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At least 19 recordsLinked to original sources
PubMed1978

Mucinous cystadenoma, serous cystadenoma and benign cystic teratoma of the ovary: clinico-pathologic differences observed in a Malaysian hospital.

A study of 207 benign ovarian tumors seen at the University Hospital, Kuala Lumpur between 1968 and 1975 was made to evaluate the clinical features that might be useful in the preoperative differentiation of mucinous cystadenoma, serous cystadenoma, and cystic teratoma of the ovary. This study indicated that the pertinent information included the mean age of the patient, the marital and menstrual status, and the estimated tumor size. The racial background was an additional factor in serous cystadenoma. Features like parity, the location of the tumor, and ABO blood group pattern were of no value in the preoperative differentiation.

Adult↗
PubMed1996

Solid serous adenoma of the pancreas. The solid variant of serous cystadenoma?

Serous cystadenomas of the pancreas are uncommon benign neoplasms that occur most frequently in elderly females. Characteristically, the tumors have a spongy gross appearance and are composed of innumerable cysts lined by flat, cuboidal, and polygonal cells with clear to pale eosinophilic cytoplasm and round, hyperchromatic central nuclei. Macrocystic variants with an oligolocular gross appearance have also been described. In this report we describe a solid pancreatic neoplasm arising in a 70-year-old woman who remains well 5 years after a distal pancreatectomy. The well-circumscribed tumor measured 4.0 cm in maximal diameter and was formed by clear to pale polygonal to cuboidal cells arranged in nests, sheets, and trabeculae separated by thick fibrous bands. Although small acini with glandular spaces were present within the nests, cystic spaces were absent. Periodic acid-Schiff (PAS) and PAS-dismutase (PAS-D) stains revealed a large amount of cytoplasmic glycogen. The tumor cells were immunoreactive for CAM 5.2, epithelial membrane antigen, and neuron-specific enolase. The cytologic, histochemical, and immunohistochemical features of the tumor were indistinguishable from those of serous cystadenomas; therefore, we believe this solid serous adenoma represents a solid variant of serous cystadenoma. Recognition of this lesion is important because the vast majority of solid tumors in the pancreas are malignant. The differential diagnosis includes the rare primary clear-cell "sugar" tumor of the pancreas, clear cell carcinoma, clear cell islet cell tumor, and metastatic renal cell carcinoma.

Adenoma↗
PubMed2004

Molecular genetic analysis of ovarian serous cystadenomas.

Ovarian serous cystadenomas are common ovarian lesions that may be precursors of serous borderline tumors, which can in turn progress to low-grade serous carcinomas. It has been shown that low-grade serous carcinoma and serous borderline tumors are characterized by frequent mutations in BRAF or KRAS genes, but the mutational status of these genes in serous cystadenomas and the clonal nature of serous cystadenomas have not been fully investigated. We isolated cyst-lining epithelium from 30 consecutive serous cystadenomas, and analyzed their BRAF and KRAS mutational status. Wild-type sequences of BRAF and KRAS were detected in all specimens. Using the human androgen receptor gene as a polymorphic marker, we also examined the clonal status of epithelial cells in all of the serous cystadenomas. Four of 29 (14%) informative specimens were monoclonal based on the methylation pattern. These monoclonal cystadenomas were significantly (P<0.01) larger in size (>8 cm) than the nonclonal cystadenomas. These data indicate that serous cystadenomas do not contain mutations in either BRAF or KRAS genes and that most serous cystadenomas are polyclonal. Accordingly, it appears that serous cystadenomas develop as a hyperplastic expansion from epithelial inclusions with a clonal/neoplastic transformation occurring in a subset of them.

Apoptosis↗
PubMed1996

Interphase cytogenetic analysis of serous ovarian tumors of low malignant potential: comparison with serous cystadenomas and invasive serous carcinomas.

