GPR: 2021 - Week 25

From MGH Learn Pathology

Clinical history

67 year-old female with enlarging pancreatic mass


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Serous Cystadenoma
Benign, cystic epithelial neoplasm

May present clinically because of an abdominal mass and/or pain

Most likely in female patients in 6th decade of life

Discrete, well-demarcated lesion composed of numerous thin-walled cysts filled with serous fluid (microcystic); may have central stellate scar

Other variants include solid and oligocystic types
 

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Intraductal Papillary Mucinous Neoplasm (IPMN)

Grossly visible, mucin-producing epithelial neoplasm present within main pancreatic duct &/or its branches

Most patients are asymptomatic

Associated invasive adenocarcinoma may be present; more common in main duct IPMNs
 

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Adenocarcinoma

Malignant epithelial neoplasm

Can arise from the pancreas, bile ducts or ampulla

Ampullary Adenocarcinoma; exophytic &/or ulcerated mass in ampullary region
 

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Neuroendocrine tumor (well-differentiated)

Solid, round to oval, well-circumscribed mass; ~5% of tumors are cystic

May be related to a syndrome (MEN, VHL, TS); majority of cases are non-syndromic and sporadic

May present with abdominal pain or jaundice or because of endocrine function
 
Dr. Angela Shih Dr. Miranda Machacek
[1] Expertpath.com, Serous Cystadenoma, Sanjay Kakar, MD; Grace E. Kim, MD, Accessed 6/3/21

[2] Expertpath.com, Intraductal Papillary Mucinous Neoplasm; Mari Mino-Kenudson, MD; Sanjay Kakar, MD; Laura W. Lamps, MD, Accessed 6/3/21 [3] Expertpath.com, Ampullary Adenocarcinoma and Variants; Hanlin L. Wang, MD, PhD, Accessed 6/3/21

[4] Expertpath.com, Well-Differentiated Neuroendocrine Tumor, Pancreas; Sanjay Kakar, MD, Accessed 6/3/21

This week's Gross Pathology Roundup was presented by Jakob Moran, MD on Mon, Jun 21, 2021.