Abstract
We reported a case involving a giant serous cystadeoma of the pancreas that was difficult to diagnose preoperatively due to its specific radiological findings. The patient was a 75-year-old woman suffering from abdominal mass and discomfort. Abnormal gas in mass shadow, showing air-fluid level, was observed in an abdominal plain X-ray film. CT scan revealed a cystic mass having a mixture of low and high density areas. Endoscope and upper gastrointestinal series did not reveal any fistulation to the tumor. From the diagnosis of cystic tumor of the pancreatic head, we performed pancreatoduodenectomy. The tumor weighed 1035 g, and consisted of numerous small cysts and a large cyst. This large cyst showed pin-point fistulation in thirds of the duodenum. This fistula explained the abnormal gas on preoperative plain X-P. Histologically the tumor was diagnosed as serous cystadenoma of the pancreas. Such tumors are relatively rare and the preoperative diagnosis can be made by US, CT, and angiography. However, in tumors growing as large as penetrating to the intestine like this case, it is not always easy to diagnose preoperatively because of its specific findings.
