Presentation
Asymptomatic. Screening ultrasound identified a cystic lesion in the pancreatic head.
Patient Data
Age: 70 years
Gender: Male
From the case:
Intraductal papillary mucinous neoplasm - main duct type
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/92414/annotated_viewer_json?iframe=true\u0026lang=us"}
- an about 54 x 48 x 42 mm cystic lesion is visible in the pancreatic head, seemingly in connection with the moderately dilated main pancreatic duct
- focal calcification in the pancreatic tail
- no sign of local or distant malignant disease
From the case:
Intraductal papillary mucinous neoplasm - main duct type
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/92415/annotated_viewer_json?iframe=true\u0026lang=us"}
- the cystic lesion is high on T2 and low on T1, shows no significant internal enhancement or restricted diffusion
- MRCP confirms direct connection with the main duct, indicative of a main duct type IPMN
Case Discussion
The lesion was completely resected during a modified Whipple procedure.
Postoperative histopathological assessment confirmed the diagnosis of IPMN with signs of high grade dysplasia.
This case is also contributed by Dr. Nándor Faluhelyi