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Case report
Pancreatic microcystic serous cystadenoma: a lethal disease? Rare case of a life-threatening haemorrhage
  1. Maria João Amaral1,2,
  2. Marco Serôdio1,2,
  3. Fátima Ramalhosa3 and
  4. José Guilherme Tralhão1,2,4
  1. 1General Surgery Department, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
  2. 2Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  3. 3Pathology Department, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
  4. 4Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  1. Correspondence to Dr Maria João Amaral; mariajoaoamaral{at}hotmail.com

Abstract

Serous pancreatic cystadenomas are benign tumours and most cases are detected incidentally. Complications are unusual. A patient with a history of a large pancreatic serous cystadenoma (SCA) presented to the emergency department with abdominal pain and haemodynamic shock. After haemodynamic stabilisation, an urgent abdominal CT scan revealed a large hemoperitoneum but the origin of the bleeding was not found. The patient was submitted to an angiography that revealed a bleeding hypervascular pancreatic mass and an embolisation was done successfully. After 3 weeks, the patient underwent a laparotomic left pancreatectomy with en bloc splenectomy. The anatomopathological results were consistent with a microcystic SCA of the pancreas. Despite the high vascularity of pancreatic SCA, haemorrhage is a very rare but life-threatening complication.

  • serous cystadenoma
  • haemorrhage
  • abdominal pain
  • peritoneal effusion
  • surgery
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Footnotes

  • Contributors All the authors have contributed significantly to the care of this patient and in the drafting of this manuscript. MJA: acquisition of data, discuss planning, conception and design, literature review, wrote the manuscript; MS: discuss planning, conception and design, critical review, supervision; FR: literature review, wrote the manuscript, critical review and JGT: critical review, supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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