Cytodiagnosis of serous oligocystic adenoma of the pancreas with an unusual clinical presentation

Benign serous oligocystic adenoma, also known as "macrocystic adenoma" is a rare variant of serous cystadenoma of exocrine pancreas which often mimics a malignant tumor clinically as well as radiologically. It has no age or sex predilection and occurs in children also. Here we report a case of serous oligocystic adenoma of 12 cm diameter occurring in a young female, located in the head of pancreas. She presented with a mass abdomen and progressive obstructive jaundice. Clinical and radiological findings simulated a pancreatic carcinoma. Preoperative ultrasound-guided trans-abdominal fine-needle aspiration cytology was done which revealed groups of bland epithelial cells with round nucleus. A benign cystic epithelial neoplasm was diagnosed through cytological features. The patient underwent surgery and the neoplasm was enucleated sparing the major portion of pancreas. Postoperative period was uneventful. Histopathology examination of the specimen confirmed it as "serous oligocystic adenoma of the pancreas." It is essential to diagnose serous oligocystic adenoma preoperatively through cytology to avert a major surgery and the uninvolved pancreas can be spared.