PMC8286360_01
Magnetic resonance imaging. (A) Axial T2-weighted image showing T2 hyperintense lesion in the pancreatic tail (*) with proximal ductal dilatation (dotted red arrow). (B) Reformatted T2-weighted image showing the communication between the lesion and the collection (solid red arrow). (C) Reconstructed volume-rendered image showing the dilated and the relation of the collection
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F1
Magnetic resonance cholangiopancreatography (MRCP) confirmed the suspicion of pancreatic duct communication with an associated proximal duct dilatation (Fig. 1).
Intraoperative image. (A) Collection bulging through the transverse colon (*). (B) After complete mobilization of the pancreatic tail and the spleen. (C) Opening of the fistula between the lesion and the pancreatic duct (solid black arrow)
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F2
Intraoperatively, serous fluid of 300 mL in the lesser sac was found tracking along the superior border of the pancreas from body to tail and abutting the transverse mesocolon (Fig. 2). Pancreatic duct disruption was noted at the level of body with mucinous material around the duct (Fig. 2).
Photomicrograph of H&E of resected specimen. (A) High-power field (40x) showing presence of ovarian stroma (*). (B) High-power field (40x) showing the presence of adjacent pancreatic acinar tissue (black solid arrow) and dilated pancreatic duct with inspissated mucinous material (dotted black arrow). (C) High-power field (100x) showing corpora albicans. (D) High-power field (40x) showing dilated pancreatic duct
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F3
Histopathological examination was consistent with the ruptured benign epithelial cystic lesion with ovarian type stroma arising from distal pancreas suggestive of the mucinous cystadenoma (Fig. 3).