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Wednesday 9 April 2014

CASE 246: PANCREAS TUMOR, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM



14yo girl  for  a long time epigastric pain  like gastric syndrome.
But ultrasound detected one round mass of 4 cm at the head of pancreas, without dilated CBD or Wirsung duct. CDI no detection vascular intratumor and echostructure was inhomogeneous (see 3 US pictures).





MSCT with CE showed  this mass well bordered at the head of pancreas, slow enhancement of contrast.




Blood tests no abnormal.

Based on clinical status and  ultrasound and MSCT imaging,  what is your suggestion of diagnosis and what is your plan for treatment ?

Discussion: young girl with chronic pain.
US and MSCT cannot make sure diagnosis.
Operation for biopsy this tumor; the tumor is fixed to deep structure, thickening of the wall.After opening  the wall, the black fluid came out and red blood following. Biopsy the wall of this tumor and one lymph node nearby.



Microscopic report is  pseudocyst of  pancreas and  lymphadenitis.



Plan to treat  is waiting  and seeing  the evolution  of  this cyst.

REFERENCE
 pdf..  Management  cystic structure of pancreas.

 

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