PMC5633824_01
Abdominal CT scan.. (a) Pre-contrast phase: A low density polycyclic mass is seen at the body of the pancreas.. (b) Portal phase: Weak tumor enhancement (80 HU) compared with the adjacent normal pancreatic tissues (100 HU).
gr1.jpg
PMC5633824_01_gr1.jpg
fig0005
An abdominal CT scan confirmed the presence of a 3.5 cm diameter well defined solid polycyclic mass at the pancreatic body, hypodense in the pre-contrast phase as compared to the surrounding pancreatic tissue (20-40 HU), without a dilatation of the distal pancreatic duct (Fig. 1a). In the portal phase, weak tumor enhancement (80-100 HU) compared with the adjacent normal pancreatic tissues (70 HU) (Fig. 1b).
Per-laparoscopic view. A well-encapsulated polycyclic mass was recognized at the pancreatic body after exposing the Lesser Sac by freeing the greater omentum off the transverse colon using Harmonic scalpel.
gr2.jpg
PMC5633824_01_gr2.jpg
fig0010
Intraoperatively, a well-encapsulated polycyclic mass was recognized at the pancreatic body (Fig. 2), the adjacent pancreatic tissue was completely normal, there was no local invasion neither macroscopic lymphadenopathies.
Per-laparoscopic view. The splenic artery and vein were identified and clipped near to the celiac trunk.
gr3.jpg
PMC5633824_01_gr3.jpg
fig0015
The splenic artery and vein were identified and clipped near to the celiac trunk (Fig. 3).
Per-laparoscopic view. pancreatic body divided by a 60-mm green stapler.
gr4.jpg
PMC5633824_01_gr4.jpg
fig0020
The pancreatic body was divided by a 60-mm green stapler (Fig. 4).
Pathologic findings of solid serous adenoma of the pancreas.. (a) Macroscopic view shows a well-circumscribed whitish solid mass measuring 3 x 1 x 1 cm.. (b) Microscopy shows a tumor composed of small acini with glandular spaces with fine collagenous stroma (H&E, x100).. (c) Tumor cells were polygonal with clear or pale eosinophilic cytoplasm with well-defined cell border (H&E, x200).. (d) The tumor cells did not show staining to chromogranin.
gr5.jpg
PMC5633824_01_gr5.jpg
fig0025
Macroscopically, the resection specimen showed a solid whitish, well circumscribed, encapsulated mass, measuring 3 x 1 x 1 cm, located in the pancreatic body, 1.5 cm from the pancreatic surgical margin (Fig. 5a). The tubes are surrounded by medium sized cells with clear cytoplasm and regular nuclei, no pleomorphism or mitotic activity was identified (Fig. 5b and c). This study did not show tumor cell labeling to these two markers (Fig. 5d).