A Case of Cystadenoma of the Pancreas with Internal Hemorrhage Presenting Hematemesis

Takahiro Sasaya, Akihiro Yamaguchi, Masatoshi Isogai, Tohru Harada, Yuji Kaneoka, Masahiko Suzuki, Junji Washizu and Keita Sakata*

Department of Surgery, Ogaki Municipal Hospital
*Department of Pathology, Ogaki Municipal Hospital

A 73-year-old woman admitted for epigastric pain and hematemesis and having a 10-year history of aspirin ingestion was found in abdominal CT to have a 68×74 mm cystic lesion in the pancreatic tail. The lesion contained a slightly high-density area with a low-density area in the center. The CT number of each was 17 HU, 75 HU, and 45 HU. ERCP showed a dilated main pancreatic duct and the cyst communicating with a pancreatic duct branch in the tail. MRI suggested hemorrhage into the pancreatic cyst, but we could not exclude malignancy due to the elevated tumor marker. A distal pancreatectomy showed clotted blood but no elevated lesion, suggesting neoplasm within the cyst. Histological examination showed the cyst wall to be lined with columnar epithelium, leading to a final diagnosis of cystadenoma of the pancreas. The postoperative course was uneventful and she was discharged on postoperative day 22.

Key words
cystadenoma of the pancreas, internal hemorrhage in cyst, digestive bleeding

Reprint requests
Takahiro Sasaya Department of Surgery, KKR Tokai Hospital
1-1-1 Chiyodabashi, Chikusaku Nagoya, 464-8512 JAPAN

Accepted
March 24, 2004

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