Cases reported "Cystadenoma, Serous"

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11/65. Macrocystic type of serous cystadenoma with a communication between the cyst and pancreatic duct.

    A 42-year-old woman with a cystic lesion in the head of the pancreas was evaluated by using abdominal ultrasonography, a computed tomographic scan, magnetic resonance imaging and endoscopic retrograde pancreatography. Multiple cystic lesions, 5 cm in diameter, which had papillary protrusion inside the cyst in the head of the pancreas and had the communication between the cysts and pancreatic duct, were determined. pylorus-preserving pancreaticoduodenectomy was performed under the diagnosis of mucinous cystic neoplasm of the pancreas. Although the cut surface of the tumor showed a macrocystic tumor of 3 cm in diameter, part of the cyst wall was cavernous. A histopathological examination showed single-layered cuboidal cells, which lead to the diagnosis as being serous cystadenoma of the pancreas. Serous cystadenoma is a rare, almost benign pancreatic tumor. The macrocystic subtype of serous cystadenoma is even more rare. We describe a patient who had this macrocystic subtype of serous cystadenoma with a communication between the cyst and pancreatic duct. This case illustrates the difficulty in the diagnosis of cystic lesions in the pancreas, and might support the single category of cystic lesions of the pancreas.
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12/65. Torsion of benign serous cystadenoma of the fallopian tube: a challenge in differential diagnosis of abdominal pain in women during their childbearing years--a case report.

    The differential diagnosis of abdominal pain in women during their childbearing years is still a challenge. abdominal pain caused by isolated tubal torsion is extremely rare. In the report, we presented a case of isolated tubal torsion caused by benign serous cystadenoma. A 28-year-old married woman (G0) having lower abdominal pain and nausea was referred to our Emergency Room with suspicion of ovarian mass. physical examination, transvaginal ultrasound and computed tomography showed a 4-cm right adnexal cystic mass. Other laboratory data were all within normal limits. She was managed by laparoscopic examination due to a lack of improvement in her clinical symptoms and inclusive diagnosis after 48-hours' conservative treatment. laparoscopy showed isolated torsion of right fallopian tube but the right ovary was normal without torsion. Initially, detorsion was performed but necrotic change of the fallopian tube persisted because of permanent darkened color tube without blood flow redistribution, so salpingectomy was performed 30 minutes later. Final pathology showed benign serous cystadenoma of fallopian tube. The present case is the first case of benign serous cystadenoma with resultant necrotic tubal torsion. We reported this case to emphasize the possible value of early performance of laparoscopy in aiding an accurate diagnosis.
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keywords = cystadenoma
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13/65. Pancreatic head resection for noninflammatory benign lesions of the head of the pancreas.

    INTRODUCTION: duodenum-preserving pancreatic head resection (DPPHR) has been safely performed in patients with chronic pancreatitis. The procedure has rarely been used to remove benign or borderline lesions of the head of the pancreas. AIMS: To review our experience with 13 patients who underwent DPPHR and to review reports in the literature on the same subject. METHODOLOGY: From October 1991 to September 2000, 13 patients underwent DPPHR to resect endocrine pancreatic tumors (n = 4), beta cell hyperplasia (n = 1), pancreatic pseudocysts (n = 2), serous cystadenomas (n = 3), congenital (n = 1) and choledochal (n = 1) cysts, and intraductal papillary mucinous tumor (n = 1). The Kocher maneuver was performed in seven patients (group 1) and avoided in six (group 2). Type 1, 2, and 3 DPPHR were defined depending on the amount of pancreatic tissue left at the inner surface of the duodenum. Ten patients underwent evaluation that included an oral glucose tolerance test and exocrine pancreatic function test. RESULTS: The mortality rate was zero; the complication rate was 69%. patients in whom the Kocher maneuver was not performed (group 2) experienced fewer complications, shorter stay on nasogastric tube and abdominal drain(s), and earlier water intake and discharge. Type of DPPHR did not influence the postoperative course. One patient died 3 months after surgery of unrelated disease. Twelve patients were alive and well 2 months to 8 years after surgery. CONCLUSION: DPPHR is a low-risk procedure in patients with benign or borderline noninflammatory lesions of the head of the pancreas in whom pylorus-preserving pancreaticoduodenectomy is otherwise indicated. Whenever possible, the Kocher maneuver should be avoided.
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ranking = 0.125
keywords = cystadenoma
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14/65. Serous cystadenoma of the pancreas with papillary features: a diagnostic pitfall on fine-needle aspiration biopsy.

