# Microcystic serous cystadenoma of the pancreas causing biliary obstruction: a case report and review of the literature

## TL;DR

A rare case of a large benign pancreatic tumor causing biliary blockage is reported, highlighting the need for surgical evaluation due to size and symptoms.

## Contribution

This case report adds to the limited literature on serous microcystic adenomas of the pancreas and their potential for causing obstruction.

## Key findings

- A 15 cm benign serous microcystic adenoma was found in a patient presenting with jaundice and weight loss.
- The tumor caused biliary and pyloric obstruction, necessitating surgical resection.
- Pathology confirmed the tumor was benign despite its size and concerning symptoms.

## Abstract

Cystic tumors account for 15% of pancreatic tumors. Of these, serous microcystic adenomas represent 1–2% of pancreatic exocrine neoplasms. While typically benign, a small percentage possess malignant potential. Given imaging improvements, serous cystadenomas are being identified more frequently. A 63-year-old female was admitted with complaints of jaundice and unintentional weight loss. Abdominal computed tomography scan showed a 16 cm obstructive pancreatic mass near the porta hepatis region. Endoscopic ultrasonography and fine needle aspiration biopsy indicated a large pancreatic head cystic mass favoring serous microcystadenoma causing biliary and some pyloric obstruction. Malignant potential could not be ruled out because of size and symptoms. A pylorus-preserving pancreaticoduodenectomy revealed a cystic tumor invading the pancreatic duct and adhering to the duodenum of the pancreatic head. Pathology confirmed a 15 cm benign pancreatic serous cystadenoma. Although most serous cystadenomas are benign, surgical resection was prudent given the size, symptoms, and adjacent organ involvement.