A 31-year-old man presented with a 6-month history of occasional abdominal distension.
He suffered from alcohol abuse and reported having pancreatitis 8 months ago. He had
no history of gallstone disease. Abdominal CT showed a large peripancreatic cystic
mass (Fig. 1A) with a smooth surface and internal debris (Fig. 1B). Abdominal MR revealed the cystic mass with high signal intensity on T1WI and T2WI.
Internal debris appeared as marked high signal intensity on T1WI (Fig. 1C) and low signal intensity on T2WI (Fig. 1D). Coronal maximum intensity projection (Fig. 1E) stereoscopically showed the cystic mass, measuring 25 × 15 × 22 cm. Tumor markers
were normal, including alpha fetoprotein, carcinoembryonic antigen and cancer antigen
199. The patient underwent laparoscopic Roux-en-Y cystojejunostomy and surgical findings
revealed brown liquid in the cyst. Histopathology (Fig. 1F) confirmed the pseudocyst with no epithelial lining and a fibrocollagenous wall.
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References
- Giant pancreatic pseudocyst.J Coll Physicians Surg Pak. 2012; 22: 325-327
- Giant pseudocyst of the pancreas: a report of three cases.Int J Surg Case Rep. 2020; 77: 284-297
- Differentiating pancreatic cystic neoplasms from pancreatic pseudocysts at MR imaging: value of perceived internal debris.Radiology. 2009; 251: 77-84
Article info
Publication history
Published online: February 12, 2023
Accepted:
February 8,
2023
Received:
September 22,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.