Serous cystadenoma of the pancreas: Report of 30 cases with emphasis on the imaging findings

Purpose: Our goal was to evaluate retrospectively 30 cases of serous cystadenoma (SCA) to determine its main imaging features as well as to discuss the differential diagnosis problems versus the other cystic lesions of the pancreas. Method: Thirty SCAs were analyzed; they were all benign lesions, proven at surgery. Twenty-three tumors were evaluated with US, 26 with CT, and 5 with MRI. Results: Three different morphostructural patterns were identified: microlacunar (n = 19), mixed (n = 6), and macrolacunar (n = 5). The diagnosis of SCA, possible in either the microlacunar or the mixed patterns, was achieved in 74% of cases with US (17/23) and in 61.5% with CT (16/26). Among the 19 patients evaluated with both modalities, the joint information allowed a correct diagnosis in 16 cases (84%). The five macrolacunar tumors were undistinguishable from other cystic masses of the pancreas. Conclusion: The diagnosis of SCA can be considered certain in the microlacunar, likely in the mixed, and not possible in the macrolacunar type.