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Adhish Basu, MS, MRCS; Sarath Chandra Sistla, MS; Krishnan R. Iyengar, MD, DipNB
[+] Author Affiliations

Author Affiliations:Departments of Surgery (Drs Basu and Sistla) and Pathology (Dr Iyengar), Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.


Section Editor: Carl E. Bredenberg, MD


Arch Surg. 2009;144(1):89. doi:10.1001/archsurg.2008.527-a.
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Published online

A 37-year-old woman presented with a gradually enlarging abdominal mass and weight loss over a period of 6 months. On examination, there was a freely mobile, yielding mass in the right hypochondrium. Ultrasonography of the abdomen revealed a large cyst with internal septations abutting the head of the pancreas. The head, body, and tail of the pancreas appeared normal. The hepatobiliary tree also appeared normal. Serum amylase level and liver function test results were normal.

Laparotomy revealed a 9-cm diameter, freely mobile cystic tumor attached to the pancreatic head by a broad pedicle. No evidence of metastasis to other organs or lymph nodes was identified. Pancreaticoduodenectomy was completed with a curative intent (Figure 1). Cut section revealed a multiloculated cystic tumor containing hemorrhagic fluid and necrotic material. There were no papillary projections inside the cyst (Figure 2). The adjacent pancreatic tissue appeared normal.

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Figure 1.

Pancreaticoduodenectomy specimen showing a large spherical lesion arising from the head of the pancreas. Ruler is in centimeters.

Graphic Jump Location

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Figure 2.

Cut-open specimen showing multiple loculations within the pancreatic cyst. Ruler is in centimeters.

Graphic Jump Location

The patient made an uneventful recovery. One year after surgery, the patient had no detectable recurrence or metastasis.

WHAT IS THE DIAGNOSIS?

A. Pancreatic acinar cell cystadenoma

B. Pancreatic mucinous cystadenoma

C. Cystic pancreatic endocrine neoplasm

D. Solid cystic pseudopapillary tumor of the pancreas

Figures

Place holder to copy figure label and caption
Figure 1.

Pancreaticoduodenectomy specimen showing a large spherical lesion arising from the head of the pancreas. Ruler is in centimeters.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Cut-open specimen showing multiple loculations within the pancreatic cyst. Ruler is in centimeters.

Graphic Jump Location

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