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  • Surgical Pathology Criteria
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    Solid Serous Adenoma of the Pancreas

    Definition

    • Benign solid pancreatic neoplasm composed of bland clear cells

    Diagnostic Criteria

    • Circumscribed mass
    • Solid pattern
      • At most, small lumens
      • No cyst formation
    • Composed of bland clear cells
      • Identical to those seen in serous microcystic adenoma
      • Cytoplasm of some cells may be finely granular and eosinophilic
      • Glycogen positive
    • Metastatic renal cell carcinoma must be ruled out clinically
    • May represent a variant of serous microcystic adenoma

    Robert V Rouse MD
    Department of Pathology
    Stanford University School of Medicine
    Stanford CA 94305-5342

    Original posting/updates: 1/4/07, 1/4/12

    Supplemental studies

    Histochemistry

    PAS+, diastase sensitive pos
    Mucin neg

    Immunohistology

    CK7 pos
    CK18 pos
    CK19 pos
    Neuron specific enolase pos
    Chromogranin neg
    Synaptophysin neg
    CK20 neg

     

    Differential Diagnosis

    Serous Microcystic Adenoma Well Differentiated Pancreatic Neuroendocrine (Islet Cell) Tumor
    Synaptophysin and chromogranin negative Synaptophysin and chromogranin positive

  • Islet cell tumors may occasionally have clear cytoplasm
  • Serous Microcystic Adenoma Solid Serous Adenoma of the Pancreas
    Innumerable cysts millimeters in diameter Solid with spaces at most tenths of millimeters in diameter

  • Solid and microcystic serous adenoma are composed of histologically identical cells
  • Solid adenomas may be considered a variant of the microcystic type
  • Metastatic Renal Cell Carcinoma must be ruled out clinically

    Clinical

    • Very rare
    • Reported cases all in adults
    • No aggressive behavior reported

    Grading / Staging / Report

    • Grading
      • Not applicable
    • Staging
      • Not applicable
    • Report
      • Comment that the lesion is very rare but that no aggressive behavior has been reported

    Lists

    Serous Pancreatic Lesions

    Bibliography

    • Bosman FT, Carneiro F, Hruban RH, Thiese ND (Eds). WHO Classifiication of Tumors of the Digestive System, IARC, Lyon 2010.
    • Matsumoto M, Iguchi M, Ohtsuki Y, Kimura M, Watanabe R, Watanabe N, Okada Y, Kurabayashi A, Takahashi T, Furihata M. A case of solid serous adenoma of the pancreas ultrastructurally harbouring ribosome-lamella complexes. Pathology. 2006 Aug;38(4):361-4.
    • Reese SA, Traverso LW, Jacobs TW, Longnecker DS. Solid serous adenoma of the pancreas: a rare variant within the family of pancreatic serous cystic neoplasms. Pancreas. 2006 Jul;33(1):96-9.
    • Yamaguchi M. Solid serous adenoma of the pancreas: a solid variant of serous cystadenoma or a separate disease entity? J Gastroenterol. 2006 Feb;41(2):178-9.
    • Perez-Ordonez B, Naseem A, Lieberman PH, Klimstra DS. Solid serous adenoma of the pancreas. The solid variant of serous cystadenoma? Am J Surg Pathol. 1996 Nov;20(11):1401-5.
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