A Case of Pancreatic Serous Cystic Neoplasm with Multiple Micro Lesions in Addition to Two Tumors

Abstract

A 60-year-old man with two pancreatic cystic lesions had been followed up by his previous doctor for 11 years. He was referred to our hospital for surgery because the tumors were increasing in diameter and CT findings showed a possibility of malignancy, such as enhancement with contrast effect and invasion into the surrounding tissues. These tumors were clinically diagnosed as serous cystic neoplasm (SCN), and laparoscopic distal pancreatectomy (LDP) was performed because the tumors had large diameter and were increasing. Histopathologically, the two tumors were diagnosed as microcystic type SCN, and other small cysts were scattered in the body and tail of the background pancreas in addition to the two tumors. It has been reported that multiple or diffuse SCNs are often associated with von Hippel-Lindau disease (VHL). In this case, although there was no significant family history, a detailed medical interview revealed that the patient had been operated on for cerebral hemangioblastoma 12 years previously. This case was suspicious of VHL presented with a diagnosis of rare SCN with multiple microlesions in addition to two tumors.