[Intraductal papillary mucinous tumor of the pancreas mimicking pancreatic pseudocyst].
BACKGROUND
Most of pancreatic cysts are in fact pseudocysts. Only 10 to 20% are real cystic tumors. Intraductal papillary mucinous tumors of the pancreas represent nearly 15% of them.


OBJECTIVE
To illustrate, by an observation, the difficulties to diagnose a cystic tumor of the pancreas.


METHODS
We report the case of a 55 year old woman complaining of epigastric pain for one month with an elevated pancreatic enzymes level. Ultrasonography and computed tomography scan showed two cystic formations measuring 6 and 7 cm localized respectively in the head and the body of the pancreas. The diagnosis of pancreatic pseudocysts was maintained. The appearance of a jaundice made us think about a pseudocyst's compression of the common bile duct. A cysto-gastric anastomosis was made. The recurrence of the jaundice associated to diabetes and a general state deterioration led to the practice of magnetic resonance cholangiopancreatography. It revealed an intraductal papillary mucinous tumor of the pancreas affecting secondary ducts. The presence of a peritoneal carcinosis led to therapeutic abstention.


CONCLUSIONS
The diagnosis of intraductal papillary mucinous tumor of the pancreas must be referred to in case of pancreatic cystic tumor without extrapancreatic necrosis. This kind of tumor can simulate a pancreatic pseudocyst.
Service de Chirurgie B, Hôpital Charles Nicolle, Tunis, Tunisie.
Riadh
R
Bedoui
Ramzi
R
Nouira
Nabil
N
Najah
Chadli
C
Dziri
D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D010192:Pancreatic Pseudocyst / Q000175:diagnosis*