Which pancreatic cystic neoplasm accounts for about 50% of cystic neoplasms and is mostly found in the body and tail?

• A. Cystadenoma
• B. Mucinous cystic neoplasm
• C. Intraductal papillary mucinous neoplasm
• D. Serous cystadenoma

Answer: (A)

The main idea is understanding which pancreatic cystic neoplasm is most common and where it typically appears. Serous cystadenoma is the most frequent pancreatic cystic neoplasm, accounting for about half of cystic pancreatic tumors. It has a strong tendency to arise in the body and tail of the pancreas, rather than the head.

This type is usually benign and often shows a multiple-mystery-like, microcystic (honeycomb) appearance on imaging, sometimes with a central scar. Its behavior and location contrast with other cystic neoplasms: mucinous cystic neoplasms (which also favor the body/tail but are less common and have mucin with ovarian-type stroma and malignant potential) and intraductal papillary mucinous neoplasms (which typically involve the pancreatic ducts and more often affect the head).