Horiuchi Atsushi, Akehi Shun, Abe Yousuke, Ichikawa Nanako, Kawaharada Sakura, Kitazawa Sohei, Kitazawa Riko
Department of General Surgery, Ehime Prefectural Niihama Hospital, Niihama City, Ehime, Japan.
Department of Molecular Pathology, Ehime University Graduate School of Medicine, Toon City, Ehime, Japan.
J Surg Case Rep. 2023 Feb 6;2023(2):rjad026. doi: 10.1093/jscr/rjad026. eCollection 2023 Feb.
Mucinous cystadenoma of the pancreas is considered as a premalignant lesion, and resection is recommended. The majority of pancreatic cystic lesions are pancreatic pseudocysts, so differentiation between mucinous cystadenoma and pseudocyst is frequently required. We report a rare case of mucinous cystadenoma of the pancreas coexisting with pseudocyst. A 43-year-old woman presented with abdominal pain. Imaging examinations showed a large cystic lesion in the tail of the pancreas, and distal pancreatectomy and splenectomy were performed. Pathological examination revealed that the majority of the cystic wall comprised thick collagen fibrous connective tissue, while part of the cystic wall represented a single layer of columnar, mucin-producing epithelium without atypia. Those findings suggested mucinous cystadenoma with an inflammatory pseudocyst. The mixture of mucinous cystadenoma and pseudocyst within the same cystic lesion appears to be very rare. Complete resection of the cystic lesion seems to allow an excellent prognosis.
胰腺黏液性囊腺瘤被视为一种癌前病变，建议进行切除。大多数胰腺囊性病变是胰腺假性囊肿，因此经常需要区分黏液性囊腺瘤和假性囊肿。我们报告一例罕见的胰腺黏液性囊腺瘤与假性囊肿并存的病例。一名43岁女性因腹痛就诊。影像学检查显示胰腺尾部有一个大的囊性病变，遂行远端胰腺切除术和脾切除术。病理检查显示，大部分囊壁由厚的胶原纤维结缔组织构成，而部分囊壁为单层柱状、产生黏液的上皮，无异型性。这些发现提示为伴有炎性假性囊肿的黏液性囊腺瘤。同一囊性病变内黏液性囊腺瘤与假性囊肿的混合似乎非常罕见。完整切除囊性病变似乎可带来良好的预后。
