ABSTRACT
Serous cystadenomas (SCAs) of the pancreas are benign cystic tumors. Although still controversial, asymptomatic SCAs, in contrast to their mucinous counterparts, can be treated conservatively. This attitude is mostly defendable for lesions of the pancreas head or multiple lesions distributed throughout the entire pancreas, as their surgical resection is still associated with significant morbidity. Thus, correct diagnosis is essential, and this relies on radiological and biological characteristics. Asymptomatic multiple SCAs are rare. Most cases described in the literature are either symptomatic, degenerated, or both. We present a case of huge (>10 cm), multiple asymptomatic SCAs, not associated with von Hippel-Lindau disease, involving the entire pancreas. The patient has been followed up for 3 years and remains asymptomatic. Tumor markers were within normal ranges. On abdominal computed tomography (CT) and magnetic resonance imaging (MRI), the lesions showed pathognomonic characteristics of SCAs, and their uncommon dimensions and number remained stable over time. 18-Fluorodeoxyglucose positron emission tomography (PET) scan performed at 3-year follow-up did not show hypermetabolic lesions.
Subject(s)
Cystadenoma, Serous/diagnosis , Neoplasms, Multiple Primary/diagnosis , Pancreatic Neoplasms/diagnosis , Cystadenoma, Serous/diagnostic imaging , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Neoplasms, Multiple Primary/diagnostic imaging , Pancreatic Neoplasms/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
The aim of this study was to identify and to classify anatomical hepatic artery (HA) variations concerning 932 HA dissections in liver transplantation (LT). Normal HA distribution was found in 68.1%. Variations of HA were detected in 31.9% and were divided into three groups describing 48 common hepatic artery (CHA) anomalies, 236 left or right hepatic artery (RHA) anomalies and 13 rare variations including one case of RHA stemmed from the inferior mesenteric artery and one case of normal CHA passed behind the portal vein. The authors propose a modified classification for HA anomalies which are based on the origin of the hepatic arterial supply (either by the CHA as the only source of the arterial vascularization or by additional or replaced right and left arteries) in order to improve management of liver disease thus as in LT.
