Mucinous Cystic Neoplasm Case Studies
Mucinous cystic neoplasms (MCN) are a group of rare pancreatic lesions that include benign cystadenomas and malignant cystadenocarcinomas. Middle aged women are almost exclusively affected, with a female to male predominance of 20:1 and an average age of diagnosis of 50. Affected individuals are frequently asymptomatic and lesions are discovered incidentally. Few present with nonspecific symptoms, such as abdominal pain, or sequelae of metastatic spread.
Wide-spread availability and improved resolution of cross sectional CT imaging has increased detection of pancreatic cystic neoplasms, with a prevalence of 3% in the general population. While cystic neoplasms as a whole account for less than 10% of all pancreatic lesions, accurate identification …show more content…
Contrast enhanced CT demonstrates enhancement of the cyst wall and internal septations, if multilocular.
Differentiation of mucinous cystadenomas versus cystadenocarcinomas is often difficult based on imaging alone. Certain morphologic characteristics, however, increase index of suspicious for malignancy. Increased size, thickened or irregular cyst-wall, thickened septations, peripheral calcifications, intracystic solid areas, or a bordering solid lesion increase the likelihood of malignancy. MCN rarely present with metastases, but when seen, confirms …show more content…
Pseudocysts represent roughly 80% of all pancreatic cystic lesions. Affected patients often have a history of chronic alcohol abuse, acute pancreatitis, or abdominal trauma. CT imaging demonstrates a round, homogenous, hypodense cyst with near water density and a well-defined fibrous wall, which enhances with contrast. Parenchymal inflammatory changes and infiltration of the peripancreatic fat are suggestive. Serous cystadenomas are benign lesions, most commonly seen in the head of the pancreas. These can be oligocystic or microcystic, with multiple 5-29 mm cysts present within a larger pancreatic cyst. On contrast enhanced CT, a thin enhancing wall with a central fibrous scar is highly specific. An IPMT appears as a multicystic lesion with associated ductal dilation. A significantly dilated pancreatic duct may mimic a MCN on imaging. A bulging ampulla of Vater with mucus secretion and/or communication between cystic regions and the pancreatic duct on ERCP, however, are characteristic of
Wide-spread availability and improved resolution of cross sectional CT imaging has increased detection of pancreatic cystic neoplasms, with a prevalence of 3% in the general population. While cystic neoplasms as a whole account for less than 10% of all pancreatic lesions, accurate identification …show more content…
Contrast enhanced CT demonstrates enhancement of the cyst wall and internal septations, if multilocular.
Differentiation of mucinous cystadenomas versus cystadenocarcinomas is often difficult based on imaging alone. Certain morphologic characteristics, however, increase index of suspicious for malignancy. Increased size, thickened or irregular cyst-wall, thickened septations, peripheral calcifications, intracystic solid areas, or a bordering solid lesion increase the likelihood of malignancy. MCN rarely present with metastases, but when seen, confirms …show more content…
Pseudocysts represent roughly 80% of all pancreatic cystic lesions. Affected patients often have a history of chronic alcohol abuse, acute pancreatitis, or abdominal trauma. CT imaging demonstrates a round, homogenous, hypodense cyst with near water density and a well-defined fibrous wall, which enhances with contrast. Parenchymal inflammatory changes and infiltration of the peripancreatic fat are suggestive. Serous cystadenomas are benign lesions, most commonly seen in the head of the pancreas. These can be oligocystic or microcystic, with multiple 5-29 mm cysts present within a larger pancreatic cyst. On contrast enhanced CT, a thin enhancing wall with a central fibrous scar is highly specific. An IPMT appears as a multicystic lesion with associated ductal dilation. A significantly dilated pancreatic duct may mimic a MCN on imaging. A bulging ampulla of Vater with mucus secretion and/or communication between cystic regions and the pancreatic duct on ERCP, however, are characteristic of