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Giant pancreatic pseudocyst with internal debris

Published:February 12, 2023DOI:
      A 31-year-old man presented with a 6-month history of occasional abdominal distension. He suffered from alcohol abuse and reported having pancreatitis 8 months ago. He had no history of gallstone disease. Abdominal CT showed a large peripancreatic cystic mass (Fig. 1A) with a smooth surface and internal debris (Fig. 1B). Abdominal MR revealed the cystic mass with high signal intensity on T1WI and T2WI. Internal debris appeared as marked high signal intensity on T1WI (Fig. 1C) and low signal intensity on T2WI (Fig. 1D). Coronal maximum intensity projection (Fig. 1E) stereoscopically showed the cystic mass, measuring 25 × 15 × 22 cm. Tumor markers were normal, including alpha fetoprotein, carcinoembryonic antigen and cancer antigen 199. The patient underwent laparoscopic Roux-en-Y cystojejunostomy and surgical findings revealed brown liquid in the cyst. Histopathology (Fig. 1F) confirmed the pseudocyst with no epithelial lining and a fibrocollagenous wall.
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