A Case of Cystadenoma of the Pancreas with Internal Hemorrhage Presenting Hematemesis

Abstract

A 73-year-old woman admitted for epigastric pain and hematemesis and having a 10-year history of aspirin in-gestion was found in abdominal CT to have a 68×74 mm cystic lesion in the pancreatic tail. The lesion con-tained a slightly high-density area with a low-density area in the center. The CT number of each was 17HU, 75HU, and 45HU. ERCP showed a dilated main pancreatic duct and the cyst communicating with a pancreatic duct branch in the tail. MRI suggested hemorrhage into the pancreatic cyst, but we could not exclude malig-nancy due to the elevated tumor marker. A distal pancreatectomy showed clotted blood but no elevated le-sion, suggesting neoplasm within the cyst. Histological examination showed the cyst wall to be lined with co-lumnar epithelium, leading to a final diagnosis of cystadenoma of the pancreas. The postoperative course was uneventful and she was discharged on postoperative day 22.