Giant Cystic Pancreatic Mass

¹Department of General Surgery, Ospedali Riuniti Marche Nord, Pesaro, Italy, ²Department of General Surgery, Carlo Urbani Hospital, Jesi, Ancona, Italy

^&Corresponding author
Danilo Coco, Department of General Surgery, Ospedali Riuniti Marche Nord, Pesaro, Italy

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A 47 years old Caucasian woman presented to the emergency department with significant abdominal pain, vomiting and abdominal distension. She denied any medical history and any therapy. Her vital signs were: blood pressure, 130/70 mmHg, respiratory rate 30 breaths/minute, heart rate 70 beats/minute and temperature of 36°C. Oxygen saturation was 95% on room air. The abdominal examination showed an abnormal mass in epigastric region. Thoracic examination reported reduced vesicular murmur. Laboratory evaluation revealed normal leukocytosis with a White Blood Cell (WBC) count of 9 per mm³. Arterial Blood Gases (ABG) was normal. Abdominal Computed Tomography revealed a giant cystic mass in left pancreas and adhesion with stomach and colon trasversum. An open laparotomy showed a voluminous cystic lesions in distal pancreas. En-bloc spleno-pancreatectomy following trasversum resection and colo-colonic anastomosis was performed. Histopathological findings showed a 14 x 9 cm mucinous adenoma with cellular atipias. After a pancreatic fistulas Grade A, the patient was discharged 10 days after.

Figure 1: Abdominal Computed Tomography revealed a giant cystic mass in left pancreas and adhesion with stomach and colon transversum