    Serous cystadenoma of the pancreas is an uncommon neoplasm that occasionally exhibits papillary differentiation. The cytomorphologic structure of pancreatic serous cystadenoma has been rarely described, and, to our knowledge, such papillary morphologic structure has never been reported on fine-needle aspiration cytologic examination. We present a case of serous cystadenoma of the pancreas in a 77-year-old woman. Endoscopic ultrasonography showed a well-demarcated solid/cystic mass in the midbody of the pancreas, suggestive of solid pseudopapillary tumor. Aspiration cytologic examination, performed under endoscopic ultrasound guidance, showed a predominantly papillary epithelial neoplasm consistent with the radiologic impression. Gross and histologic examination of the excised specimen revealed a pancreatic serous cystadenoma with multifocal papillae. This case illustrates the cytomorphologic structure of serous cystadenoma that presents with prominent papillary differentiation on aspiration cytologic examination. The unusual cytologic appearance of this tumor introduces significant diagnostic challenges to the pathologist. Serous cystadenoma must be included in the differential diagnosis of pancreatic neoplasms with papillary morphologic structure as evaluated by fine-needle aspiration cytologic examination.
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ranking = 1.25
keywords = cystadenoma
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15/65. Serous cystadenoma of the pancreas associated with pancreas divisum.

    pancreas divisum is an embryologic anomaly of the pancreas that is characterized by a lack of fusion of the dorsal and ventral pancreatic ducts. It is rarely associated with pancreatic neoplasms. We report herein a rare association of pancreas divisum and serous cystadenoma of the pancreas. A 46-year-old Japanese woman presented with epigastralgia. ultrasonography, computed tomography (CT) and magnetic resonance cholangiopancreatography revealed a multilocular cystic mass, measuring 7 cm in diameter, with a central stellate scar, in the body and tail of the pancreas. angiography demonstrated a relatively hypervascular mass, suppressing the splenic vein. No arterial encasement was evident. Endoscopic retrograde pancreatography through the major papilla demonstrated only the duct of Wirsung; cannulation into the minor papilla was unsuccessful. In addition, CT showed a mildly dilated main pancreatic duct draining into the minor papilla. Distal pancreatectomy and splenectomy were performed, with the tentative diagnosis being serous cystic neoplasm of the pancreas, possibly malignant, and pancreas divisum. The cut surface of the resected specimen had a honeycomb-like appearance and the specimen consisted of multiple cysts of various sizes. Histopathological examination showed multiple cysts lined by a single layer of flat or cuboidal epithelial cells with glycogen in the cytoplasm. There was no evidence of malignancy. The histopathological diagnosis was serous cystadenoma of the pancreas. To the best of our knowledge, only three cases of serous cystadenoma of the pancreas associated with pancreas divisum have been reported. We report the fourth case of such an association, and briefly review the literature.
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ranking = 0.875
keywords = cystadenoma
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16/65. Macrocystic serous adenoma of the pancreas.

    Macrocystic serous adenoma of the pancreas (MSAP) is a rare neoplasm. Its preoperative diagnosis by physical examination and imaging studies is challenging, if not impossible. In recent years, a few cases of MSAP with correct cytodiagnosis by transabdominal fine-needle aspiration (TFNA) have been documented. This paper reports two cases of MSAP that were successfully diagnosed by TFNA cytology. Two adult women presented with epigastric discomfort. Abdominal imaging studies revealed a large pancreatic cystic lesion in both cases. TFNAs of the pancreatic lesions were subsequently performed and revealed a clear serous fluid containing small monolayered sheets of benign cuboidal epithelial cells with scant, clear or granular cytoplasm, vesicular nuclei and micronucleoli. The cell cytoplasm stained positively with periodic acid-Schiff (PAS) and negatively with PAS with prior digestion with diastase (PASD). The cytological findings in both cases were similar and suggested a serous cystadenoma. The two pancreatic lesions were removed by Whipple's operation. They showed features of a macrocystic serous adenoma of the pancreas that were characterized by a small number of large cystic cavities lined by a single layer of non-mucus secreting, PAS-positive and PASD-negative cuboidal epithelial cells. By electron microscopy, the epithelial lining cells showed short and aborted apical microvilli, well-formed desmosomes and a large amount of intracytoplasmic glycogen, suggesting a centroacinar ductal cell origin.
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ranking = 0.125
keywords = cystadenoma
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17/65. An ovarian tumor larger than the patient's body weight.

