Pancreatic cancer initially presenting with a pseudocyst at the splenic flexure

• Published in: Pathology international Vol. 56; no. 9; pp. 558 - 562
• Main Authors: Inagi, Eiji, Shimodan, Shun, Amizuka, Hisato, Kigawa, Sanshiro, Shimizu, Yozo, Nagashima, Kazuo, Tanaka, Shinya
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.09.2006
• Subjects: abdominal pseudocyst; acute pancreatitis; Adult; Carcinoma, Pancreatic Ductal - complications; Carcinoma, Pancreatic Ductal - pathology; Cholangiopancreatography, Endoscopic Retrograde; ductal adenocarcinoma; Humans; Male; pancreas; pancreas body cancer; Pancreatic Ducts - pathology; Pancreatic Neoplasms - complications; Pancreatic Neoplasms - pathology; Pancreatic Pseudocyst - etiology; Pancreatic Pseudocyst - pathology; Pancreatitis - etiology
• ISSN: 1320-5463; 1440-1827
• DOI: 10.1111/j.1440-1827.2006.02006.x

Pancreatic cancer and pancreatitis associated pseudocyst are not uncommon disorders. However, occurrence of the cancer with an initial manifestation of pseudocyst has been rarely reported. Surgery was performed on a 44‐year‐old male patient for an abscess‐like cavity situated at the mesenteric side of the colon and extending from the splenic flexure to the descending colon. The lesion was verified as a pseudocyst with fat necrosis due to leakage of pancreatic fluid. When further surgery was carried out 1 month later in order to manage the drainage site of the pancreatic fluid, cancer of the pancreas body was detected proximal to the drainage site. The cancer was a moderately differentiated ductal adenocarcinoma with wide peripancreatic infiltration. It is thought that the cancer‐associated duct obstruction caused a local pancreatitis resulting in a large communicating pseudocyst, although the exact mechanism remains unresolved. The present case may be instructive in showing physicians that a pseudocyst may obscure the presence of pancreatic cancer.