Postoperative histopathological examination confirmed that the diagnosis was a neuroendocrine tumor involving the tail of pancreas
The arrows point out the lesion in the tail of pancreas
. (b) Endoscopic ultrasound (EUS) of the lesion followed by FNA biopsy.
All the patients who had imaging suggestive of solid/cystic mass in the head, body or tail of pancreas
which are confirmed by surgery are included in my study; (2 patients underwent Whipple's PD and post-operative biopsy came negative for malignancy, these cases are not included in the study).
Given these findings and the clinical suspicion of MEN1, the study was completed with a CT scan of the neck, chest, abdomen, and pelvis, which showed a hypervascular heterogeneous mass with lobulated and well-defined edges of 6.8 x 7.7 x 6.4 cm in the tail of pancreas
, plus another mass of similar characteristics of 6 x 4.2 cm in the uncinate process and at least three more pancreatic focal lesions of less than 1 cm on the head and neck of pancreas (Figure 2).
Strasberg, "Single institution results of radical antegrade modular pancreatosplenectomy for adenocarcinoma of the body and tail of pancreas
in 78 patients," Journal of Hepato-Biliary-Pancreatic Sciences, vol.
Caption: Figure 1: (a) The SPN locating at the tail of pancreas
with complete capsule was confirmed to be benign.
In this article, we report a 36-year-old African-American woman with a history of colon cancer and hemicolectomy who was incidentally found to have a cystic lesion in the tail of pancreas
during surveillance abdominal imaging.
In addition, the CT scan revealed the presence of multiple hypodense formations in the body and tail of pancreas
. During the hospital stay an abdominal MR was performed.
He underwent an MRI scan (Figure 1) of his abdomen which reported a 2.8cm ring enhancing lesion in the tail of pancreas
. At endoscopic ultrasound (EUS) a 2 x 2 cm well circumscribed mass was demonstrated in the tail of the pancreas close to the splenic artery but, not involving the vessel.
Computed tomography of the upper abdomen demonstrated that the body and tail of pancreas
were replaced by a 10 x 10 x 10 cm hypodense mass lesion with encasement of splenic artery.
Given the rapid reaccumulation of pleural fluid and raised amylase, lipase in pleural fluid, CECT of thorax and abdominal was performed, which revealed a well-defined hypoattenuating collection measuring 30-40 cc, anterior to the tail of pancreas
suggestive of a pseudocyst and a large left pleural collection.
Pre-operative triple phase CT (computed tomography) scan of the abdomen showed a resectable ill-defined hypodense mass in the region of ampulla, the pancreatic head and uncinate were normal however the neck, body and tail of pancreas
were absent (figure 1,2).