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Serious Cystadenoma (SCA) of the Pancreas is seldom malignant and is usually monitored over time. Here we report a case of SCA an enlarged cyst that had to be excised because it was difficult to diagnose by intraductal papillary-mucinous neoplasm (IPMN). The patient was a 58-year-old woman with thecoma of the right ovary accompanied by Meigs syndrome, who had undergone abdominal total hysterectomy and bilateral oophorectomy. Abdominal computed tomography scan (CT) showed a multilocular cyst 2.4 cm in diameter in the head of the pancreas. Fourteen months later, a periodic CT showed that the multilocular cyst had enlarged from 2.4 to 3.5 cm in diameter. Branch duct intraductal papillary-mucinous neoplasm (IPMN) with a tendency to enlargement and with mural nodule was suspected. Pylorus-preserving pancreatoduodenectomy (PPPD) was performed, and pathological findings revealed that the cyst was lined with a single layer of simple cuboidal epithelium. Periodic acid-Shiff staining, with and without diastase digestion, showed abundant glycogen within epithelial cells, yielding a definitive diagnosis of SCA. The ascites were probably due to the Meigs syndrome pressing the cyst, and the size of the cyst appeared smaller than the real size.

Serous Cystadenoma of the Pancreas Showing Enlargement on Images: A Case Report