Revised: February 11, 2014
Accepted: March 3, 2014
Published online: March 28, 2014
The aim of this article is to clarify diagnostic pitfalls of pancreatic serous cystic neoplasm (SCN) that may result in erroneous characterization. Usual and unusual imaging findings of SCN as well as potential SCN mimickers are presented. The diagnostic key of SCN is to look for a cluster of microcysts (honeycomb pattern), which may not be always found in the center. Fibrosis in SCN may be mistaken for a mural nodule of intraductal papillary mucinous neoplasm (IPMN). The absence of cyst wall enhancement may be helpful to distinguish SCN from mucinous cystic neoplasm. However, oligocystic SCN and branch duct type IPMN may morphologically overlap. In addition, solid serous adenoma, an extremely rare variant of SCN, is difficult to distinguish from neuroendocrine tumor.
Core tip: Most serous cystic neoplasm (SCN) consist of a combination of microcystic, macrocystic, and solid-appearing components. The imaging appearance of each component simply reflects the different sizes of cysts that comprise the SCN. The diagnostic key of SCN is to look for a cluster of microcysts (honeycomb pattern). However, differentiation between oligocystic SCN and branch duct type intraductal papillary mucinous neoplasm, and between neuroendocrine tumor and extremely rare solid serous adenoma, may be difficult.