Ann Hepatobiliary Pancreat Surg.  2021 May;25(2):293-298. 10.14701/ahbps.2021.25.2.293.

Squamoid cyst of pancreatic ducts: A case report

Affiliations
  • 1Department of Surgery, Ulsan University Hospital, University of Ulsan, College of Medicine, Ulsan, Korea

Abstract

The term squamoid cyst of pancreatic ducts (SCOP) has been proposed recently, and it is a very rare benign lesion. We report a case of SCOP in a patient who underwent laparoscopic distal pancreatectomy. A 51-year-old woman presented with a pancreatic cystic lesion (3.3 cm) as an incidental finding on abdominal ultrasonography. A computed tomography scan showed a well-defined cystic lesion in the body of the pancreas with peripheral nodular calcification. Histology showed a unilocular cyst with a thin, fibrotic wall, and it was surrounded by normal-appearing pancreatic tissue. The lining of the cyst was composed of stratified non-keratinized squamous epithelium without significant nuclear atypia. Immunohistochemistry showed positive nuclear p63 expression in the cyst lining. The final diagnosis of SCOP was established. It is important to distinguish SCOPs from mucinous pancreatic cysts that have malignant potential. Preoperative diagnosis of SCOP is still difficult, and further studies are needed to identify specific preoperative characteristics that can accurately distinguish this lesion.

Keyword

Cysts; Pancreas; Pancreatic neoplasms

Figure

  • Fig. 1 Abdominal US showed a well-demarcated cyst lesion with a smooth surface (A). CT scan showed a 4-cm sized cystic lesion in the body of the pan-creas, with well-defined margin and peripheral nodular calcifi-cation (B).

  • Fig. 2 Unilocular cyst surrounded by pancreatic tissue. The cyst is well-circumscribed with fibrotic wall ((A) Hematoxylin-eosin, ×10). The cyst lining is composed of stratified squamous epithelium without keratinization ((B) HE ×20; (C) HE ×400).

  • Fig. 3 Immunohistochemstrical staining for p63 shows nuclear staining in cyst lining cells ((A) ×20; (B) ×400).


Reference

1. Othman M, Basturk O, Groisman G, Krasinskas A, Adsay NV. 2007; Squamoid cyst of pancreatic ducts: a distinct type of cystic lesion in the pancreas. Am J Surg Pathol. 31:291–297. DOI: 10.1097/01.pas.0000213349.42143.ec. PMID: 17255775.
Article
2. Kurahara H, Shinchi H, Mataki Y, Maeda S, Takao S. 2009; A case of squamoid cyst of pancreatic ducts. Pancreas. 38:349–351. DOI: 10.1097/01.mpa.0000281377.56438.70. PMID: 19307935.
Article
3. Yoo DG, Hwang S, Hwang DW, Kim KH, Ahn CS, Ha TY, et al. 2013; Case report of a pancreatic squamoid cyst. Korean J Hepatobiliary Pancreat Surg. 17:181–185. DOI: 10.14701/kjhbps.2013.17.4.181. PMID: 26155237. PMCID: PMC4304511.
Article
4. Hanson JA, Salem RR, Mitchell KA. 2014; Squamoid cyst of pancreatic ducts: a case series describing novel immunohistochemistry, cytology, and quantitative cyst fluid chemistry. Arch Pathol Lab Med. 138:270–273. DOI: 10.5858/arpa.2012-0667-CR. PMID: 24476523.
Article
5. Assifi MM, Nguyen PD, Agrawal N, Dedania N, Kennedy EP, Sauter PK, et al. 2014; Non-neoplastic epithelial cysts of the pancreas: a rare, benign entity. J Gastrointest Surg. 18:523–531. DOI: 10.1007/s11605-014-2459-7. PMID: 24449000.
Article
6. Milanetto AC, Iaria L, Alaggio R, Pedrazzoli S, Pasquali C. 2013; Squamoid cyst of pancreatic ducts: a challenging differential diagnosis among benign pancreatic cysts. JOP. 657–660.
7. Snozek CL, Mascarenhas RC, O'Kane DJ. 2009; Use of cyst fluid CEA, CA19-9, and amylase for evaluation of pancreatic lesions. Clin Biochem. 42:1585–1588. DOI: 10.1016/j.clinbiochem.2009.06.020. PMID: 19576876.
Article
8. Jani N, Bani Hani M, Schulick RD, Hruban RH, Cunningham SC. 2011; Diagnosis and management of cystic lesions of the pancreas. Diagn Ther Endosc. 2011:478913. DOI: 10.1155/2011/478913. PMID: 21904442. PMCID: PMC3166757.
Article
9. Adsay NV, Hasteh F, Cheng JD, Klimstra DS. 2000; Squamous-lined cysts of the pancreas: lymphoepithelial cysts, dermoid cysts (teratomas), and accessory-splenic epidermoid cysts. Semin Diagn Pathol. 17:56–65.
10. Fernandez-Cebrian JM, Carda P, Morales V, Galindo J. 1998; Dermoid cyst of the pancreas: a rare cystic neoplasm. Hepatogastroenterology. 45:1874–1876.
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