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The pathology report confirmed benign macrocystic serous cystadenoma. Serous cystadenomas are rare benign cystic lesions of the pancreas. Although they are benign lesions, it is crucial to differentiate them from other cystic lesions of the pancreas and malignant serous cystadenocarcinomas. Aggressive pancreatobiliary tumors often require oxaliplatin-based therapies, instead of standard gemcitabine-based therapy and biomarker studies at diagnosis to decide the appropriate therapeutic regimen. The ribonucleotide Reductase catalytic subu