The cytogenetic and molecular genetic changes in serous tumors of low malignant potential (LMP) of the ovary have not been well characterized so far. Therefore, we analyzed 20 serous tumors of LMP, 10 invasive serous ovarian carcinomas, and 7 benign serous cystadenomas by nonisotopic in situ hybridization (seven different centromere-specific probes) as well as by flow and image DNA cytometry and compared the data with results of p53 and Ki67 immunohistochemistry, MYC DNA PCR analysis and with the clinical follow-up. All but two tumors of LMP were DNA cytometrically diploid; 9 of 10 invasive carcinomas proved to be DNA nondiploid (p < 0.0001). Nonisotopic in situ hybridization revealed a mean number of 1.5 chromosomal aberrations in tumors of LMP, which differed statistically significantly from cystadenomas (mean, 0.4) and from invasive carcinomas (mean, 3.4) (rho < 0.01). The main changes in tumors of LMP were +6 (7 of 18 cases) and +7 (6 of 19) followed by -3 (5 of 20), -1 (4 of 17) and +X (3 of 20). In the group of invasive carcinomas, the number of cases with signal gains for chromosomes 6 (5 of 8), 7 (7 of 10) and X (4 of 10) and signal loss for chromosome 1 (4 of 9) was even larger. In addition, statistically significantly more cases showed gain of 8 (5 of 10) and loss of 17 (5 of 10) (p < 0.05). Proliferative activity (Ki67 index) was positively correlated with the number of chromosomal aberrations (p < 0.05). There was no association between changes in the centromere signal number of chromosomes 8 and 17 and MYC DNA amplification and immunohistochemical p53 accumulation, respectively. Clinical follow-up showed prognostic differences between tumors of LMP and invasive carcinomas as expected (rho < 0.001) but did not reveal differences within the group of tumors of LMP with regard to the number or type of the chromosomal abnormalities detected. In conclusion, the patterns of chromosomal gains and losses in serous tumors of LMP and invasive serous carcinomas of the ovary do not seem random and suggest a close relation between these neoplasms compatible with sequential stages in a multistep model of ovarian carcinogenesis.

Adult↗
PubMed2005

Benign ovarian serous tumors: a re-evaluation and proposed reclassification of serous "cystadenomas" and "cystadenofibromas".

OBJECTIVE: Serous cystadenomas and cystadenofibromas of the ovaries are currently regarded as neoplasms and are considered the most common ovarian neoplasms. The purpose of this study is to determine what proportion of benign serous tumors contain an epithelial proliferation (the hallmark of a neoplastic process in nearly all other sites) that can be considered neoplastic as opposed to reactive in nature. METHODS: An unselected series of 113 ovarian serous tumors (76 serous cystadenomas and 37 serous cystadenofibromas) were histologically evaluated. A 1-mm in diameter area of epithelial proliferation was considered potentially neoplastic. RESULTS: Eight tumors (7%) displayed at least 1 mm of epithelial proliferation (1% of serous cystadenomas and 19% of serous cystadenofibromas). CONCLUSION: The vast majority of benign serous tumors may not be bona fide epithelial neoplasms, but rather, may represent cystically dilated glandular inclusions (cystadenomas) and fibromas with epithelial inclusions (cystadenofibromas). A recently published study evaluating clonality in serous cystadenomas found that the vast majority are polyclonal and thus supports this hypothesis. These findings have important implications for the pathogenesis of ovarian cancer, for the distribution of ovarian neoplasms, and for the interpretation of molecular biological studies of ovarian tumors.

Cell Proliferation↗
PubMed2000

A discrepant finding between magnetic resonance imaging and other imaging modalities suggests a microcystic serous cystadenoma of the pancreas.

BACKGROUND: Serous cystadenoma of the pancreas is generally considered as having no malignant potential. Thus, of clinical importance is a differential diagnosis of this neoplasm from other solid tumors that are often malignant. RESULTS: We report a case of microcystic serous cystadenoma of the pancreas. Abdominal ultrasonography, computed tomography, and endoscopic ultrasonography showed a solid mass in the body of the pancreas with a diameter of 15 mm, but magnetic resonance imaging revealed it as a unilocular cystic lesion. Histological examinations on the surgically resected tissue specimen showed a honeycombed tumor with innumerable tiny cysts appearing grossly as a solid mass. The discrepant finding between magnetic resonance imaging and other imaging modalities observed in this case is suggestive of and might be specific to microcystic serous cystadenoma of the pancreas. CONCLUSIONS: Magnetic resonance imaging is a mandatory modality to identify pancreatic serous cystadenoma that contains no visible cystic compartments on computed tomography and ultrasonography.

