Cystic tumors Pancreas

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Cystic tumors Pancreas MCQ | Central Scar Microcystic Lesion

Serous Cystadenoma Pancreas MCQ – Central Scar Microcystic Lesion

📘 Theme: Pancreas – Cystic Neoplasms (NEET SS / INI-CET High Yield)

Cystic tumors Pancreas Imaging MCQ

A 52-year-old woman undergoes imaging for vague abdominal discomfort. CT scan shows a well-circumscribed lesion in the head of the pancreas with multiple small cysts and a central stellate scar. Serum CEA and CA 19-9 levels are normal. What is the most likely diagnosis?

A. Mucinous cystic neoplasm
B. Intraductal papillary mucinous neoplasm (IPMN)
C. Serous cystadenoma
D. Solid pseudopapillary tumor

Answer: C. Serous cystadenoma

Explanation

Serous cystadenoma (microcystic adenoma) is a benign pancreatic cystic tumor characterized by a microcystic appearance and a central stellate scar (sunburst pattern). Tumor markers such as CEA and CA 19-9 are typically normal, helping differentiate it from mucinous lesions.

Why other options are incorrect

  • Mucinous cystic neoplasm: Macrocystic, occurs in body/tail, elevated CEA, malignant potential.
  • IPMN: Communicates with pancreatic duct, causes ductal dilation, may raise CA 19-9.
  • Solid pseudopapillary tumor: Seen in young women, mixed solid-cystic, no central scar.

High-yield teaching points

  • Central stellate scar + microcystic lesion = serous cystadenoma.
  • Normal CEA favors serous over mucinous lesions.
  • Surgery indicated only if symptomatic, large, or uncertain diagnosis.

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