2022 Volume 37 Issue 2 Pages 74-80
The patient is a 33-year-old woman. Eight weeks after the birth of her first child, she visited her family doctor because she found a mass in the right upper quadrant of her abdomen. A cystic tumor was found in the pancreatic head, and she was referred for further investigation and treatment. Abdominal computed tomography scan showed an 8cm cystic lesion in the pancreatic head, with a faint contrast effect on the cyst septa. Magnetic resonance imaging showed a multilocular cystic lesion. Considering the possibility of a solid pseudopapillary neoplasm or a pancreatic serous cystic neoplasm (SCN) in the differential diagnosis based on gender, tumor size, and imaging findings, malignant disease could not be ruled out and a subtotal stomach-preserving pancreaticoduodenectomy with D1 lymph-node dissection were performed. The histopathological diagnosis was serous cystadenoma with intracystic hemorrhage. Intracystic hemorrhage in a SCN is an extremely rare condition, and may be difficult to diagnose due to varied imaging findings. An SCN larger than 4cm has an increased risk of containing malignancy and resection should be considered.
