PMC6833349_01
Enhanced computed tomography findings.. Enhanced abdominal computed tomography showed the tumor (white arrow) adjacent to the common bile duct.
gr1.jpg
PMC6833349_01_gr1.jpg
fig0005
Annual follow-up for breast cancer by contrasted computed tomography (CT) showed an intraductal papillary mucinous neoplasm (IPMN) in the pancreas head and an enhanced tumor image around the hepatoduodenal ligament (Fig. 1).
Endoscopic ultrasonography findings.. Endoscopic ultrasonography demonstrated the tumor (white arrow) at the junction of the cystic duct. On Sonazoid-enhanced echo, the tumor was universally enhanced.
gr2.jpg
PMC6833349_01_gr2.jpg
fig0010
The tumor was located at the junction of the cystic duct and was enhanced with Sonazoid (Fig. 2).
Magnetic resonance cholangiopancreatography findings.. Magnetic resonance cholangiopancreatography findings show that the tumor (white arrow) had a slightly high signal on T2 weighted imaging. The remnant cystic duct was dilated by the tumor, which displayed high intensity on T2 weighted imaging (arrowhead).
gr3.jpg
PMC6833349_01_gr3.jpg
fig0015
Magnetic resonance cholangiopancreatography (MRCP) showed that the tumor presented with a slightly high signal on T2 weighted imaging, and the periphery remnant cystic duct of the tumor presented as a high-intensity lesion on T2 weighted imaging (Fig. 3).
Macroscopic findings.. Macroscopic findings had two components; the dilated remnant cyst with white bile (arrowhead), and the whitish main tumor with substantial neurofibrotic changes (white arrow).
gr4.jpg
PMC6833349_01_gr4.jpg
fig0020
Macroscopic findings had two components; the dilated remnant cyst with white bile, and the whitish main tumor with substantial neurofibrotic changes (Fig. 4).
Pathological findings.. The tumor was stained by anti S-100 antibody (white arrow). The wall of the cystic duct (black arrow) was compressed by the tumor, narrowing the intraductal space (black arrowhead).
gr5.jpg
PMC6833349_01_gr5.jpg
fig0025
Immunohistological examination revealed that the AN was compressing the cystic duct from the outside (Fig. 5).