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Mucinous cystadenoma of the pancreas

Case contributed by Ammar Ashraf
Diagnosis certain

Presentation

Recurrent pain in the left hypochondrium for 5 months. No aggravating or relieving factors associated with this pain. No nausea, anorexia, change in bowel habits, or weight loss.

Patient Data

Age: 25 years
Gender: Female
ultrasound

Findings: A well-defined cystic lesion is seen in the left hypochondrium adjacent to the tail of the pancreas. A thin septum and few internal echoes are noted within it. Possible differential diagnosis includes mucinous cystic neoplasm of the pancreas, pancreatic pseudocyst, and mesenteric cyst.

Findings: A well-defined rounded exophytic cystic lesion measuring 6.3 x 7 x 7 cm is seen originating from the tail of the pancreas. It has an average density of 8 HU and shows mild peripheral enhancement on post contrast study. A few thin septations and a tiny mural calcification are seen in it. No solid component is seen in it. Morphology of the remaining pancreas is unremarkable.

Impression: Well-defined rounded exophytic cystic lesion originating from the tail of the pancreas, which is likely, a mucinous cystadenoma of the pancreas (mucinous cystic neoplasm of the pancreas) with possible differential diagnosis of pancreatic pseudocyst (if there is a past history of pancreatitis).  Another possible differential can be a hydatid cyst which is however, very unlikely.   

Case Discussion

Procedure (Laparotomy): Cystectomy with distal pancreatectomy & splenectomy.

Diagnosis: Mucinous cystadenoma of the pancreas. No significant abnormality is seen in the spleen.

 

 

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