PMID- 36749262
OWN - NLM
STAT- MEDLINE
DCOM- 20230209
LR  - 20230209
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 102
IP  - 5
DP  - 2023 Feb 3
TI  - Pancreatic serous cystic neoplasm mimicking intraductal papillary mucinous 
      neoplasm: Two case reports and literature review.
PG  - e32820
LID - 10.1097/MD.0000000000032820 [doi]
LID - e32820
AB  - RATIONALE: Serous cystic neoplasms (SCNs) are treated as benign lesions. It is 
      widely known that SCN rarely have a connection with the main pancreatic duct 
      (MPD), which helps differentiate them from other cystic lesions, such as 
      intraductal papillary mucinous neoplasm (IPMN). However, very rare cases where 
      the SCN appears connected to the MPD cause diagnostic confusion. PATIENT 
      CONCERNS: We present 2 patients with SCN (1 male, 54, and 1 female, 42). Both 
      patients were asymptomatic, without abnormal laboratory results. DIAGNOSIS: In 
      both cases, abdominopelvic computed tomography and pancreatic magnetic resonance 
      imaging scans revealed a multilobulated cystic lesion in communication with the 
      MPD. Since the size of each patient's lesion was >3 cm and there was connectivity 
      with the MPD, it was strongly suspected to be a branch duct-type IPMN with 
      worrisome features rather than SCN and surgical intervention was considered. 
      INTERVENTIONS: Both neoplasms were misdiagnosed as IPMN due to appearing 
      connected with the MPD on radiologic imaging. Surgery was performed. OUTCOMES: A 
      final diagnosis of microcystic serous cystadenoma of the pancreas without 
      connectivity of MPD was confirmed in both patients. LESSONS: An unnecessary 
      surgery was performed due to atypical radiologic features in which the pancreatic 
      duct seems to be connected to the pancreatic cystic lesion on magnetic resonance 
      imaging, leading to misdiagnosis of SCN as IPMN. Particular attention should be 
      paid to interpretation of clinicoradiologic findings of pancreatic cystic 
      lesions, especially to the decision of surgical intervention. Also, awareness of 
      presence of the atypical radiologic features of SCN may broaden the knowledge 
      base of radiologists. LESSONS: An unnecessary surgery was performed due to 
      atypical radiologic features in which the pancreatic duct seems to be connected 
      to the pancreatic cystic lesion on magnetic resonance imaging, leading to 
      misdiagnosis of SCN as IPMN. Particular attention should be paid to 
      interpretation of clinicoradiologic findings of pancreatic cystic lesions, 
      especially to the decision of surgical intervention. Also, awareness of presence 
      of the atypical radiologic features of SCN may broaden the knowledge base of 
      radiologists.
CI  - Copyright (c) 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Park, Mihyeon
AU  - Park M
AD  - Department of Radiology, Chungbuk National University Hospital, Cheongju, 
      Republic of Korea.
FAU - Lee, Jisun
AU  - Lee J
AD  - Department of Radiology, College of Medicine, Chungbuk National University, 
      Chungbuk National University Hospital, Cheongju, Republic of Korea.
FAU - Kim, Yook
AU  - Kim Y
AD  - Department of Radiology, Chungbuk National University Hospital, Cheongju, 
      Republic of Korea.
FAU - Yi, Kyung Sik
AU  - Yi KS
AD  - Department of Radiology, College of Medicine, Chungbuk National University, 
      Chungbuk National University Hospital, Cheongju, Republic of Korea.
FAU - Cho, Bum Sang
AU  - Cho BS
AD  - Department of Radiology, College of Medicine, Chungbuk National University, 
      Chungbuk National University Hospital, Cheongju, Republic of Korea.
FAU - Choi, Chi-Hoon
AU  - Choi CH
AD  - Department of Radiology, College of Medicine, Chungbuk National University, 
      Chungbuk National University Hospital, Cheongju, Republic of Korea.
FAU - Park, Kil Sun
AU  - Park KS
AD  - Department of Radiology, College of Medicine, Chungbuk National University, 
      Chungbuk National University Hospital, Cheongju, Republic of Korea.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Humans
MH  - Male
MH  - Female
MH  - *Carcinoma, Pancreatic Ductal/pathology
MH  - *Pancreatic Intraductal Neoplasms
MH  - *Pancreatic Neoplasms/pathology
MH  - Pancreatic Ducts/pathology
MH  - *Neoplasms, Cystic, Mucinous, and Serous/pathology
MH  - *Pancreatic Cyst/pathology
PMC - PMC9901981
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2023/02/08 06:00
MHDA- 2023/02/10 06:00
PMCR- 2023/02/03
CRDT- 2023/02/07 10:07
PHST- 2023/02/08 06:00 [pubmed]
PHST- 2023/02/10 06:00 [medline]
PHST- 2023/02/07 10:07 [entrez]
PHST- 2023/02/03 00:00 [pmc-release]
AID - 00005792-202302030-00043 [pii]
AID - 10.1097/MD.0000000000032820 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2023 Feb 3;102(5):e32820. doi: 10.1097/MD.0000000000032820.