Malignant epithelial tumor composed of uniform cuboidal glycogen rich cells that usually form numerous cysts containing serous fluid.
Malignancy is defined by the presence of metastasis to extra pancreatic tissue or organs
General feature
Usually serous neoplasms involve lymphnodes and liver
Age- older (56 to 72 years)
Sex- male and femal are equally affected.
Vascular, perineural invasion, invasion into duodenum or stomach are the signs of potentially aggressive behaviour and are not sufficient to diagnose malignancy.
Clinical features
Patients commonly present with GI bleed, jaundice or large abdominal mass.
Gross findings
Large and frequently invade adjacent organs like duodenum, stomach and spleen.
Metastasis should be present and metastasis to Lymphnode, peritoneum and the liver.
Microscopic findings:
Remarkably bland and histologically identical to serous cystadenomas.
Mitoses are not numerous
Perineural and vascular invasion in serous cystic neoplasm suggesting the possibility of aggressive behaviour.
Diagnosis of malignancy should be established only when there are unequivocal metastasis to extra pancreatic organs or tissue
Immunohistochemistry – Tumor cells are positive for Cytokeratin, α –inhibin, MUC 6
Treatment is Surgical resection. Patients with locally aggressive tumor should be monitored clinically for recurrence following surgical resection.
References
Ralph H. Hruban, Martha Bishop Pitman, David S. Klimstra. Serous Cystic Neoplasms.In: Tumors of the Pancreas. AFIP Atlas of Tumor Pathology Series 4;33-47.