Serous cystadenomas have virtually no potential for malignant transformation; thus, observation is appropriate for this patient, given the lesion’s classic appearance and her significant medical comorbidities. If there is uncertainty about the diagnosis, resection via distal pancreatectomy (which is always performed with splenectomy) could be considered, whereas a Whipple procedure would be performed for pancreatic head lesions. Endoscopic drainage of the cysts is contraindicated in this patient.