Cystadenoma, Serous↗
PubMed1997

Pancreatic serous cystadenoma mimicking pseudocyst.

The serous cystadenoma of the pancreas is a rare lesion that is usually found incidentally. It is mostly observed as a spongy microcystic mass but rare variants such as macrocystic, unicystic, or multicentric are also seen. We recently experienced a unique case of unicystic serous cystadenoma mimicking a pseudocyst. It was grossly a unilocular cyst with surrounding dense fibrosis resembling a pseudocyst. Microscopically, the cyst was partly lined by low columnar-to-cuboidal cells with clear cytoplasm containing glycogen.

Adult↗
PubMedDate not supplied

[Serous cystadenoma of the pancreas. An occasionally compressive tumor].

Serous cystadenomas of the pancreas are slow growing tumors, rarely compressive and therefore rarely symptomatic. Morphologically typical serous cystadenomas can be safely followed up. We report here three atypical cases of serous cystadenomas compressing either biliary, pancreatic main ducts or splenic vascular pedicle. We analyze from the literature the frequency of these various compressions by different types of cystic pancreatic tumors of the pancreas. Because of the rarity of pancreatic ductal and vascular compressions by serous cystadenomas, the occurrence of such compressions should lead to surgical resection to rule out a pre-malignant or malignant cystic tumor. On the contrary, compression of bile ducts by serous cystadenomas appears as relatively frequent and is therefore less suggestive of potential malignancy. A simple bilio-enteric by-pass can be performed when lesions are morphologically typical of serous cystadenomas and confirmed by surgical biopsy.

Abdominal Pain↗
PubMed1992

Some considerations on the biology of pancreatic serous cystadenoma.

Five cases of pancreatic serous cystadenoma were examined pathologically, and their nuclear DNA ploidy patterns were determined. Four were unifocal tumors, and one was a multifocal tumor. The four unifocal tumors were typical serous cystadenomas. However, the multifocal tumor exhibited an increased N/C ratio, irregular nuclear margins, various-sized nuclei, coarse nuclear chromatin, and neural invasion. All tumor cells were stained with antiCA19-9 but none with antiCEA. In the antiCA19-9 staining, the four unifocal tumors and the tumors of the pancreatic tail in the multifocal case were positive only on the apical membrane, whereas the tumor cells of the pancreatic head in the multifocal case were positive within the whole cytosol. The unifocal tumors were diploid with a DNA Index (DI) of 1.0 and proliferation indices (PI) from 4.9 to 20.9% with a mean of 14.4%. In the multifocal case, the tumor in the pancreatic head was aneuploid (DI = 1.9) and had a PI of 27.8%. The multifocal sites in the pancreatic body were aneuploid (DI = 1.9) with a PI of 22.4%. We suggest that the biological property of serous cystadenoma should be revisited.

Aged↗
PubMed2004

Simultaneous serous cystadenoma of the pancreas and mucinous cystadenoma of the appendix.

CONTEXT: Serous cystadenoma of the pancreas and mucinous tumors of the vermiform appendix are rare. To our knowledge, the simultaneous occurrence of these two tumors has not been reported. CASE REPORT: Here, we report an adult female who presented with signs and symptoms of appendicitis. A preoperative CT scan confirmed the findings of appendicitis and also showed an incidental large mass in the head of the pancreas. The patient underwent uneventful appendectomy. Her pathology revealed an acutely inflamed appendix with a benign mucinous cystadenoma at the tip. Several months after her recovery, a Whipple procedure was performed. Pathologic examination showed a 5x5 cm serous cystadenoma of the head of the pancreas without evidence of malignancy. Two years later, the patient is alive and well without evidence of tumor recurrence. CONCLUSIONS: Cystadenomas of the pancreas and appendix are unusual and their simultaneous occurrence is a rare event.

