Mucinous cystic adenoma with inflammatory cell infiltration around the splenic artery mimicking pancreatic cancer: a cas
- PDF / 1,742,301 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 19 Downloads / 185 Views
CASE REPORT
Mucinous cystic adenoma with inflammatory cell infiltration around the splenic artery mimicking pancreatic cancer: a case report Hiroaki Okuse1 · Reiko Yamada2 · Kyosuke Tanaka3 · Noriyuki Horiki3 · Yoshiyuki Takei2 Received: 20 July 2020 / Accepted: 27 August 2020 © The Author(s) 2020
Abstract A 45-year-old woman presented with upper abdominal and back pain. A cystic lesion in the pancreas and inflammation around the splenic artery were detected by computed tomography. Although imaging studies were difficult to exclude malignancy, pathological and cytological findings of a fine-needle aspiration showed no signs of malignancy. The patient was, therefore, followed-up for 3 months, during which time the cyst increased in size and developed a cyst-in-cyst structure. She was diagnosed with mucinous cyst neoplasm and underwent distal pancreatectomy. Histologically, the patient was diagnosed as low-grade mucinous cystic adenoma. Soft tissue shadows around the splenic artery were considered to indicate fibrosis and infiltration of inflammatory cells. After distal pancreatectomy, the patient has been uneventful with symptom resolution. This case highlights the potentially atypical presentation of mucinous cystic neoplasms with inflammatory cell infiltration around the splenic artery. Keywords Mucinous cystic neoplasm · Ovarian-like stroma · Inflammatory cell infiltration
Introduction Mucinous cystic neoplasms (MCNs) are cystic tumors covered with mucus-producing epithelium, with a characteristic ovarian-like stroma. MCNs are relatively rare tumors, accounting for only 2–5% of exocrine pancreatic tumors and occurring most frequently in the distal pancreas in younger women [1]. MCNs often appear as solitary or multilocular elliptical or spherical cystic tumors, typically protruding from the pancreas, in the form of a so-called cyst-in-cyst, with a common thick fibrous cap covering multiple cysts [2]. Most MCNs are slow growing and asymptomatic [3]. Naveed et al. reported a typical clinical appearance characterized by epigastric heaviness and fullness (60–90%) or by an abdominal mass (30–60%), sometimes with nausea, * Reiko Yamada reiko‑[email protected]‑u.ac.jp 1
Department of Gastroenterology, Suzuka Kaisei Hospital, Suzuka, Mie, Japan
2
Department of Gastroenterology and Hepatology, Mie University Hospital, 2‑174 Edobashi, Tsu, Mie 514‑8507, Japan
3
Department of Endoscopy, Mie University Hospital, Tsu, Mie, Japan
vomiting (20–30%), and back pain (7–40%) [3]. Yamao et al. also reported that 51.4% of MCNs were asymptomatic, and 6.5% presented with acute pancreatitis [4]. We report a case of mucinous cystic adenoma (MCA) with inflammatory cell infiltration around the splenic artery which was confirmed by pathology. The present case showed atypical imaging findings at the first examination, including infiltration around the splenic artery located at the back of the unilocular cystic lesion. However, during a 3-month observation period, the lesion showed a cyst-incyst appearance, thus supporting
Data Loading...
