A case of macrocystic type pancreatic serous cystic neoplasm with recurrent pancreatitis

A 76-year-old woman with hypertension and hyperlipidemia had been diagnosed with a 30 mm cyst in the pancreatic head at another clinic three years previously. She was referred to our hospital a year ago on suspicion of acute pancreatitis due to the cyst's enlargement and abdominal pain. Imaging examination revealed a bifocal cystic lesion in the pancreatic head measuring 46.8 mm and 13.8 mm with no wall mural nodules or ductal communication. EUS did not show any honeycomb-like components in the lesion; therefore, a diagnosis of SCN (serous cystneoplasm) could not be confirmed. The pancreatitis improved and careful follow-up was continued, but the patient had another attack of acute pancreatitis, and pancreatoduodenectomy was performed. The pathological diagnosis was macrocystic type serous cystadenoma. We report this interesting and valuable case as it reflects the importance of diagnostic imaging when considering cystic lesions.