Appendiceal Neoplasms↗
PubMed2000

[Serous cystadenoma of the pancreas].

INTRODUCTION: Serous cystadenomas of the pancreas are rare tumors and thought to be almost always benign. METHODS: We report our experience in the diagnosis and surgical treatment of 12 patients with these tumors. RESULTS: Between October 1993 and December 1998, 41 patients with cystic tumors of the pancreas underwent surgical resection; in 12 cases (11 women, 1 man) a serous cystadenoma (10 micro-cystic, 2 oligo-microcystic) was found. Only 6 (50%) patients had symptoms. The mean tumor size was 4.8 (2.7-10) cm. Ultrasound, CT and MRT usually could detect the mass, but differentiation with other cystic lesions was not reliable. All tumors were resected: 4 Whipple procedures, 7 distal pancreatectomies and 1 segmental resection were performed. No patient died after surgery and none had to be reoperated on. CONCLUSIONS: Because of the difficulty in reliably differentiating benign and malignant lesions of the pancreas, we believe that cystic tumors of the pancreas should be resected.

Adult↗
PubMed2003

[A case of serous cystadenoma of the pancreas communicating with the pancreatic duct].

Serous cystadenoma of the pancreas is a rare disease and is usually benign. Mucinous cystadenoma, another cystic neoplasm of the pancreas, has a malignant potential. Serous cystadenoma is usually composed of many small cysts lined by small, cuboidal or flattened cells containing abundant glycogen. With the finding of endoscopic retrograde pancreatography, a communication between the cyst and pancreatic duct is observed occasionally in the mucinous cystadenoma, but rarely in the case of serous cystadenoma of the pancreas. We experienced a case of serous cystadenoma of the pancreas that had a communication between a cyst and the pancreatic duct.

Adult↗
PubMed1998

Serous cystadenoma of the pancreas with atypical cells. Case report.

CONCLUSION: Serous cystadenomas of the pancreas may have the biologic ability to undergo malignant transformation. BACKGROUND: It is generally recognized that: serous cystadenomas of the pancreas are benign and that their malignant potential is low. METHODS: A serous cystadenoma of the pancreas was resected from a 53-yr-old woman. In the central portion of the tumor, papillary structures were found on the cyst wall. Immunohistologic studies using antibodies to carbohydrate antigen 19-9, carcinoembryonic antigen, and proliferating cell nuclear antigen were performed to determine the malignant potential of this tumor. RESULTS: On histology, most tumor cells were positive for periodic acid-Schiff but were negative for periodic acid-Schiff after diastase digestion and Alcian blue, a staining pattern typical of serous cystadenomas. The cells found in the papillary structure of the cyst wall were mildly atypical. These cells were stained with antibodies to carbohydrate antigen 19-9, carcinoembryonic antigen, and proliferating cell nuclear antigen, indicating that the cells comprising the papillary structure were proliferating more rapidly than cells in other parts of the tumor and strongly suggesting that the cells are premalignant.

CA-19-9 Antigen↗
PubMed2001

Serous cystadenoma of the pancreas with papillary features: a diagnostic pitfall on fine-needle aspiration biopsy.

Serous cystadenoma of the pancreas is an uncommon neoplasm that occasionally exhibits papillary differentiation. The cytomorphologic structure of pancreatic serous cystadenoma has been rarely described, and, to our knowledge, such papillary morphologic structure has never been reported on fine-needle aspiration cytologic examination. We present a case of serous cystadenoma of the pancreas in a 77-year-old woman. Endoscopic ultrasonography showed a well-demarcated solid/cystic mass in the midbody of the pancreas, suggestive of solid pseudopapillary tumor. Aspiration cytologic examination, performed under endoscopic ultrasound guidance, showed a predominantly papillary epithelial neoplasm consistent with the radiologic impression. Gross and histologic examination of the excised specimen revealed a pancreatic serous cystadenoma with multifocal papillae. This case illustrates the cytomorphologic structure of serous cystadenoma that presents with prominent papillary differentiation on aspiration cytologic examination. The unusual cytologic appearance of this tumor introduces significant diagnostic challenges to the pathologist. Serous cystadenoma must be included in the differential diagnosis of pancreatic neoplasms with papillary morphologic structure as evaluated by fine-needle aspiration cytologic examination.

