title: Differentiation of mucinous cystic neoplasm and cystic changes associated with pancreatic adenocarcinoma.
abstract: A 63-year-old woman presented to the hospital with persistent nausea, dyspepsia and weight loss for 6 months. Abdomen CT showed a low-attenuation mass, approximately 7.6 cm diameter, in the region of the body and tail of the pancreas. Cystic lesions, 5.5×4.9 cm and 4.6×3.7 cm in size, were observed in the body and tail of the pancreas, respectively, associated with the low-attenuation mass. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) revealed fetal carcinoembryonic antigen levels of >1000 ng/mL and necrotic cells with no malignant cells. On the basis of the imaging and EUS-FNA results, a putative diagnosis of mucinous cystadenoma accompanying pancreatic adenocarcinoma was made, and distal pancreatectomy and splenectomy were performed. Final biopsy using the surgical specimen confirmed pancreatic adenocarcinoma with moderate differentiation accompanied by degenerative cystic changes.
authors.affiliation: Division of Gastroenterology Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.
authors.forename: Tae Hwan
authors.initials: TH
authors.lastname: Ha
authors.forename: Tae Joo
authors.initials: TJ
authors.lastname: Jeon
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Park
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D018291:Cystadenoma, Mucinous / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D011182:Postoperative Care; D013156:Splenectomy / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome