Abstract
The patient was a 74-year old woman who had been followed for a cystic tumor at the pancreas tail 4cm in diameter in an outpatient basis since the age of 64. The tumor diameter gradually increased at first, but ERP performed four years after her first visit disclosed communication between the main pancreatic duct and the cyst. Four years and four months later she developed acute pancreatitis. And further three months later the tumor enlarged to the diameter of 7 cm. The patient had epigastric distress about 10 years after her first visit when the tumor further enlarged to the diameter of 11 cm. ERP showed disappearance of the communication between the main pancreatic duct and the cyst. Mucinous cystic neoplasm of the pancreas was likely and resection of the pancreas tail with splenectomy was performed. The tumor was a cystic lesion having a thick fibrous capsule with part of ovary like stroma. Mucinous cystadenoma was thus diagnosed.
Since mucinous cystic neoplasm of the pancreas has malignant potential, it carries poor prognosis in malignant cases, and we often have difficulties in differentiation between benign and malignant lesions before surgery, surgical resection is recommended. We experienced a case of mucinous cystic neoplasm of the pancreas resected after a long-term observation of the clinical course that might offer some explanation for natural course of this disease. Accordingly we present the case with a review of the literature.
