Pancreatic cancer initially presenting with a pseudocyst at the splenic flexure

Abstract

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.

Treatment and Prognosis for Pancreatic Duct Disruption Associated with Pancreatic Cancer: a case series of 16 patients

“…PD disruptions associated with pancreatic cancer and the need for therapeutic intervention are rare; only a few cases have been reported [8][9][10][11][12][13][14][15]. Given their infrequency, the effectiveness and safety of endoscopic treatments have not been su ciently investigated.…”

“…There have been several reports on PD disruption and PPC caused by pancreatic cancer [8][9][10][11][12][13][14][15][16]. When pancreatic cancer coexists, it is necessary to address not only PD disruption and the accompanying PPC/WON but also devise a therapeutic strategy for the pancreatic malignancy itself.…”

Anaplastic pancreatic carcinoma growing within the main pancreatic duct complicated by a large pseudocyst

“…Furthermore, pancreatic carcinoma rarely occurs in association with PPCs. To our knowledge, only nine cases of pancreatic carcinoma with PPCs have been reported in the English literature (Table 1) [6][7][8][9][10][11][12][13] . In eight cases of them, the pathological findings revealed pancreatic ductal adenocarcinoma, while one case was associated with poorly differentiated invasive ductal adenocarcinoma with osteoclast-like giant cells.…”