Triple threat: pancreatic cystic lesion presenting with spontaneous hemorrhage is found to harbor three distinct neoplasms
Abstract Background Pancreatic serous cystadenoma (SCA) is a benign, cystic lesion with an indolent growth pattern. Complications such as spontaneous hemorrhage or malignant transformation from SCA are extremely rare. Our case report describes an unusual presentation of a patient with a previously d...
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-021-02119-3 |
| _version_ | 1819056234716725248 |
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| author | Da Eun Cha Callie Horn Michael Passeri |
| author_facet | Da Eun Cha Callie Horn Michael Passeri |
| author_sort | Da Eun Cha |
| collection | DOAJ |
| description | Abstract Background Pancreatic serous cystadenoma (SCA) is a benign, cystic lesion with an indolent growth pattern. Complications such as spontaneous hemorrhage or malignant transformation from SCA are extremely rare. Our case report describes an unusual presentation of a patient with a previously diagnosed SCA, made unique by the presence of three separate neoplasms in the final specimen. Case presentation A 74-year-old male with a previous diagnosis of SCA presented emergently with epigastric pain and non-bilious vomiting. Laboratory results were notable for a hemoglobin of 8.3 g/dl. CT scan of the abdomen demonstrated a complex, solid-cystic mass in the pancreatic head with a large hematoma and questionable focus of active hemorrhage. Surgical resection was recommended due to the risk of malignancy, possibility of re-bleeding, and symptoms of severe duodenal compression. Pancreaticoduodenectomy was performed, and final pathology demonstrated three separate neoplasms: serous cystadenoma, intraductal papillary mucinous neoplasm, and neuroendocrine tumor. Conclusion While pancreatic SCA are benign tumors that can be observed safely in the majority of cases, surgical intervention is often indicated in patients with large, symptomatic cysts or when diagnosis is unclear. When undergoing surveillance, it is crucial for both the patient and the care team to be aware of the possibility of rare, but life-threatening complications, such as hemorrhage. Likewise, the possibility of misdiagnosis or concurrent neoplasia should be considered. |
| first_indexed | 2024-12-21T13:20:11Z |
| format | Article |
| id | doaj.art-46866738ab214edd8933cc999428abb1 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-21T13:20:11Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-46866738ab214edd8933cc999428abb12022-12-21T19:02:36ZengBMCWorld Journal of Surgical Oncology1477-78192021-01-011911510.1186/s12957-021-02119-3Triple threat: pancreatic cystic lesion presenting with spontaneous hemorrhage is found to harbor three distinct neoplasmsDa Eun Cha0Callie Horn1Michael Passeri2Surgery Department, Mount Sinai West and MorningsideSurgery Department, Mount Sinai West and MorningsideHPB Surgery and Surgical Oncology, Valley Medical GroupAbstract Background Pancreatic serous cystadenoma (SCA) is a benign, cystic lesion with an indolent growth pattern. Complications such as spontaneous hemorrhage or malignant transformation from SCA are extremely rare. Our case report describes an unusual presentation of a patient with a previously diagnosed SCA, made unique by the presence of three separate neoplasms in the final specimen. Case presentation A 74-year-old male with a previous diagnosis of SCA presented emergently with epigastric pain and non-bilious vomiting. Laboratory results were notable for a hemoglobin of 8.3 g/dl. CT scan of the abdomen demonstrated a complex, solid-cystic mass in the pancreatic head with a large hematoma and questionable focus of active hemorrhage. Surgical resection was recommended due to the risk of malignancy, possibility of re-bleeding, and symptoms of severe duodenal compression. Pancreaticoduodenectomy was performed, and final pathology demonstrated three separate neoplasms: serous cystadenoma, intraductal papillary mucinous neoplasm, and neuroendocrine tumor. Conclusion While pancreatic SCA are benign tumors that can be observed safely in the majority of cases, surgical intervention is often indicated in patients with large, symptomatic cysts or when diagnosis is unclear. When undergoing surveillance, it is crucial for both the patient and the care team to be aware of the possibility of rare, but life-threatening complications, such as hemorrhage. Likewise, the possibility of misdiagnosis or concurrent neoplasia should be considered.https://doi.org/10.1186/s12957-021-02119-3Pancreatic cystic neoplasmPancreatic serous cystadenomaHemorrhageIntraductal papillary mucinous neoplasmPancreatic neuroendocrine tumor |
| spellingShingle | Da Eun Cha Callie Horn Michael Passeri Triple threat: pancreatic cystic lesion presenting with spontaneous hemorrhage is found to harbor three distinct neoplasms World Journal of Surgical Oncology Pancreatic cystic neoplasm Pancreatic serous cystadenoma Hemorrhage Intraductal papillary mucinous neoplasm Pancreatic neuroendocrine tumor |
| title | Triple threat: pancreatic cystic lesion presenting with spontaneous hemorrhage is found to harbor three distinct neoplasms |
| title_full | Triple threat: pancreatic cystic lesion presenting with spontaneous hemorrhage is found to harbor three distinct neoplasms |
| title_fullStr | Triple threat: pancreatic cystic lesion presenting with spontaneous hemorrhage is found to harbor three distinct neoplasms |
| title_full_unstemmed | Triple threat: pancreatic cystic lesion presenting with spontaneous hemorrhage is found to harbor three distinct neoplasms |
| title_short | Triple threat: pancreatic cystic lesion presenting with spontaneous hemorrhage is found to harbor three distinct neoplasms |
| title_sort | triple threat pancreatic cystic lesion presenting with spontaneous hemorrhage is found to harbor three distinct neoplasms |
| topic | Pancreatic cystic neoplasm Pancreatic serous cystadenoma Hemorrhage Intraductal papillary mucinous neoplasm Pancreatic neuroendocrine tumor |
| url | https://doi.org/10.1186/s12957-021-02119-3 |
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