Published online Jan 14, 2018. doi: 10.3748/wjg.v24.i2.297
Peer-review started: October 20, 2017
First decision: November 8, 2017
Revised: November 15, 2017
Accepted: November 22, 2017
Article in press: November 22, 2017
Published online: January 14, 2018
A 34-year-old man was referred to our hospital with right upper abdominal pain, and a pancreatic solid and cystic lesion found on computed tomography (CT), magnetic resonance (MR) image with MR cholangiography, and endoscopic ultrasonography (EUS).
Branch duct type intraductal papillary mucinous neoplasm.
Serous cystadenoma among solid and cystic pancreatic neoplasms.
Abnormal laboratory results included slightly elevated level of total bilirubin (1.3 mg/dL, normal range of 0.2-1.2) and gamma-glutamyl transferase (108 IU/L, normal range of 8-60).
CT and MR imaging showed a delayed contrast-enhanced solid lesion containing pruning-pattern branch duct dilatation in uncinate process and head of pancreas, with small hyperechoic mural nodules in the dilated branch ducts on EUS.
Microscopic findings of resected specimen revealed mass forming chronic pancreatitis including branch duct dilatation.
The patient was treated with pylorus-preserving pancreaticoduodenectomy.
There have been many reports for the discrimination between mass forming chronic pancreatitis and pancreatic adenocarcinoma using various imaging modalities.
There are no non-standard medical terms used in this manuscript.
The author presents this case to share the very unusual but important knowledge that mass forming chronic pancreatitis might include the branch duct dilatation.