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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2013 May;172(5):373-8
Congenital true cystic mass of the pancreas in a young woman: which treatment?
Cremona F. 1, Ciulla A. 1, Agnello G. 1, Farinella D. 2, Maiorana A. M. 1
1 Department of General Surgery and Metabolic Diseases, Paolo Giaccone General Hospital, Palermo, Italy;
2 Department of Sciences for Health Promotion,, “Hygiene and Preventive Medicine”, Paolo Giaccone General Hospital, Palermo, Italy
Aim: We report a case of congenital true pancreatic cyst with high level of enzymatic activity, rarely seen in young and children which, to the best of our knowledge, rarely has previously been reported. A young girl was admitted to our clinic with a history of abdominal swelling and pain during exercise for many months. A mobile, smooth, non-tender mass was palpated on the left side of the abdomen during physical examination. Ultrasonography and computed tomography imaging revealed a not subdivide cystic mass sized 11.51x8.2 cm.
Methods: Surgical treatment was considered, but given the young age of the patient, we declined for fear of complications. Therefore, US-guided percutaneous drainage of cystic was performed. After a week, at the ultrasound check, thanks to obstruction of drainage, we decided to intervene surgically. During abdominal surgical exploration, the pancreatic tail was larger than normal, and a pancreatic cyst arising from the tail of the pancreas was observed. Total cystectomy was performed with distal pancreatectomy.
Results: The postoperative period was complication free and the patient was discharged on the seventh postoperative day. No complications occurred during the six-month follow-up period.
Conclusion: Early diagnosis and timely intervention have improved the results of surgical therapy in this disease. Although it is extremely rare in children, congenital true pancreatic cyst should be diagnostically considered in cases involving a cystic mass neighbouring the pancreas. Ultrasonography, computed tomography and magnetic resonance imaging is helpful in differential diagnosis of other cysts originating from neighbouring organs. Total excision with distal pancreatectomy and splenic preservation are advised for distal pancreatic cyst.