2013 Volume 28 Issue 6 Pages 800-805
A 45-year-old woman was referred to our hospital because of epigastralgia and back pain. Contrast-enhanced CT, revealed a cystic lesion in the pancreatic head, and the main pancreatic duct of the body and tail was distended. EUS showed multiple cystic lesions in the pancreatic head. There was no nodule in the cystic wall. Relatively smooth stenosis was identified in the main pancreatic duct of pancreatic head in ERCP. Brushing cytology of the stenosis was pseudopositive. Based on these results, we diagnosed it as IPMN. Subtotal stomach preserved pancreaticoduodenectomy was performed because we could not rule out the possibility of malignancy. Small and large cysts were recognized in cut surface and the pathological diagnosis was serous cystadenoma. The stenosis of main pancreatic duct was induced by the oppression of the tumor. Stenosis of main pancreatic duct due to serous cystadenoma is rare. Serous cystadenoma is typically benign, and surgery is not needed if it is diagnosed definitely. In our case, a surgical procedure was performed due to the symptoms and the suspicion of malignancy.
