Linda Chi Hang Chu MD, Presenter: Nothing to Disclose

Aatur Singhi MD,PHD, Abstract Co-Author: Nothing to Disclose

Ralph H. Hruban, Abstract Co-Author: Royalties, Myriad Genetics, Inc

Elliot K. Fishman MD, Abstract Co-Author: Research support, Siemens AG Advisory Board, Siemens AG Research support, General Electric Company Advisory Board, General Electric Company Co-founder, HipGraphics, Inc

The purpose of this study is to characterize features of pancreatic serous cystadenoma on dual phase multidetector CT.

From January 2003 to December 2010, 69 cases of pathologically confirmed pancreatic serous cystadenoma with preoperative dual phase multidetector CT were identified. The CTs were retrospectively reviewed to determine the location, size, maximum and minimum attenuation on arterial and venous phase, the presence of septations, calcifications, peripheral rim enhancement, main pancreatic duct dilatation, presence of vascular invasion, and morphology of background pancreas.

The mean maximum axial dimension of the pancreatic serous cystadenomas was 4.5 cm (range 1.0 cm to 12.2 cm). The masses were most commonly found in the tail (27), followed by head (20), body (18), and neck (4). On arterial phase, the mean maximum density and mean minimum density were 49 and 31 Hounsfield units, respectively. On venous phase, the mean maximum density and mean minimum density were 49 and 32 Hounsfield units, respectively. 59 cases contain internal septations and 25 cases contain calcifications. Peripheral rim enhancement was present in 22 cases. Main pancreatic duct dilatation was present in 10 cases. Vascular invasion was absent in all cases, although displacement or compression of traversing vessels was present in 17 cases. The background pancreas was normal in 61 cases and was atrophic or fatty replaced in 8 cases.   15 cases (21.7%) demonstrated "classic" morphology, as defined by presence of multiple thin non-enhancing septations, calcifications, and absence of main pancreatic duct dilatation and vascular invasion. This "classic" morphology was generally found in the larger serous cystadenomas. In many of these cases, it was difficult to distinguish serous cystadenoma from mucinous cystic neoplasm, intraductal papillary mucinous neoplasm, islet cell tumor, and adenocarcinoma.  

Pancreatic serous cystadenomas can have a wide spectrum of CT appearances and they display the "classic" morphology in only a minority of cases. These atypical cases pose a diagnostic challenge to radiologists.

Pancreatic serous cystadenomas have a wide spectrum of CT appearance which poses a diagnostic challenge to radiologists.

Chu, L, Singhi, A, Hruban, R, Fishman, E, Characterization of Pancreatic Serous Cystadenoma on Dual-phase Multidetector CT.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034355.html