PMC4812127_01
Computed tomography revealed a large complex cystic and solid mass in the body and tail of the pancreas.
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Abdominal computed tomography (CT) revealed a large complex cystic and solid mass measuring 10x12.5 cm in the body and tail of the pancreas with a thick capsule (Fig. 1) and ascites in the pouch of Douglas.
Endoscopic retrograde cholangiopancreatography revealed disruption of the duct of Wirsung in the body of the pancreas.
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Endoscopic retrograde cholangiopancreatography revealed disruption of the major pancreatic duct, the duct of Wirsung, in the body of the pancreas (Fig. 2).
Distal pancreatectomy combined with splenectomy and partial resection of the transverse colon was performed.
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En bloc distal pancreatectomy with lymphadenectomy, splenectomy and partial resection of the transverse colon was performed (Fig. 3).
The cut surface of the cystic mass exhibited a smooth external surface. The mass was filled with mucinous fluid with a solid component.
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The cut surface of the cystic mass exhibited a smooth external surface, and it was filled with mucinous fluid and a solid component (Fig. 4).
(A) Histopathological analysis revealed mucinous cystic neoplasm compatible with ovarian-type stromal tissue. (B) Immunohistochemistry revealed positive staining for progesterone and estrogen receptors in stromal cell nuclei. (C) Spindle and pleomorphic tumor cells were positive for immunohistochemical staining for both cytokeratin AE1/AE3 and vimentin in the solid area of the tumor, compatible with anaplastic carcinoma.
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Histopathological analysis revealed MCN compatible with ovarian-type stromal tissue (Fig. 5A). Immunohistochemical analysis revealed positive staining for progesterone receptor in stromal cell nuclei (Fig. 5B). In addition, anaplastic carcinoma was suggested since the spindle and pleomorphic tumor cells stained positive for cytokeratin AE1/AE3 and vimentin in the solid area of the tumor (Fig. 5C).