Uncommon Lymphoepithelial Cyst with Sebaceous Glands of the Pancreas

Tsukasa Nakamura, Yoshio Osaka, Shoichi Ishikawa, Hirotaka Sako, Naoaki Akamatsu, Yoshihiro Yamamoto, Yohei Hosokawa, Norio Yoshimura

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Abstract

Context Lymphoepithelial cysts with sebaceous glands of the pancreas are extremely rare, with only 7 cases, including thiscase, published in English literature. Case report We herein present the case of a 67-year-old Asian man who underwent aresection of a lymphoepithelial cyst of the pancreas during the follow up care for lung cancer. Fourteen years previously heunderwent a right lower lobectomy at the right segment nine for lung cancer. A 20 mm mass in the body of the pancreas wasidentified by CT scan 4 years ago, and the diagnosis was intraductal papillary mucinous neoplasm (IPMN) at that time. Over a 5-year period, this mass grew to 42 mm without dilatation of the main pancreatic duct. The preoperative evaluation,including endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), indicated a cystic neoplasm with suspicion ofmalignancy. Intraoperative frozen section revealed a squamous-lined cyst accompanied by sebaceous glands without anymalignant findings. Following this pathological finding, resection of the cyst was performed. Consequently, microscopicexamination revealed that it was a lymphoepithelial cyst with sebaceous glands of the pancreas. Conclusions Pancreaticlymphoepithelial cysts can be cured by conservative resection, but if they are asymptomatic and are diagnosed beforesurgery, no treatment is necessary. To our knowledge, this is the first ever published case of a lymphoepithelial cyst withsebaceous glands of the pancreas, which was found during the follow up care for lung cancer.

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