Mederos MA, Villafañe N, Dhingra S, Farinas C, McElhany A, Fisher WE, Van Buren II G. Pancreatic endometrial cyst mimics mucinous cystic neoplasm of the pancreas. World J Gastroenterol 2017; 23(6): 1113-1118 [PMID: 28246486 DOI: 10.3748/wjg.v23.i6.1113]
Corresponding Author of This Article
George Van Buren II, MD, Assistant Professor, Department of General Surgery, Baylor College of Medicine, 6620 Main St, Suite 1350, Houston, TX 77030, United States. george.vanburen@bcm.edu
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Feb 14, 2017; 23(6): 1113-1118 Published online Feb 14, 2017. doi: 10.3748/wjg.v23.i6.1113
Pancreatic endometrial cyst mimics mucinous cystic neoplasm of the pancreas
Michael A Mederos, Nicole Villafañe, Sadhna Dhingra, Carlos Farinas, Amy McElhany, William E Fisher, George Van Buren II
Michael A Mederos, Nicole Villafañe, Amy McElhany, William E Fisher, George Van Buren II, Department of General Surgery, Baylor College of Medicine, Houston, TX 77030, United States
Sadhna Dhingra, Department of Pathology, Baylor College of Medicine, Houston, TX 77030, United States
Carlos Farinas, Department of Radiology, Baylor College of Medicine, Houston, TX 77030, United States
Author contributions: Mederos MA and Villafañe N designed the report and wrote the paper; Amy M assisted in writing and editing the paper; Fisher WE assisted in writing and editing the paper; Van Buren II G performed the surgery, collected the patient’s clinical data, designed the report and wrote the paper; Dhingra S reviewed the pathology, selected the images, and wrote the paper; Farinas C reviewed the imaging, selected the images, and wrote the paper.
Institutional review board statement: After approval from the institutional review board through Baylor College of Medicine tissue and clinical information was obtained.
Informed consent statement: The patient provided informed consent for the study.
Conflict-of-interest statement: None of the authors have any conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: George Van Buren II, MD, Assistant Professor, Department of General Surgery, Baylor College of Medicine, 6620 Main St, Suite 1350, Houston, TX 77030, United States. george.vanburen@bcm.edu
Telephone: +1-7137982262 Fax: +1-713798258
Received: September 30, 2016 Peer-review started: September 30, 2016 First decision: December 19, 2016 Revised: January 13, 2017 Accepted: January 17, 2017 Article in press: January 17, 2017 Published online: February 14, 2017 Processing time: 135 Days and 10.6 Hours
Abstract
Pancreatic cysts include a variety of benign, premalignant, and malignant lesions. Endometrial cysts in the pancreas are exceedingly rare lesions that are difficult to diagnose pre-operatively. This report describes the findings in a 43-year-old patient with a recent episode of acute pancreatitis who presented with a large cyst in the tail of the pancreas. Imaging demonstrated a loculated pancreatic cyst, and cyst fluid aspiration revealed an elevated amylase and carcinoembryonic antigen. The patient experienced an interval worsening of abdominal pain, fatigue, diarrhea, and a 15-pound weight loss 3 mo after the initial episode of pancreatitis. With concern for a possible pre-malignant lesion, the patient underwent a laparoscopic distal pancreatectomy with splenectomy, which revealed a 16 cm × 12 cm × 4 cm lesion. Final histopathology was consistent with an intra-pancreatic endometrial cyst. Here we discuss the overlapping imaging and laboratory features of pancreatic endometrial cysts and mucinous cystic neoplasms of the pancreas.
Core tip: Intra-pancreatic endometrial cysts are an exceedingly rare entity. Imaging and laboratory assessments are valuable tools for diagnosing pancreatic cysts. However, pre-operative diagnosis of pancreatic endometrial cysts remains problematic. These lesions have overlapping radiographic and laboratory features with premalignant lesions, such as mucinous cystic neoplasms. Due to the diagnostic similarities between these rare endometrial cysts and the more common mucinous cystic lesions, the optimal diagnostic and therapeutic option is resection.
