Intraductal Papillary Mucinous Tumor Of The Pancreas Mimicking Pancreatic Pseudocyst

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Published May 31, 2010
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Vol. 88 No. 6 (2010): Issue Jun 2010

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Riadh Bedoui
Ramzi Nouira
Nabil Najah
Chadli Dziri

Abstract

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.
Aim: To illustrate, by an observation, the difficulties to diagnose a cystic tumor of the pancreas.
Case report: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 7cm 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.
Conclusion: 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.

Keywords:

Pancreas, Intraductal papillary mucinous tumor of the pancreas, pancreatic pseudocyst

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