Clinical History A 61-year-old gentleman with a history of recurrent
episodes of epigastric pain for five years presented again with
another severe attack. Ultrasonography and computed tomography of
the upper abdomen were performed.
Diagnosis:
Intraductal papillary mucinous tumor (IPMT) of the pancreas
Comment :
Ultrasonography showed a heterogeneous mass at the pancreatic head. The common
bile duct and the pancreatic duct were dilated - the double duct sign. Contrast-enhanced
computed tomography confirmed the presence of a complex cystic mass at the
pancreatic head. The biliary tree and the pancreatic duct were dilated. The
duodenal papilla was prominent and protruded into the duodenal lumen.
These findings are suggestive of Intraductal papillary mucinous tumor (IPMT)
of the pancreas. The diagnosis can be confirmed by observing mucin oozing
out of the duodenal papilla at ERCP, or by demonstrating communication between
the cystic lesion and the pancreatic duct and Intraductal filling defect with
various imaging modalities. |