Aged↗
PubMed2005

Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment.

OBJECTIVE: To define the natural history and optimal management of serous cystadenoma of the pancreas. SUMMARY BACKGROUND DATA: Serous cystadenoma of the pancreas is the most common benign pancreatic neoplasm. Diagnostic criteria, potential for growth or malignancy, and outcomes are not well defined. As a result, management for patients with serous cystadenomas varies widely in current practice. METHODS: A total of 106 patients presenting with serous cystadenoma of the pancreas from 1976-2004 were identified. Hospital records were evaluated for patient and tumor characteristics, diagnostic workup, treatment, and outcome. Twenty-four patients with serial radiographic imaging were identified, and tumor growth curves calculated. RESULTS: Mean age at presentation was 61.5 years and 75% of patients were female. The most common symptoms were abdominal pain (25%), fullness/mass (10%), and jaundice (7%); 47% were asymptomatic. Mean tumor diameter was 4.9 +/- 3.1 cm, which did not vary by location. Tumors <4 cm were less likely to be symptomatic than were tumors > or =4 cm (22% vs. 72%, P < 0.001). The median growth rate in the patients who had serial radiography was 0.60 cm/y. For tumors <4 cm at presentation (n = 15), the rate was 0.12 cm/y, whereas for tumors > or =4 cm (n = 9), the rate was 1.98 cm/y (P = 0.0002). Overall, 86 patients underwent surgery, with one perioperative death. CONCLUSIONS: Large (>4 cm) serous cystadenomas are more likely to be symptomatic. Although the median growth rate for this neoplasm is only 0.6 cm/y, it is significantly greater in large tumors. Whereas expectant management is reasonable in small asymptomatic tumors, we recommend resection for large serous cystadenomas regardless of the presence or absence of symptoms.

Aged↗
PubMed2003

Discrimination of unilocular macrocystic serous cystadenoma from pancreatic pseudocyst and mucinous cystadenoma with CT: initial observations.

PURPOSE: To compare the computed tomographic (CT) appearance of pancreatic unilocular macrocystic serous cystadenoma, mucinous cystadenoma, and pseudocyst to determine if there are findings that assist in the differential diagnosis. MATERIALS AND METHODS: CT findings in 33 patients (24 women, nine men; age range, 18-84 years; mean age, 41 years) with unilocular pancreatic lesions (macrocystic serous cystadenoma, n = 12; mucinous cystadenoma, n = 11; pseudocyst, n = 10) were retrospectively and jointly reviewed by two blinded observers. Twenty-three patients underwent helical CT, which included pancreatic and portal venous phase imaging with delays of 40 seconds and 65 seconds, respectively, after contrast material injection. Ten patients underwent conventional (nonhelical) CT. The number, size, location, and contour of lesions were reviewed, along with wall thickness and enhancement and other signs of pancreatic and peripancreatic involvement. Diagnosis was based on lesion resection (n = 22) or on a combination of cytologic findings, biochemical markers, and tumor markers (n = 11). The Fisher exact test was used to analyze the results. RESULTS: Three of four CT findings were independently specific for macrocystic serous cystadenoma: location in the pancreatic head, lobulated contour, and absence of wall enhancement. When two of these four criteria were used in combination, 83% (10 of 12) of patients with unilocular macrocystic serous cystadenoma were identified. When three or four of these criteria were used, a specificity of 100% was achieved. Location in the pancreatic head (P <.05), lobulated contour (P <.005), and lack of wall enhancement (P <.005) were specific for macrocystic serous cystadenoma in comparison with mucinous cystic tumor. Lobulated contours (P <.005) were specific for macrocystic serous cystadenoma in comparison with pseudocyst. Other CT findings were not helpful in distinguishing between the three types of lesions. CONCLUSION: A combination of CT findings is helpful in making the diagnosis of pancreatic unilocular macrocystic serous cystadenoma.

Adolescent↗