Acinar Cell Cystadenoma: A Case Report and Literature Review.

Acinar cell cystadenoma (ACA) of the pancreas, also known as acinar cystic transformation, is a rare benign cystic lesion with no established malignant potential. Preoperative distinction from mucinous and other premalignant cystic neoplasms remains unreliable. A 39-year-old Indian woman presented with persistent upper abdominal pain. Cross-sectional imaging demonstrated a 4 × 4 cm multiloculated cystic lesion in the pancreatic head with septations and peripheral calcifications and without ductal communication, findings suggestive of a mucinous cystic neoplasm. Serum tumor markers were normal. Because of the symptomatic presentation and radiological concern for premalignant pathology, pancreaticoduodenectomy was performed. Histopathological examination confirmed ACA, with no evidence of dysplasia or malignancy. The postoperative course was uneventful, and the patient remained asymptomatic on follow-up with no evidence of recurrence. This case highlights the diagnostic challenges associated with ACA and the risk of overtreatment due to its radiological similarity to premalignant cystic neoplasms.