Abstract
An intramural pseudocyst in the alimentary tract develops as a rare complication of acute pancreatitis or trauma. A 60-year-old woman with pancreatic head cancer underwent preoperative radiological examinations, which revealed a 45-mm cystic mass around the second portion of the duodenum. Endoscopic ultrasonography confirmed a cystic lesion in the submucosal layer of the duodenum and fine needle aspiration cytology of the cystic contents suggested adenocarcinoma. The cystic fluid was amylase-rich, at 17040 U/l. We performed pancreaticoduodenectomy for the pancreatic head cancer. Pancreatography of the resected specimen showed a communication between the main pancreatic duct and the cystic lesion. The cut surface of the resected specimen revealed a cystic lesion, which surrounded the duodenum. Pathologically, the cystic lesion was diagnosed as a pseudocyst, located between the dissociated smooth muscle layers of the duodenum.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Juric I, Pogorelic Z, Biocic M, Todoric D, Furlan D, Susnjar T. Management of blunt pancreatic trauma in children. Surg Today. 2009;39:115–9.
Grynszpzn A, Bryk D, Pochaczevsky R. Duodenal obstruction caused by cystic masses. J Can Assoc Radiol. 1976;126:985–91.
Loludice TA, Jarmolych J, Buhac I. Pancreatic retention cyst. A cause of obstructive jaundice. JAMA. 1977;238:889–90.
Bellon EM, George CR, Schreiber H, Marshall JB. Pancreatic pseudocysts of the duodenum. Am J Roentgenol. 1979;133:827–31.
McCowin MJ, Federle MP. Computed tomography of pancreatic pseudocysts of the duodenum. Am J Roentgenol. 1985;145:1003–7.
Sobin LH, Gospodarowicz MK, Witterkind C, editors. TNM classification of malignant tumors. 7th ed. New York: Wiley–Blackwell; 2009.
Zahlan B, Bret PM, Merran S, Bourdon-Conochie F, Jabbari M, Thompson AG. Gastric intramural pseudocyst of the pancreas. Can Assoc Radiol J. 1988;39:282–3.
Eisenberger CF, Kropp A, Langwieler TE, Gocht A, Izbicki JR, Knoefel WT. Heterotopic pancreatitis: gastric outlet obstruction due to an intramural pseudocyst and hamartoma. Z Gastroenterol. 2002;40:259–62.
Koop I, Monnikes H, Fehmann C, Schwerk WB, Hugens-Penzel M, Rothmund M, et al. Intramural pancreatic pseudocyst in the gastric wall: diagnosis by sonography and ultrasound-guided puncture. J Clin Gastroenterol. 1990;12:466–9.
Shockman AT, Marasco JA. Pseudocysts of the pancreas. Am J Roentgenol Radium Ther Nucl Med. 1967;101:628–38.
Balzan S, Kianmanesh R, Farges O, Sauvanet A, O’Toole D, Levy P, et al. Right intrahepatic pseudocyst following acute pancreatitis: an unusual location after acute pancreatitis. J Hepatobiliary Pancreat Surg. 2005;12:135–7.
Belagyi T, Issekutz A, Paukovics A, Kecskes G, Olah A. Successful treatment of mediastinal pancreatic pseudocyst by pancreatic head resection. JOP. 2008;9:346–9.
Acknowledgments
This paper was presented at the Joint Meeting of the International Association of Pancreatology and the Japan Pancreas Society, held in July 2010, in Fukuoka, Japan.
Conflict of interest
The authors declare no financial or any other type of support.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sugiura, T., Uesaka, K., Kanomata, H. et al. Intramural pseudocyst of the duodenum caused by pancreatic head cancer: report of a case. Surg Today 42, 805–807 (2012). https://doi.org/10.1007/s00595-012-0154-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00595-012-0154-4