関: adenoma、cystadenoma、follicular adenoma、papillary adenoma

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a benign epithelial tumor of glandular origin

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/01/29 09:02:49」(JST)

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Pancreatic serous cystadenoma, also known as serous cystadenoma of the pancreas and serous microcystic adenoma, a benign tumour of pancreas. It is usually found in the head of the pancreas,^[1] and may be associated with von Hippel-Lindau syndrome.^[2]

In contrast to some of the other cyst-forming tumors of the pancreas (such as the intraductal papillary mucinous neoplasm and the mucinous cystic neoplasm), serous cystic neoplasms are almost always entirely benign. There are some exceptions; rare case reports have described isolated malignant serous cystadenocarcinomas.^[3] In addition, serous cystic neoplasms slowly grow, and if they grow large enough they can press on adjacent organs and cause symptoms.

Classification

Pathologists classify serous cystic neoplasms into two broad groups. Those that are benign, that have not spread to other organs, are designated "serous cystadenoma."^[4] Serous cystadenomas can be further sub-typed into microcystic, oligocystic (or macrocystic), solid, mixed serous-endocrine neoplasm, and VHL-associated serous cystic neoplasm. This latter classification scheme is useful because it highlights the range of appearances and the clinical associations of these neoplasms. Serous cystic neoplasms that have spread ("metastasized") to another organ are considered malignant and are designated "serous cystadenocarcinoma."

Diagnosis

Serous cystic neoplasms can come to clinical attention in a variety of ways. The most common symptoms are very non-specific and include abdominal pain, nausea and vomiting. In contrast to many of the other tumors of the pancreas, patients rarely develop jaundice (a yellowing of the skin and eyes caused by obstruction of the bile duct), or weight loss. These signs and symptoms are not specific for a serous cystic neoplasm, making it more difficult to establish a diagnosis. Doctors will therefore often order additional tests.

Once a doctor has reason to believe that a patient may have serous cystic neoplasm, he or she can confirm that suspicion using one of a number of imaging techniques. These include computerized tomography (CT), endoscopic ultrasound (EUS), and magnetic resonance cholangiopancreatography (MRCP).^[5] These tests will reveal a cystic mass within the pancreas. The cysts do not communicate with the larger pancreatic ducts. In some cases a fine needle aspiration (FNA) biopsy can be obtained to confirm the diagnosis. Fine needle aspiration biopsy can be performed through an endoscope at the time of endoscopic ultrasound, or it can be performed through the skin using a needle guided by ultrasound or CT scanning. A growing number of patients are now being diagnosed before they develop symptoms (asymptomatic patients). In these cases, the lesion in the pancreas is discovered accidentally (by chance) when the patient is being scanned (x-rayed) for another reason.

Pathology

Images

Treatment

The treatment of choice is either surgery, or if the clinician is certain of the diagnosis and the lesion is small, careful observation. Surgery can include the removal of the head of the pancreas (a pancreaticoduodenectomy), removal of the body and tail of the pancreas (a distal pancreatectomy), or rarely removal of the entire pancreas (a total pancreatectomy).^[6] In selected cases the surgery can be performed using minimally invasive techniques such as laparoscopy.^[7]

References

^ Colonna, J.; Plaza, JA.; Frankel, WL.; Yearsley, M.; Bloomston, M.; Marsh, WL. (2008). "Serous cystadenoma of the pancreas: clinical and pathological features in 33 patients". Pancreatology 8 (2): 135–41. doi:10.1159/000123606. PMID 18382099.
^ Eras, M.; Yenigun, M.; Acar, C.; Kumbasar, B.; Sar, F.; Bilge, T. "Pancreatic involvement in Von Hippel-Lindau disease". Indian J Cancer 41 (4): 159–61. PMID 15659868.
^ Galanis C, Zamani A, Cameron JL, et al. (July 2007). "Resected serous cystic neoplasms of the pancreas: a review of 158 patients with recommendations for treatment". J. Gastrointest. Surg. 11 (7): 820–6. doi:10.1007/s11605-007-0157-4. PMID 17440789.
^ "Pathology of Neoplasms of the Pancreas". Johns Hopkins University. Retrieved 25 April 2010.
^ "Diagnostic tests". Johns Hopkins University. Retrieved 25 April 2010.
^ "Pancreatic Surgery". Johns Hopkins University. Retrieved 25 April 2010.
^ "Laproscopic Pancreatic Surgery". Johns Hopkins University. Retrieved 25 April 2010.

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English Journal

Prevalence of colorectal adenomas in asymptomatic young adults: a window to early intervention?

Kwak JY1, Kim KM2, Yang HJ3, Yu KJ2, Lee JG2, Jeong YO2, Shim SG2.
Scandinavian journal of gastroenterology.Scand J Gastroenterol.2016 Jun;51(6):731-8. doi: 10.3109/00365521.2015.1130163. Epub 2016 Jan 14.
Objective The prevalence of colorectal adenoma is increasing in the average-risk population. However, little research is available on colorectal adenoma in young adults under age 40. The aim of this study was to investigate the prevalence and risk factors of colorectal adenoma in 20- to 39-year-old
PMID 26863602

Fruit and vegetable intakes and risk of colorectal cancer and incident and recurrent adenomas in the PLCO cancer screening trial.

Kunzmann AT1, Coleman HG1, Huang WY2, Cantwell MM1, Kitahara CM2, Berndt SI2.
International journal of cancer.Int J Cancer.2016 Apr 15;138(8):1851-61. doi: 10.1002/ijc.29922. Epub 2015 Dec 8.
The roles of fruits and vegetables in colorectal cancer development are unclear. Few prospective studies have assessed the association with adenoma, a known precursor to colorectal cancer. Our aim was to evaluate the association between fruit and vegetable intake and colorectal cancer development by
PMID 26559156

Follicular Thyroid Adenoma Showing Avid Uptake on 68Ga PSMA-HBED-CC PET/CT.

Kanthan GL1, Drummond J, Schembri GP, Izard MA, Hsiao E.
Clinical nuclear medicine.Clin Nucl Med.2016 Apr;41(4):331-2. doi: 10.1097/RLU.0000000000001084.
Ga-prostate-specific membrane antigen (PSMA) PET/CT imaging is a relatively new imaging technique used to evaluate the extent of disease in prostate carcinoma. Various other neoplasms may also express PSMA and show uptake on PSMA PET/CT scan. We report a case of a 62-year-old man who had a PSMA PET/
PMID 26646999

Japanese Journal

VHL病の膵病変に対して膵頭十二指腸切除術と膵尾部切除術を併施した2例

日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 74(5), 1366-1371, 2013-05-25
NAID 10031177954

Cyst in cyst様構造を呈し診断に難渋したmacrocystic type漿液性嚢胞腺腫の1例

膵臓 27(6), 786-791, 2012
NAID 130004496010

Pancreatic serous microcystic adenoma with extensive oncocytic change

Pathology international 59(2), 102-106, 2009-02-01
NAID 10027379213

Related Pictures

★リンクテーブル★

リンク元	「papillary adenoma」
関連記事	「adeno」「microcystic」「microcyst」

「papillary adenoma」

Pancreatic serous cystadenoma
	Micrograph showing a pancreatic serous cystadenoma. H&E stain.
Classification and external resources
eMedicine	article/371105