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Special Feature
October 1, 2003

Image of the Month—Quiz Case

Author Affiliations

From the Department of Surgery, Basque Country University School of Medicine, San Sebasti[[aacute]]n, Spain.



Arch Surg. 2003;138(10):1157. doi:10.1001/archsurg.138.10.1157

WIDESPREAD USE of abdominal imaging techniques has resulted in increasing diagnoses of pancreatic cyst and masses, which are asymptomatic otherwise. This has produced a growing interest in more acute and refined preoperative diagnostic interventions to guide surgical approach and technique.

A 57-year-old woman had symptoms of epigastric fullness and a palpable mass. A computed tomographic (CT) scan showed a well-defined pancreatic tumor localized in the body (Figure 1). The patient was scheduled for surgery. At celiotomy, a large capsulated pancreatic tumor was identified, and a distal near-total pancreatectomy with splenectomy was performed (Figure 2). The patient recovered uneventfully and is free of disease 8 years later. Results of a glucose tolerance test are within normal limits despite extended pancreatic resection.

What Is the Diagnosis?

A. Hydatid disease of the pancreas

B. Giant serous microcystic adenoma of the pancreas

C. Mucinous cystic neoplasm of the pancreas

D. Papillary cystic neoplasm of the pancreas

Corresponding author and reprints: Echenique-Elizondo, MD, Basque Country University, Unidad Docente de Medicina de San Sebastián, Paseo Dr Beguiristain, 105, 20014 San Sebastián, Spain (e-mail: