Giant pancreatic incidentaloma: Report of a case and literature review.

INTRODUCTION: Asymptomatic lesions of the pancreas, referred to as 'incidentalomas', have appeared with increased frequency in recent years. Giant incidentalomas have rarely been reported in the literature.

PRESENTATION OF CASE: We report herein a rare case of a giant cystic pancreatic incidentaloma measuring 12.7cm×8cm, which was found in an otherwise healthy male patient during a routine genitourinary imaging work-up. The patient underwent a distal pancreatectomy and splenectomy; the pathology report demonstrated a giant serous cystadenoma of the body and tail of the pancreas.

DISCUSSION: The management of pancreatic incidentalomas is challenging. While solid lesions almost always warrant surgery, there is ongoing debate concerning the management of cystic lesions that are found incidentally in the pancreas and have no clinical manifestations.

CONCLUSION: We report herein an interesting case of a voluminous incidental cystic pancreatic lesion. The appropriate approach and the decision whether to operate or not in such cases can be puzzling to the physician.