Intraductal papillary mucinous neoplasm

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Abdominal pain and mass feeling.

Patient Data

Age: 80 years
Gender: Male

Intra & extra hepatic bile ducts are dilated and CBD measured 12mm in caliber. A 68×62mm multicystic mass with lobulated margin is noted at pancreatic head, accompanied by severe distal pancreatic atrophic changes and marked duct dilatation. Some cystic lesions are also observed at pancreatic body and tail in a branching pattern. No calcification is evident. There is no sign of local invasion to adjacent structures and no vascular involvement. Abdominal fluid is present. 
In imaged portions of lower thorax, bilateral plural effusion is also noted.
Degenerative changes as osteophytosis are seen at the lumbar spine.

Case Discussion

Pathological proven intraductal papillary mucinous neoplasm (IPMN), which is an epithelial pancreatic cystic tumor of mucin-producing cells that arise from the pancreatic ducts. They are most commonly seen in elderly patients. 

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