title: Pancreatic cancer initially presenting with a pseudocyst at the splenic flexure.
abstract: Pancreatic cancer and pancreatitis associated pseudocyst are not uncommon disorders. However, occurrence of the cancer with an initial manifestation of pseudocyst has been rarely reported. Surgery was performed on a 44-year-old male patient for an abscess-like cavity situated at the mesenteric side of the colon and extending from the splenic flexure to the descending colon. The lesion was verified as a pseudocyst with fat necrosis due to leakage of pancreatic fluid. When further surgery was carried out 1 month later in order to manage the drainage site of the pancreatic fluid, cancer of the pancreas body was detected proximal to the drainage site. The cancer was a moderately differentiated ductal adenocarcinoma with wide peripancreatic infiltration. It is thought that the cancer-associated duct obstruction caused a local pancreatitis resulting in a large communicating pseudocyst, although the exact mechanism remains unresolved. The present case may be instructive in showing physicians that a pseudocyst may obscure the presence of pancreatic cancer.
authors.affiliation: Department of Surgery, Sapporo Higashi-Tokushukai Hospital, Sapporo, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Inagi
authors.forename: Shun
authors.initials: S
authors.lastname: Shimodan
authors.forename: Hisato
authors.initials: H
authors.lastname: Amizuka
authors.forename: Sanshiro
authors.initials: S
authors.lastname: Kigawa
authors.forename: Yozo
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Kazuo
authors.initials: K
authors.lastname: Nagashima
authors.forename: Shinya
authors.initials: S
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications* / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D006801:Humans; D008297:Male; D010183:Pancreatic Ducts / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000473:pathology; D010192:Pancreatic Pseudocyst / Q000209:etiology* / Q000473:pathology; D010195:Pancreatitis / Q000209:etiology