    Surface epithelial-stromal tumors constitute by far the most important group among all ovarian neoplasms. Sixty-four kilogram left ovarian serous cystadenoma was removed from a forty-nine kilogram weighing Ethiopian woman. She presented with twenty-five years history of abdominal swelling. She had extreme degree of difficulty in bearing her weight, which resulted in keeping her to the house. This unusually big tumor is discussed with clinicopathologic correlation and literature review.
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ranking = 0.125
keywords = cystadenoma
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18/65. Segmental pancreatectomy for benign tumor of the pancreas.

    BACKGROUND: Enucleation of pancreatic tumor has the potential risk for damage of the main pancreatic duct. Benign tumors located in the neck or body of the pancreas are usually removed by left (spleno-) pancreatectomy or pancreatoduodenectomy. Standard pancreatic resection may result in serious loss of normal pancreatic parenchyme and impairment of pancreatic function. The aim of this study is to evaluate the results of segmental pancreatectomy, a limited resection of the midportion of the pancreas, in patients with benign tumor of the pancreas. methods: Four patients with benign tumor over pancreatic neck or body were treated with segmental pancreatectomy after pathological confirmation by frozen section. The proximal stump was closed and distal stump was anastomosed with a Roux-en-Y pancreaticojejunostomy. Clinical evaluation, routine blood sugar, stool fat examination and abdominal ultrasonography were performed for their follow up. RESULTS: Segmental pancreatectomy was satisfactory in these four patients. The pathologic examinations revealed serous cystadenoma. No mortality was noted. Minor pancreatic fistula was found in three of them and was treated conservatively. No obvious exocrine insufficiency was noticed. One patient had diabetes mellitus before operation, which was persisted postoperatively. CONCLUSIONS: Segmental pancreatectomy is a safe and effective alternative to major pancreatic resection in selected patients with benign tumor of the pancreas. This procedure has a surgical risk similar to that of the standard operation, but preserves more pancreatic tissues, which may prevent pancreatic function impairment.
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ranking = 0.125
keywords = cystadenoma
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19/65. Peritoneal melanosis combined with serous cystadenoma of the ovary: a case report and literature review.

    Benign peritoneal melanosis is extremely rare and traditionally occurs in association with ovarian dermoid cysts, but rarely with peritoneal cyst, enteric duplication cyst or gastric triplication. The pathogenesis of peritoneal melanosis, in particular, the origin of the pigment-producing cells is unclear. We describe a case of peritoneal melanosis that was associated with ovarian serous cystadenoma in a young woman. Ovarian serous cystadenoma has not been previously described as a combined lesion of peritoneal melanosis. Based on the extremely rare incidence of this lesion and heterogeneous combined lesions, the possibility of an incidentally found, coexisting lesion couldn't be excluded. Here, we suggest that peritoneal mesothelial cells pinched off during the developmental period might be a source of pigment-producing cells.
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ranking = 0.75
keywords = cystadenoma
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20/65. Serous cystadenoma of the pancreas associated with obstructive jaundice.

    We herein report a case of pancreatic serous cystadenoma in a patient who presented with jaundice, and we provide a review of the literature. A 53-year-old man was admitted with complaints of jaundice and weight loss. With a preoperative diagnosis of pancreatic serous cystadenoma with obstructive jaundice, he underwent pylorus-preserving pancreatoduodenectomy. A cystic tumor partially protruding into the bile duct was observed in the pancreatic head. histology verified serous cystadenoma of the pancreas. Histologically, no atypia was proven in the epithelium. There have been only eight case reports dealing with serous cystadenoma of the pancreas with obstructive jaundice. Although serous cystadenoma of the pancreas has essentially a benign nature, pylorus-preserving pancreatoduodenectomy is the treatment of choice when available to avoid the recurrence of obstructive jaundice.
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ranking = 1.125
keywords = cystadenoma
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