A Case of Pancreatic Abscess Mimicking Mucinous Cystic Tumor of the Pancreas

Satoshi Yajima, Susumu Yamasaki*, Kazuaki Shimada, Tsuyoshi Sano, Minoru Esaki, Norimasa Koide and Tomoo Kosuge

Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Central Hospital
*Tochigi National Hospital

A 39-year-old-woman with epigastric discomfort was found in abdominal ultrasonography (US) to have a 4 cm multilocular cystic lesion in the pancreas head. Laboratory data showed mildly elevated in serum CRP and WBC count. Contrast-enhanced CT showed a well-defined macrocystic mass with a thick hyperdense capsule. Image diagnosis suggested mucinous cystic tumor of the pancreas. She underwent pylorus preserving pancreatoduodenectomy. The resected specimen showed a cystic mass containing pus on mucinous fluid, which had a communication into the duodenal lumen. Microscopically, there was neither fibrosis nor inflammatory changes in the duodenal wall suggestive of previous duodenal ulcer. No neoplastic change in the cystic lesions in the pancreas was seen. Consequently, the lesion was diagnosed as a pancreatic abscess penetrating to the duodenum. Short-term observation for this lesion was a therapeutic option considering the low malignant potential of MCT.

Key words
pancreatic abscess, mucinous cystic tumor, penetration to duodenum

Reprint requests
Tomoo Kosuge Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Central Hospital
5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 JAPAN

Accepted
February 25, 2004

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