Korean J Pancreas Biliary Tract.  2015 Apr;20(2):94-98. 10.15279/kpba.2015.20.2.94.

A Case of Branch Duct Intraductal Papillary Mucinous Neoplasm Mimicking Pseudocysts Complicated by Recurrent Pancreatitis

• Kang SH
• Kim KH
• Kim TN

• KMID: 2448481
• DOI: http://doi.org/10.15279/kpba.2015.20.2.94

Abstract

Branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) are characterized by cystic dilation of secondary ducts clearly communicating with a normal-sized main pancreatic duct and seem to have a less aggressive clinical course than those arising from the main duct. BD-IPMNs are related to pancreatitis but the causal relationship is unclear. We report a case of a 62-year-old woman initially thought to have pseudocysts complicated by idiopathic recurrent pancreatitis but was finally diagnosed with BD-IPMN leading to recurrent acute pancreatitis attacks. The patient had six episodes of acute pancreatitis over 5 years. An abdominal computed tomography scan revealed two cystic lesions of 2.0 and 1.5 cm in the pancreatic body, which appeared at the second episode of acute pancreatitis. Each pancreatitis episode improved with conservative treatment, but the cystic lesions increased in size to 2.5 and 3.5 cm during the late follow-up period. A distal pancreatectomy was performed under the diagnosis of recurrent pancreatitis caused by BD-IPMN. The pathological findings revealed BD-IPMN with moderate dysplasia. We herein present a case of BD-IPMN mimicking pancreatic pseudocysts with a review of the literature.

Keyword

Acute recurrent pancreatitis; Intraductal papillary mucinous neoplasm; Pancreas; Pseudocyst

MeSH Terms

Diagnosis
Female
Follow-Up Studies
Humans
Middle Aged
Mucins*
Pancreas
Pancreatectomy
Pancreatic Ducts
Pancreatic Pseudocyst
Pancreatitis*
Mucins