Pancreatic Pseudocyst Masquerading as a Serous Cyst Adenoma: A Case Report

Abstract

A pancreatic pseudocyst (PP) is a post-inflammatory collection of pancreatic enzymes and inflammatory exudates surrounded by a fibrous tissue wall. PPs are mainly formed in the pancreatic bed. It is seen more commonly after an episode of chronic pancreatitis and less commonly after acute pancreatitis. The main differential diagnoses in such cases include pancreatic cystic neoplasms such as mucinous cyst adenoma of the pancreas, serous cyst adenoma of the pancreas, pancreatic retention cyst, and other benign congenital lesions such as gastric duplication cysts. The incidence PPs is 0.5 to 1 in 100,000 hospital admission due to pancreatitis. Complications may include bleeding, rupture, infection, gastric outlet or biliary obstruction, and thrombus formation. These lesions are typically unilocular but can be thinly septated.  Here we report a case of PP mimicking a benign cystic neoplasm, which is not typically confused with a PP. PP’s can be misdiagnosed on radiological imaging but correct diagnosis can be made through aspiration and microscopic examination of the fluid via EUS.