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
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.