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Published on: June 6, 2020
A pancreatic mucinous cystic neoplasm undergoing intriguing morphological changes over time and associated with
Erika Shioyama1, Akira Mitoro2, Hiroyuki Ogawa1
1Internal Medicine, Kokuho Central Hospital, Miyako, Tawaramoto-cho, Shiki-gun.
Rationale:
Mucinous cystic neoplasms (MCNs) are pancreatic mucin-producing cystic lesions with a distinctive ovarian-type stroma. The diagnosis is generally easy in typical cases; however, differential diagnosis is difficult in others such as in the case we report herein.
Patient Concerns:
A 27-year-old woman with sudden onset of epigastric pain was referred to our hospital for suspected acute pancreatitis. Contrast-enhanced computed tomography revealed a 25-mm cystic lesion in the pancreas and a low density area with delayed enhancement at the right upper side of the cystic lesion.
Diagnoses:
During its clinical course, the cystic lesion underwent various morphological changes. Eventually, it presented typical findings of MCNs, and could be accurately diagnosed.
Interventions:
Laparoscopic distal pancreatectomy was performed on the patient by preserving the spleen.
Outcomes:
The patient revealed no symptoms till 1 year after the operation.
Lessons:
This case of MCN with intriguing short-term morphological changes was associated with recurrent pancreatitis. A combination of imaging modalities is essential for accurate diagnosis of MCNs, and follow-up with serial imaging might be useful for certain unusual lesions.
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