In a patient suspected of having a pancreatic pseudo cyst, the finding that suggests a cystadenoma is
|A||Calcification within the cyst|
|D||Vague abdominal discomfort|
a. Most benign pancreatic exocrine tumors are cystic, but not all cystic tumors are benign.
b. Benign cystic tumors, which account for 10% to 15% of pancreatic tumors, are usually asymptomatic, but when symptoms develop, they are usually related to pressure or obstruction of an adjacent organ.
c. Serous cystadenomas account for 20% to 40% of cystic pancreatic neoplasms.
d. They are lined by a flattened epithelium with glycogen-rich cytoplasm that does not stain for mucins, and the finding of glycogen-rich cells on cytologic examination is diagnostic of a serous cystadenoma.
e. Typically, they are large, spherical masses that contain a watery fluid and have a central, calcified stellate scar.
f. Oligocystic varieties, with large cystic spaces, can occur, but most are microcystic.
g. They usually occur in the body or tail and are asymptomatic, but when located in the head, even benign serous cystadenomas can become symptomatic if they enlarge and compress adjacent structures.
h. Resection is indicated when the diagnosis is in doubt or when they become symptomatic.
i. Mucinous tumors account for 20% to 40% of cystic tumors.
j. Even if benign at the time of diagnosis, they are usually considered to have malignant potential.
k. One form contains areas of ovarian-like stroma, is almost always found in women, and is almost always found in the pancreatic tail.
l. For both types, imaging studies usually indicate that the lesion is composed of one or more very large cysts (i.e., macrocystic).