Presentation
Abdominal pain radiating to back.
Patient Data
The pancreatic head shows a large mass appearing to be innumerable internal small hypodense cysts and central calcifications. Associated pancreatic duct dilatation.
Portal vein/superior mesenteric vein distortion. The lesion also abuts the portal vein over 4.4cm, without stenosis. No definitive tumour thrombus/invasion in the portal vein.
Left VUJ stone
Small hypodensity within liver segment 7 in keeping with a simple cyst.
Large tumour arising from the pancreatic head, which is macrocystic multilocular with low T1, high T2 signal with innumerable enhancing septations and centrally thicker and low T2 signal. No abnormal diffusion restriction.
The distal pancreas demonstrates markedly dilated duct with dilated side branches and parenchymal atrophy. The mass distorts the liver, gallbladder and biliary tree although there is no biliary dilatation. Extensive contact and flattening of the inferior mesenteric vein, portal vein and inferior vena cava. No features of tumour thrombus.
Numerous hepatic cysts.
Case Discussion
Large cystic pancreatic head mass, most likely serous cystadenoma. The demographics of this patient are typical for this entity.
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