Mucinous cystic pancreatic neoplasm

Case contributed by Pranav Sharma

Presentation

Abdominal pain and vomiting

Patient Data

Age: 60 years
Gender: Female

MRCP

mri

Findings:  

  • Large macrolobular multiloculated predominantly cystic lesion with a claw of pancreatic parenchyma around it, measuring 11 x 8cm on axial sequences. 
  • Heterogeneous T1 intrinsic signal with areas of proteinaceous material and peripheral/septal enhancement without a solid enhancing nodular component.
  • No convincing main pancreatic duct connection.
  • There is mass effect on adjacent structures, particularly the stomach.
  • The splenic vein is not visualized with multiple perigastric collateral vessels.  

Conclusion:

  • Large macrolobular multiloculated 11 x 8cm cystic neoplasm arising from the pancreatic body/tail.
  • Findings are favored to represent a large mucinous neoplasm. 

CT Abdomen

ct

The large multilocular cystic mass is again demonstrated within the left upper quadrant of the abdomen. Maximum CT diameter is 110mm. The wall is relatively thin and the internal septations are thin. There is minimal calcification in one of the septations and posterior wall inferiorly. 

Case Discussion

60 year old lady. 

Presented with 3-month history of abdominal distention and post-prandial fullness with associated nausea and vomiting. Palpable mass in the epigastrium. 

CT/MRCP demonstrate pancreatic mass with partial gastric obstruction. 

CEA: 2.3 (normal) and CA 19.9: 180 (high). 

Underwent endoscopic ultrasound and biopsy which confirmed mucinous cystic neoplasm. 

 

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