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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.