Wk 2, Case 5 - Review

PATIENT HISTORY: Pancreatic mass

MRI ABDOMEN W WO IV CONTRAST MRCP

INDICATION: Pancreatic mass.

COMPARISON: None.

TECHNIQUE: MRI of the abdomen was performed with and without contrast. Coronal 3-D MRCP images were obtained.


FINDINGS

Hepatobiliary: Hepatic cysts are noted. Gallbladder sludge is present. No biliary ductal dilatation.

Pancreas: There is a 3.1 x 2.1 cm multiseptated cystic lesion arising from the uncinate process of the pancreas with mildly enhancing septations. No internal solid components are identified. Pancreatic duct is not dilated. It is unclear if the mass communicates with the main pancreatic duct.

Spleen: Unremarkable.

Adrenal glands: Unremarkable.

Kidneys: Partially duplicated left renal collecting system noted.

Bowel: Visualized bowel is unremarkable.

Upper abdominal lymph nodes: No lymphadenopathy.

Peritoneum: No abscess.


IMPRESSION:

Multiseptated pancreatic cystic mass as described. Given the morphology of the lesion, this may represent a serous cystadenoma. A side branch intraductal papillary mucinous neoplasm is also in the differential though no definite communication to the main pancreatic duct is identified. Further evaluation with endoscopic ultrasound and cyst sampling should be considered.