From the Guidelines
Serous cystadenomas are typically characterized by their appearance as unilocular or multilocular cystic lesions with thin, regular walls and no solid components on imaging, most commonly found in the pancreas, particularly in the body and tail regions. They are often described as well-circumscribed microcystic lesions with a characteristic honeycomb appearance and occasional central stellate calcification 1. On imaging, serous cystadenomas typically show:
- Anechoic or hypoechoic cystic spaces with thin septations on ultrasound
- Water-density cystic lesions on CT scans
- Low signal intensity on T1-weighted images and high signal intensity on T2-weighted images on MRI 1. The location of serous cystadenomas can vary, but they are most commonly found in the pancreas, with a lesser frequency in other locations such as the ovaries, broad ligament, fallopian tubes, or retroperitoneum 1. It's worth noting that the diagnosis of serous cystadenoma is important, as these lesions are almost always benign, with malignant transformation being extremely rare, occurring in less than 1% of cases 1. The management of serous cystadenomas often involves monitoring rather than surgical removal, especially for asymptomatic lesions, due to their benign nature and the slow growth rate of these tumors 1.
From the Research
Image Findings of Serous Cystadenoma
- Serous cystadenomas of the pancreas have a varied appearance on imaging, with a majority having a microcystic appearance 2, 3.
- Macrocystic and solid variants have also been described 2.
- On CT scans, serous cystadenomas can appear as suspicious for carcinoma, suspicious for serous cystadenoma, neoplasm not otherwise specified, or suspicious for a pseudocyst 3.
- A central scar is seen in approximately 43.4% of cases 2.
Location of Serous Cystadenoma
- Serous cystadenomas predominantly occur in the pancreatic body and tail of elderly females 2.
- The most common locations are the body and tail (either alone or in combination) 2.
- Other locations include the head of the pancreas, with 5 (15%) of cases located in this area 3.
- The pancreatic tail is the most common location, with 20 (61%) of cases located in this area 3.
Characteristics of Serous Cystadenoma
- Serous cystadenomas are rare benign epithelial neoplasms 2.
- They have a natural history and malignant potential different from that of other cystic neoplasms 4.
- The tumors show typical morphological features, including simple cuboidal to flattened epithelium with round, uniform nuclei, and glycogen-rich clear cytoplasm 2.
- Focal micropapillae formation is seen in some cases 2.