B-0576 Imaging features of acinar cell cystadenoma: can we differentiate them from branch duct IPMNs?

C. Delavaud, G. D’Assignies, J. Cros, P. Ruszniewski, P. Hammel, A. Couvelard, V. Vilgrain, M.-P. Vullierme

Purpose: Acinar cystic cystadenoma (ACC) of the pancreas is a rare benign entity first described in 2002, defined by histological criteria. Radiographic appearance had almost not been described so far. Most of the patients underwent surgical resection under the preoperative diagnosis of intraductal papillary mucinous neoplasms. The aims of this study are to define imaging diagnostic criteria of ACC based on radiopathological confrontation and to compare clinical, biological and imaging data between patients with ACC and with branch ducts IPMN.
Methods and Materials: All patients with ACC who underwent pancreatic surgery for suspicion of IPMN and the 20 last patients with histologically proven branch ducts IPMN were retrospectively included. Clinical and biological information were collected from the medical reports. Radiological and histological documents were reviewed in order to define imaging diagnostic criteria of ACC. Data were compared using the Chi-square test or Fisher’s exact test.
Results: ACC was symptomatic in all but one patient. There were no statistical difference between ACC and IPMN group with regard to clinical and biological data. Combination of four radiological criteria allowed differentiating ACC from IPMN: cyst calcification, presence of more than 5 cysts, clustered peripheral small cyst, and absence of communication with main pancreatic duct. Sensibility and specificity were, respectively, 75 and 100 % with combination of at least three of these criteria.
Conclusion: ACC is a rare benign pancreatic tumour with specific imaging features despite some similarities with IPMN. Recognition of this entity may help us to propose the diagnosis and prevent extensive surgery.

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