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A 69-year-old-woman presented with febrile epigastric pain. A laboratory analysis indicated inflammation (WBC, 19,000/μL; CRP, 34.64 mg/dL). CT showed a 50-mm cyst and an enhanced mass in the pancreatic head… Click to show full abstract
A 69-year-old-woman presented with febrile epigastric pain. A laboratory analysis indicated inflammation (WBC, 19,000/μL; CRP, 34.64 mg/dL). CT showed a 50-mm cyst and an enhanced mass in the pancreatic head (Picture 1). MRI demonstrated a fluid-fluid-level inside the cyst with edematous wall-thickness (Picture 2). Endoscopic retrograde pancreatography showed the irregular pancreatic duct leading to the cyst (Picture 3). Endoscopic transpapillary nasopancreatic drainage (ENPD) was performed; her symptoms were alleviated and the cyst became smaller. Pancreaticoduodenectomy was performed based on a cytological diagnosis of adenocarcinoma. The histological examination showed a 29-mm-mass occupying the pancreatic duct; which was well-differentiated papillary adenocarcinoma. Inside the
Journal Title: Internal Medicine
Year Published: 2019
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