In contrast to mucinous cystic tumors of the pancreas, which are known to have considerable malignant potential, the serous variant is not considered potentially malignant. Operative resection for SCT has been suggested in patients with complications, but its progress can be followed carefully without surgery [2, 13]. However, there have been several reports of malignancy in serous cystic tumors of the pancreas [15-18, 22, 38]. These tumors have metastasized or have been associated with aggressive local growth. A malignant counterpart of the serous cystic tumor has been described as serous cystadeno-carcinoma or microcystic adenocarcinoma.
Serous cystadenocarcinoma is essentially indistinguishable from serous cystadenoma, but shows signs of malignancy. Kamei et al. reported a case of multifocal SCT with atypical cells . One of the seven multiple tumors described showed an increase in the nuclear/cytoplasmic ratio, irregular nuclear margins, and perineural invasion. Abe et al. described a case of SCT with invasive growth to the lymph node and adipose tissue . Invasion of the surrounding tissue can result in a distant metastasis . In one case, the
microscopic appearance was similar to that of microcystic adenoma, but metastases were present in stomach and liver . The controversy on whether SCT has potential for malignancy provokes debate on whether surgical excision is necessary .
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