Pancreatic endometrial cyst mimics mucinous cystic neoplasm of the pancreas

World J Gastroenterol. 2017 Feb 14;23(6):1113-1118. doi: 10.3748/wjg.v23.i6.1113.


Pancreatic cysts include a variety of benign, premalignant, and malignant lesions. Endometrial cysts in the pancreas are exceedingly rare lesions that are difficult to diagnose pre-operatively. This report describes the findings in a 43-year-old patient with a recent episode of acute pancreatitis who presented with a large cyst in the tail of the pancreas. Imaging demonstrated a loculated pancreatic cyst, and cyst fluid aspiration revealed an elevated amylase and carcinoembryonic antigen. The patient experienced an interval worsening of abdominal pain, fatigue, diarrhea, and a 15-pound weight loss 3 mo after the initial episode of pancreatitis. With concern for a possible pre-malignant lesion, the patient underwent a laparoscopic distal pancreatectomy with splenectomy, which revealed a 16 cm × 12 cm × 4 cm lesion. Final histopathology was consistent with an intra-pancreatic endometrial cyst. Here we discuss the overlapping imaging and laboratory features of pancreatic endometrial cysts and mucinous cystic neoplasms of the pancreas.

Keywords: Distal pancreatectomy; Endometriosis; Mucinous cystic neoplasm of the pancreas; Pancreatic cyst; Pancreatic endometrial cyst.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Adult
  • Amylases / analysis
  • Carcinoembryonic Antigen / analysis
  • Diagnosis, Differential
  • Diarrhea / etiology
  • Endometriosis / complications*
  • Endosonography
  • Fatigue / etiology
  • Female
  • Humans
  • Laparoscopy
  • Neoplasms, Cystic, Mucinous, and Serous / diagnosis*
  • Neoplasms, Cystic, Mucinous, and Serous / pathology
  • Obesity / complications
  • Pancreas / pathology
  • Pancreatectomy / methods
  • Pancreatic Cyst / diagnosis*
  • Pancreatic Cyst / metabolism
  • Pancreatic Cyst / pathology
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / pathology
  • Pancreatitis / complications*
  • Splenectomy / methods
  • Tomography, X-Ray Computed
  • Weight Loss


  • Carcinoembryonic Antigen
  • Amylases