PMC6147936_01
Percutaneous transhepatic cholangiography shows dilatation of intrahepatic biliary ducts and common bile duct obstruction.
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Percutaneous transhepatic cholangiography confirmed that a pressure effect on the common bile duct had impaired its filling (Figure 1).
Endoscopic retrograde cholangiopancreatography shows displacement of pancreatic duct. Common bile duct is invisible.
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Endoscopic retrograde cholangiopancreatography (ERCP) showed that pancreatic and choledochal ducts were parted due to a large mass, while being compressed because of a pressure effect (Figure 2).
CT scan demonstrates two calcified deposits inside the cyst, which proved to be two teeth.
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In axial sections of a contrast-enhanced abdominal CT scan, a hypodense cystic mass with sharp borders and containing dense and calcified opacities appeared at the head and the uncinate process of the pancreas (Figure 3).
PMC6147936_02
Necrotic pancreatic tissue (lower portion) is distinguishable in cyst wall (upper portion). Note that the cyst lining is ulcerated and inflamed.(X50 H&E)
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Gross pathological examination of the cyst proved the diagnosis of mature teratoma of the pancreas (Figure 4).
The wall of the dermoid cyst lined with keratinizing squamous epithelium and containing well-developed hair follicles and sebaceous glands. (X100 H&E)
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The tumor contained hair and histological elements of the skin appendages (Figure 5).