DOI QR코드

DOI QR Code

Mucinous Cystic Neoplasm of the Pancreas Presenting with Acute Pancreatitis, Initially Misdiagnosed as a Pseudocyst

가성낭종으로 오인된 급성 췌장염을 동반한 점액성 낭성종양 1예

  • Kim, So Yeon (Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Moon, Sung-Hoon (Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Kim, Dong Hoon (Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Park, Dong Seon (Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • An, Jung Sun (Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Kim, Seong Yeol (Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Kim, Jong Hyeok (Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine)
  • 김소연 (한림대학교 의과대학 한림대학교성심병원 소화기내과) ;
  • 문성훈 (한림대학교 의과대학 한림대학교성심병원 소화기내과) ;
  • 김동훈 (한림대학교 의과대학 한림대학교성심병원 병리학과) ;
  • 박동선 (한림대학교 의과대학 한림대학교성심병원 소화기내과) ;
  • 안정선 (한림대학교 의과대학 한림대학교성심병원 소화기내과) ;
  • 김성열 (한림대학교 의과대학 한림대학교성심병원 소화기내과) ;
  • 김종혁 (한림대학교 의과대학 한림대학교성심병원 소화기내과)
  • Received : 2013.08.28
  • Accepted : 2013.12.30
  • Published : 2014.07.01

Abstract

Pancreatic cystic lesions include retention cysts (congenital cysts), pseudocysts, and cystic neoplasms. Pancreatic cystic neoplasms have recently been diagnosed more commonly, possibly due to advances in imaging and widespread screening programs. Cystic neoplasms of the pancreas account for 10-20% of pancreatic tumors. Mucinous cystic neoplasms (MCN) and intraductal papillary mucinous neoplasms are regarded as premalignant lesions, whereas serous cystadenoma is not. In the clinical setting of acute pancreatitis, pancreatic cystic lesions are usually diagnosed as pseudocysts. However, cystic neoplasms of the pancreas should be considered in the differential diagnosis of pancreatic cysts, even in patients with a history of pancreatitis. In the Korean literature, MCN combined with acute pancreatitis has rarely been reported. Here, we report a case of MCN presenting with acute pancreatitis in a 22-year-old female, which was initially misdiagnosed as pancreatic pseudocyst.

췌장염 환자의 경우에 췌장 내에 동반된 낭종성 병변이 관찰된다면 보통 췌장의 가성낭종으로 생각되어 보존적 치료와 경과관찰하는 경우가 많다. 저자들은 급성 췌장염으로 내원한 환자에서 이에 동반된 췌장의 낭성병변에 대해 가성낭종으로 추정진단하고 12개월 동안 추적관찰했으나 그 낭성병변이 점액성 낭성종양으로 최종 진단된 증례를 경험하여 문헌고찰과 함께 보고한다.

Keywords

References

  1. Kim HG. Differential diagnosis of cystic diseases of pancreas. Korean J Med 2010;78:279-288.
  2. Jeurnink SM, Vleggaar FP, Siersema PD. Overview of the clinical problem: facts and current issues of mucinous cystic neoplasms of the pancreas. Dig Liver Dis 2008;40:837-846. https://doi.org/10.1016/j.dld.2008.03.018
  3. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis: 2012: revision of the Atlanta classification and definitions by international consensus. Gut 2013;62:102-111. https://doi.org/10.1136/gutjnl-2012-302779
  4. Volkan Adsay N. Cystic lesions of the pancreas. Mod Pathol 2007;20(Suppl 1):S71-93. https://doi.org/10.1038/modpathol.3800706
  5. Kim JS. Pancreatic cystic lesion. Korean J Gastrointestinal Endosc 2008;36(Suppl 1):263-268.
  6. Spence RA, Dasari B, Love M, Kelly B, Taylor M. Overview of the investigation and management of cystic neoplasms of the pancreas. Dig Surg 2011;28:386-397. https://doi.org/10.1159/000334758
  7. Tanaka M, Fernandez-del Castillo C, Adsay V, et al. International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology 2012;12:183-197. https://doi.org/10.1016/j.pan.2012.04.004
  8. Kim JC, Kim MH, Lee TY, et al. Clinicopathologic review of 41 cases of pancreatic mucinous cystic neoplasms. Korean J Gastroenterol 2008;51:34-39.
  9. Crippa S, Salvia R, Warshaw AL, et al. Mucinous cystic neoplasm of the pancreas is not an aggressive entity: lessons from 163 resected patients. Ann Surg 2008;247:571-579. https://doi.org/10.1097/SLA.0b013e31811f4449
  10. Youn KH, Kim MH, Park CS, et al. Pancreatic mucinous cystic neoplasm presented as recurrent pancreatitis with masquerading a pseudocyst. Korean J Gastrointest Endosc 1998;18:963-967.