence to the posterior gastric wallDistal pancreatectomy with splenectomyNo postoperative complications and survived after 14 months of follow-up

Liu et al.M/67Acid reflux with abdominal bloating and pain14.8Body-tailMicrocystic typeYesAbundant feeding arteries (SA) and draining veins (drainage into the SV and the SMV)Encasement of the SA and SV; gastric vein varices, transverse mesocolon adhesionsDistal pancreatectomy with splenectomy and omentum resectionPostoperative infection and fluid accumulation in the surgical area; survived after 49 months of follow-up

Liu et al.M/48Abdominal pain and bloating10.2Body-tailMicrocystic typeNoAbundant feeding artery (SA) and draining veins (drainage into the SMV and the SV)Compression of the left RV and the SVDistal pancreatectomy with preserving spleenMild postoperative pancreatic fistula, survived after 45 months of follow-up

Liu et al.F/68Abdominal bloating, palpable mass16.5HeadMix-typeYesLack of abundant feeding artery (GDA) and draining veins (drainage into the SMV)Encasement and compression of the GDA, the PV, the SMV, and the CBDPancreaticoduodenectomy, repair of the injured portal veinNo postoperative complications and survived after 24 months of follow-up

Liu et al.F/63Abdominal pain11.2Body-tailMicrocystic typeYesAbundant feeding artery (SA) and draining veins (drainage into the SMV and the SV)Encasement and compression of the SA and SV and adherence to the posterior gastric wall and the transverse colonDistal pancreatectomy withsplenectomy and partial resection of the transverse colonNo postoperative complications and survived after 17 months of follow-up

Liu et al.M/54Abdominal bloating10.5Body-tailMicrocystic typeYesLack of abundant feeding artery (SA) and draining veins (drainage into the SMV and the SV)Encasement and compression of the SA and SV and gastric vein varicesDistal pancreatectomy with splenectomyNo postoperative complications and survived after 8 months of follow-up

Note: Y, years; F, female; M, male; PV, portal vein; SMV, superior mesenteric vein; NA, not available; GDA, gastroduodenal artery; RGA, right gastric artery, SA, splenic artery; DPA, dorsal pancreatic artery; IPDA, inferior pancreaticoduodenal arteries; SMA, superior mesenteric artery; IVC, inferior vena cava; SV, splenic vein; RV, renal vein; CBD, common bile duct.
This patient had concurrent gastric stromal tumor and rectal adenocarcinoma.