Abstract
A 78-year-old woman complaining of epigastric discomfort and nausea was suspected to have a tumor of the pancreas head on abdominal CT scan at another hospital, and was referred to the hospital. When she was first seen, a clearly demarcated and well movable tumor was palpable on the right side of the navel on physical examinations. Abdominal ultrasonography showed a 68 × 43mm clearly demarcated and solid tumor with an enhanced posterior echo in the lateral aspect of the pancreatic head. Abdominal CT scan disclosed a clearly demarcated and solid tumor 6.5cm in diameter with heterogeneous enhancement at the periphery and inner portion. Magnetic resonance imaging scan showed heterogeneous high signal intensity on T2-weighted images. From these findings, the patient was operated on with the most likely diagnosis of serous cystadenoma of the pancreas or duodenal gastrointestinal stromal tumor. During surgery, a 6-cm sized and elastic hard tumor was identified at the pancreatic head, so that pylorus preserving pancreatoduodenectomy was performed. The histopathological diagnosis was serous cystadenoma.
Since serous cystadenoma which appears as a movable tumor showing extrapancreatic growth is considered very rare, this case is presented here with some bibliograohical comments.
