We report the case of a 45-year-old woman with a history of long-standing rheumatoid arthritis.
An ultrasound in 2009 found incidentally a 14 mm unilocular cystic lesion in the pancreatic body.
The patient was studied by Digestive Appliance Medicine, who in 2010 requested MRI and ultrasound guided needle puncture (USE-PAAF), obtaining serous material without atypia.
The study of tumor markers in blood showed normal CEA and trypsin, with an CA 19.9 of 34.77 U/ml (range 0-27 U/ml).
Finally, the patient was diagnosed with a pancreatic cystic lesion compatible with serous cystadenoma.
Follow-up was done by ultrasound and, given its progressive increase, in 2014 CT and MRI were performed, which showed a lesion of approximately 3.2 x 3 x 3.3 cm, having tripled its size with respect to previous resonance.
Although the patient was asymptomatic, tumor growth during follow-up and the patient's wish led to surgical resection of the lesion by PC.
Through right transverse laparotomy we proceeded to the release of the superior and inferior edges of the body-colla of the pancreas, identifying a cystic lesion of 3-4 cm in benign isthmus.
The proximal pancreatic section was performed at the portal vein level and the pancreatic stump was sutured with loose polypropylene stitches.
The central part of the pancreas containing the lesion was dissected and resected and splenic vein and artery were preserved.
The distal pancreas was derived by pancreatic-jejunal anastomosis with Roux-en-Y loop of 60 cm. The anastomosis was reinforced by liquid fibrin sealant and a vacuum-assisted drainage was placed.
The postoperative period was uneventful and the patient was discharged on the ninth postoperative day with normal glycemia.
The pathological study confirmed the diagnosis of serous cystadenoma.
After 16 months of follow-up, the patient is asymptomatic and has not presented exoendocrine pancreatic insufficiency or readmissions in relation to surgery.
