췌장의 장액성 낭선종

Abstract

Background/Aims: Pancreatic cystic tumors, accounting for 9-10% of pancreatic cystic lesions and 1% of primary pancreatic malignant tumors, are largely categorized into serous cystadenoma and mucinous cystic neoplasm. Whereas serous cystadenoma is almost always benign in nature, mucinous cystic neoplasm indicates an overt or latent malignancy. They are usually differentiated from each other by clinical and radiological findings, but exceptions also exist. The purpose of this study was to define clinical and radiological characteristics of serous cystadenoma. Method: Seven patients were diagnosed as having serous cystadenoma from January 1981 to April 1997. We reviewed medical record and radiologic findings, and carried out follow-up interviews by telephone. Results: All patients were women and their mean age was 42.2 (28-70) years. Abdominal pain was the most common symptom presented by three patients. One case was detected by routine checkup. Ultrasonography revealed cystic masses in 6 patients. on computed tomography (CT) done in 5 patients, all lesions were detected without difficulty. Endoscopic retrograde cholangiopancreatography (ERCP) done in 4 patients and magnetic resonance cholangiopancreatography (MRCP) done in 1 patient showed ductal displacement by tumor mass in 2 patients and pancreatic ductal compression in one of them. There was no commuication between main pancreatic duct and cyst. The average size of the tumors was 5.0 cm (range 2.4-11.0) and the most common location was pancreatic head (85.7%). Six patients underwent surgical resection. One case was confirmed by needle aspiration biopsy. All patients were followed by telephone and are alive. Conclusion: Because almost all serous cystadenomas are benign, provided that radiologic study reveals typical findings of serous cystadenoma, regular follow-up may be suffice. However, if differentiation from mucinous cystic neoplasm or from other tumors is not ensured, surgical resection should be considered.