Illustration of a healthy pancreas with a small, glowing cystadenoma.

Pancreatic Serous Cystadenoma: What You Need to Know About This Rare Tumor

Nico Varela in Health & Wellness December 2025 • 4 min read.

"A deep dive into the diagnosis, characteristics, and management of serous cystadenomas of the pancreas, empowering you with essential knowledge about this often incidental finding."

Serous cystadenomas (SCAs) of the pancreas are uncommon, benign growths that primarily affect older women. These tumors are characterized by their unique appearance under a microscope, with most exhibiting a microcystic structure. Macrocystic and solid variations also exist. Distinguishing SCAs from other, more aggressive cystic pancreatic lesions is critical for appropriate patient management.

The main goal is to provide a clear understanding of the clinical and pathological features of SCAs. By understanding these characteristics, healthcare professionals can make accurate diagnoses and better understand the behavior of these tumors.

This article reviews a study of 23 SCA cases diagnosed at a major medical center between 2001 and 2018. The aim is to shed light on the typical presentation, diagnostic methods, and treatment approaches for SCAs, offering valuable insights for patients and medical professionals alike.

Decoding Serous Cystadenoma: Key Features and Diagnostic Insights

Illustration of a healthy pancreas with a small, glowing cystadenoma.

The study revealed that the average age at diagnosis was 53.43 years, with a significant female predominance (female to male ratio of 4.75:1). Over half of the cases (56.5%) were incidentally discovered, meaning they were found during imaging for unrelated conditions. Abdominal pain was the most frequently reported symptom. The tumors were commonly located in the body and tail of the pancreas, ranging in size from 2 to 16 cm. A central scar, a characteristic feature, was observed in 43.4% of cases. Two cases were identified as macrocystic (unilocular).

Microscopic examination consistently revealed simple cuboidal to flattened epithelial cells with round, uniform nuclei and clear, glycogen-rich cytoplasm. Micropapillary formations, small finger-like projections, were present in 34.7% of cases.

Mean age at presentation: 53.43 years
Female to male ratio: 4.75:1
Incidental diagnosis: 56.5% of cases
Common symptom: Abdominal pain
Common locations: Body and tail of pancreas
Tumor size range: 2 to 16 cm
Central scar presence: 43.4% of cases
Macrocystic cases: 8.6%

Surgical resection, the removal of the tumor through surgery, was performed in 82.6% of cases. Recurrence, the return of the tumor, occurred in only one case, highlighting the generally benign nature of these tumors.

The Outlook for Serous Cystadenoma: What It Means for You

Pancreatic serous cystadenomas are benign neoplasms with an excellent prognosis. The tumors typically exhibit consistent morphological features. While surgical resection was common in the reviewed study, this was often due to incomplete pre-operative radiological evaluation and concerns about potentially missing and inadequately treating mucinous cystic neoplasms, which require different management.

Modern imaging techniques (MRI and endoscopic ultrasound) enhance diagnostic accuracy, potentially reducing the need for surgery in many cases. Conservative management is appropriate for many patients, particularly those with asymptomatic or smaller tumors.

If you have been diagnosed with a serous cystadenoma, understanding its characteristics and the available management options is crucial. Discuss your case thoroughly with your healthcare team to determine the most appropriate course of action, balancing the benefits of intervention with the potential risks.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1177/2036361318809183, Alternate LINK

Title: Serous Cystadenoma Of Pancreas: A Clinicopathologic Experience Of 23 Cases From A Major Tertiary Care Center

Subject: Oncology

Journal: Rare Tumors

Publisher: SAGE Publications

Authors: Muhammad Usman Tariq, Zubair Ahmad, Jamshid Abdul-Ghafar, Nasir Ud Din

Published: 2018-01-01

Everything You Need To Know

What exactly are pancreatic serous cystadenomas, and who is most likely to be affected by them?

Pancreatic serous cystadenomas, or SCAs, are non-cancerous growths in the pancreas, primarily affecting older women. They are characterized by distinct features seen under a microscope, most often with a microcystic structure, though macrocystic and solid types also exist. Differentiating SCAs from more aggressive cystic pancreatic lesions is critical for ensuring proper patient care. While surgical resection is a common treatment, it is often performed because the initial evaluation didn't fully rule out mucinous cystic neoplasms, which require a different approach. SCAs generally have a good outlook.

What are the key characteristics that help doctors identify a pancreatic serous cystadenoma during diagnosis?

The key features of pancreatic serous cystadenomas include a mean age at presentation of around 53 years, a strong female predominance, frequent incidental discovery during imaging for other conditions, and abdominal pain as a common symptom. Tumors are typically found in the body and tail of the pancreas, ranging from 2 to 16 cm in size. A central scar is often observed, and microscopic examination reveals specific cell characteristics such as simple cuboidal to flattened epithelial cells with uniform nuclei and clear cytoplasm. Macrocystic variations can also occur, albeit less frequently.

What is the typical treatment approach for pancreatic serous cystadenomas, and what are the chances of the tumor returning after treatment?

In a study of 23 SCA cases, surgical resection was performed in over 80% of cases. However, recurrence was rare, noted in only one case, which highlights the benign nature of serous cystadenomas. The frequent use of surgery in the study reflects concerns about possibly missing or inadequately addressing mucinous cystic neoplasms, which have different treatment protocols. The study underscores the importance of carefully distinguishing between these types of pancreatic lesions.

What role do features like 'central scar' and 'micropapillary formations' play in understanding serous cystadenomas?

A central scar is a notable characteristic of pancreatic serous cystadenomas, observed in over 40% of cases. Microscopically, SCAs are composed of simple cuboidal to flattened epithelial cells with round, uniform nuclei and clear, glycogen-rich cytoplasm. Micropapillary formations, which are small finger-like projections, can also be present. These features aid in distinguishing SCAs from other pancreatic cysts, ensuring accurate diagnosis and appropriate treatment strategies.

How do serous cystadenomas differ from other types of pancreatic lesions, and why is it so important to tell them apart?

Serous cystadenomas are distinct from mucinous cystic neoplasms, which require different management strategies due to their potential for becoming cancerous. SCAs are also different from solid pseudopapillary neoplasms, another type of pancreatic tumor often found in younger women. Distinguishing SCAs from these other pancreatic lesions is critical. Accurate diagnosis through imaging and microscopic examination is essential to avoid unnecessary aggressive interventions and to ensure appropriate patient care, based on the specific type of pancreatic lesion identified.