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Special Feature
April 01, 2007

Image of the Month—Quiz Case

Author Affiliations

Author Affiliations: Department of Medical and Surgical Sciences, Clinica Chirurgica III, University of Padova School of Medicine, Padova, Italy.


Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007

Arch Surg. 2007;142(4):401. doi:10.1001/archsurg.142.4.401

A 63-year-old otherwise healthy woman presented with a 2-month history of right-upper quadrant and epigastric abdominal pain. She denied experiencing nausea, vomiting, fever, or weight loss. Physical examination revealed a discrete intra-abdominal mass that was elastic and freely mobile in all directions. Laboratory findings were unremarkable. Surgical history was positive for appendectomy and hysterectomy.

Ultrasound and magnetic resonance imaging of the abdomen revealed a cystic lesion in the right hypochondrium, close to the duodenum and the gastric antrum, with a thick and irregular wall and thin septa inside the cyst (Figure 1).

Image not available

Magnetic resonance images revealed an inhomogeneous, well-delineated mass with a size of 6 × 6 cm, which was hypointense on T1-weighed spin echo images and intensely hyperintense on T2-weighted spin echo images.

What Is the Diagnosis?

 Pancreatic cyst neoplasm

 Cystic lymphangioma

 Cystic mesothelioma

 Duodenal duplication cyst