PMC9816456_01
Imaging examinations. (a) Preoperative CT. (b) Preoperative MRI. The left abdominal cavity shows a massive mass (15 cm x 12 cm). There were septa and wall nodules, and the enhanced scanning septum and wall nodules were significantly enhanced. The adjacent peritoneum was slightly thickened, and the adjacent pancreas was pressurized and pushed upward, with an unclear boundary with the lesion. (c) Postoperative CT at 3 months after surgery.
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Abdominal enhanced computed tomography (CT) revealed a large mass with an unclear boundary at the lower margin of the pancreas (Figure 1a). There were septa and wall nodules (Figure 1b). The abdominal wall had no special structure (Figure 1). A follow-up CT scan revealed no obvious lesion (Figure 1c).
(a) Gross examination showing a 27 cm long, 2.5 cm diameter colon specimen without a difference in the mucous membrane. The external side of the intestinal wall showed a cystic neoplasm of 16 cm x 12 cm x 3.5 cm, with a cystic wall thickness of 0.3-1.4 cm. The multilocular lesion contained a turbid purulent thick liquid. Most of the capsule wall was smooth, with local, visible nodular protrusions. The cystic wall originated near the pancreas, which was 12 cm x 3.5 cm x 1.4 cm. The spleen was 14 cm x 8 cm x 2.5 cm, palm red, soft, and without obvious nodules and masses. (b) Well-differentiated columnar cells and ovarioid stroma (x20). (c) Cells were arranged in pseudostratification. The nuclei were enlarged and crowded, vacuolated, and visible (x400).
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An exploratory laparotomy was performed on December 19, 2019, and a large thick-walled cystic lesion filled with a turbid purulent thick liquid was found (Figure 2a). The tumor was composed of two distinct components: epithelial cells and dense spindle cells (Figure 2b). At high magnification, a small number of tumor cells were well-differentiated and columnar (Figure 2c). The nuclei were enlarged, crowded, vacuous, and visible (Figure 2c).