[Pancreas pseudocyst or metastasis?].
The authors review a case of a 24-year-old male patient hospitalised for repeated acute abdominal symptoms. His medical history included no diseases worth of mentioning. By imaging techniques (abdominal US and CT scan) a cystic lesion, measuring 40 x 35 x 30 mm in diameter was found, and was diagnosed as pseudocyst in the region of the tail of the pancreas. Jejunal feeding was introduced. The lesion did not improve and the second CT scan suggested a suspicion of pancreatic cystadenoma. Three months after first presentation the surgical resection was performed. The tumour, however, was found independent of the pancreas (90 x 80 x 50 mm). Both histologically and immunohistochemically the lesion proved to be the metastasis of a germ cell (yolk-sac) tumour. Following the morphological diagnosis, detailed urological and medical check up was performed. A previously nonpalpable small tumour was found in the left testis which was radically resected. The testicular tumour measuring 9 x 9 x 5 mm in diameter was diagnosed as embryonal carcinoma. Later on the patient underwent chemotherapy. He has been undergoing close oncological followup. Clinically, he is disease free. Authors emphasize the importance of imaging techniques and fine needle aspiration cytology in the case of retroperitoneal masses in young males. The possibility of a metastasis, especially of germ cell origin, should be excluded (not only by physical examination, but by ultrasound of testis also) in case of retroperitoneal cystic tumours even with unusual morphology.
Gyorffy
Hajnalka
H
Semmelweis Egyetem, Altalános Orvostudományi Kar, II. Patológiai Intézet, Budapest.
Tihanyi
Tibor
T
Gyökeres
Tibor
T
Zsirka-Klein
Attila
A
Kádár
Péter
P
Kaszás
Ilona
I
Kovács
Margit
M
D000328:Adult; D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D018240:Endodermal Sinus Tumor / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D010192:Pancreatic Pseudocyst / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed