Cases reported "Pancreatic Cyst"

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1/13. Lymphoepithelial cyst of the pancreas: report of a case.

    An extremely rare case of a lymphoepithelial cyst (LEC) of the pancreas is described herein. A pancreatic cystic tumor was initially detected in a 50-year-old man at a medical checkup. On admission, his serum carbohydrate antigen (CA) 19-9 level was 8100 U/ml and a computed tomography scan revealed a well-circumscribed multilocular cystic tumor in the pancreatic head and body. Magnetic resonance cholangiopancreatography showed no communication between the pancreatic ducts and the tumor. A distal pancreatectomy with lymph node dissection was performed because the lesion was suspected to be a mucinous cystadenoma or cystadenocarcinoma of the pancreas. However, histological examination revealed that the cyst was lined by stratified squamous epithelium and surrounded by lymphoid tissue. thereby confirming the diagnosis of LEC of the pancreas. The superficial layer of squamous epithelium and the cystic contents were found to be immunohistologically positive for CA19-9. Establishing a preoperative diagnosis of LEC is quite difficult because it resembles other cystic neoplasms of the pancreas in radiographic features and is frequently associated with an elevation of serum tumor markers such as CA19-9.
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2/13. diagnostic imaging in a case of a cystic lesion of the pancreas.

    The case of a patient admitted to hospital for symptoms characterized by upper abdominal pain of pancreatic type associated with vomiting, is discussed. MRI was performed. It documented a focal fluid lesion apparently in communication with the dilated main pancreatic duct showing filling defects. Based on previous radiologic examinations performed elsewhere and MRI findings the diagnostic suspicion was of a cystic lesion. MRI was performed again for re-evaluation and lithotripsy was done; the patient was discharged with the diagnosis of chronic pancreatitis from alcohol abuse.
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3/13. Spontaneous internal drainage of pancreatic pseudocysts.

    Six cases are reported in which spontaneous internal drainage between a pancreatic pseudocyst and the alimentary tract became established. In each instance the communication was demonstrated radiologically. The clinical circumstances and radiographic features of these cases are described, and the existing literature pertaining to this phenomenon is reviewed.
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4/13. Gastric duplication cyst communicating with the pancreatic duct: a rare cause of recurrent abdominal pain.

    A 41-year-old woman with recurrent attacks of postprandial abdominal pain was found on endoscopic retrograde cholangiopancreatography and subsequent computed tomographic scan to have an enteric duplication within the substance of the pancreas with communication to the pancreatic duct. Celiotomy demonstrated a noncontiguous gastric duplication cyst. Internal drainage was curative.
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5/13. Mucinous cystadenoma: pitfalls of differential diagnosis.

    Cystic neoplasms of the pancreas often are difficult to differentiate from pseudocysts. It has been proposed that a history of clinical pancreatitis, elevated serum pancreatic enzymes, elevated cyst fluid amylase, and a communication with the pancreatic duct suggest the diagnosis of a pseudocyst. We report the case of a young woman who presented with a cystic mass in the pancreas and was thought to have a pseudocyst because of the above; at surgery, a mucinous cystadenoma was documented. The pitfalls of differentiating neoplastic cysts of the pancreas from pseudocysts are discussed.
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6/13. Operative strategies in the management of mediastinal pancreatic pseudocyst.

    Thirty-four cases of mediastinal pancreatic pseudocyst have been previously reported. Among the 32 previous reports with operative or autopsy analysis, communication has been identified in 30. Even when this communication has been quite small between the mediastinal fluid collection and the pancreas, the recommended operative strategy has been enteric drainage directly to this communicating tract. We report the case of a patient with a mediastinal pancreatic pseudocyst in whom the communication between the pancreas and the pseudocyst was not located. The condition was managed by drainage of the mediastinal pseudocyst with decompression of the main pancreatic duct by means of a longitudinal pancreaticojejunostomy in a patient with chronic pancreatitis.
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7/13. pancreatic pseudocyst involving the spleen.

    pancreatic pseudocyst involving the spleen in a 52-year-old man is reported, with review of the literature. physical examination and laboratory data revealed no specific abnormalities. A CT scan demonstrated multiple calcifications throughout the pancreas, with a cystic mass in the tail of the pancreas involving the spleen. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a dilated main pancreatic duct with a direct communication to the cyst. Distal pancreatectomy with splenectomy was performed on a diagnosis of pancreatic pseudocyst. The 10 x 9.5 x 7 cm in size cyst had no epithelial lining on its wall. The amylase level in the cystic fluid was 23424 IU/l. The literature reveals that hemorrhagic complications are common and often serious. Timely surgical intervention is advocated to reduce mortality and morbidity from complications.
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8/13. An unusual complication of chronic pancreatitis: a recanalized portal tree communicating with a pancreatic pseudocyst.

    A patient with chronic pancreatitis was admitted for digestive bleeding from esophageal varices. Portal thrombosis and cavernomatous periportal collateral circulation were found at laparotomy. The partially recanalized portal tree was excluded from the portal circulation and filled with pancreatic juice due to a communication with a pancreatic pseudocyst. splenectomy, partial left pancreatectomy, Roux en Y pancreatico-cysto-jejunostomy, and external drainage of the portal tree were performed. The postoperative course was uneventful and the patient is symptom-free and doing well 2 yr after surgery.
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9/13. pancreatic pseudocyst of the mediastinum. Evaluation by CT.

    This paper describes a case of pancreatic pseudocyst involving the mediastinum. diagnosis was made by CT, which demonstrated the cystic nature of the lesion and its communication with an intra abdominal pseudocyst.
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10/13. Fistulous communication of pseudocyst to the common bile duct: a complication of pancreatitis.

    A pseudocyst developed in a child following acute pancreatitis and spontaneously drained into the common bile duct, a rare occurrence previously described only in adults. The imaging findings are similar to those of a choledochal cyst; serial sonograms enabled diagnosis by documenting evolution of the lesion and should be of value in demonstrating resolution.
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