A Case of a Pancreatic Mucinous Cystic Tumor Diagnosed during Pregnancy

Abstract

A 37-year-old woman presented with a cystic lesion in the pancreatic tail. Abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) revealed a 20-mm cystic mass in the tail of the pancreas. Additionally, endoscopic ultrasound (EUS) revealed a 25-mm structure with a cyst-like appearance, suggesting an intraductal papillary mucinous neoplasm (IPMN). She delivered her first child at 37 years of age. Abdominal CT performed 6 months after delivery revealed that the cystic mass had grown to 35 mm, with atrophy of the pancreatic tail and dilation of the main pancreatic duct. EUS revealed an enlargement of the cystic mass ; therefore, a laparoscopic distal pancreatectomy was performed. The postoperative course was uneventful ; the patient was discharged on the sixth day. Histopathological findings revealed that the cyst was lined by a poorly defined atypical cylindrical epithelium and ovarian-like stroma below the epithelium, consistent with a mucinous cystadenoma. No apparent recurrence was observed at follow-up, and the patient later gave birth to her second child without complications. Pregnancy may rapidly increase the size of mucinous cystic neoplasms (MCN). Thus, monitoring patients carefully during follow-up and considering possible surgery for patients who are pregnant is necessary.