A Wolf in Sheep's Clothing: A Non-Functioning Islet Cell Tumor of the Pancreas Masquerading as a Microcystic (Serous Cystic) Adenoma

John Baillie, Henning Gerke, Paul S Jowell, Michaell F Byrne, Huiwen Bill Xie, Erik K Paulson, Douglas S Tyler

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Abstract

Context The endosonographic appearance of a microcystic “honeycomb” lesion of the pancreas usually indicates a serous cystic adenoma. Case report We report a case of a nonfunctioning islet cell tumor that has the typical  icrocystic “honeycomb” appearance of a serous cystic adenoma. The implications for endoscopic ltrasound diagnosis and management of cystic pancreatic lesions are discussed. Conclusion Islet cell tumors are a rare differential diagnosis of microcystic pancreatic lesions. If fine needle aspiration remains non-diagnostic preoperative distinction from serous cystic  adenomas may be impossible.

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