A pancreatic mucinous cystic neoplasm undergoing intriguing morphological changes over time and associated with recurrent pancreatitis: A case report

Medicine (Baltimore). 2019 Jul;98(28):e16435. doi: 10.1097/MD.0000000000016435.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma, Mucinous / complications
  • Adenocarcinoma, Mucinous / diagnostic imaging
  • Adenocarcinoma, Mucinous / pathology*
  • Adenocarcinoma, Mucinous / surgery
  • Adult
  • Disease Progression
  • Female
  • Humans
  • Pancreas / diagnostic imaging
  • Pancreas / pathology*
  • Pancreas / surgery
  • Pancreatic Cyst / complications
  • Pancreatic Cyst / diagnostic imaging
  • Pancreatic Cyst / pathology*
  • Pancreatic Cyst / surgery
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery
  • Pancreatitis / complications
  • Pancreatitis / diagnostic imaging
  • Pancreatitis / pathology*
  • Pancreatitis / surgery
  • Recurrence