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A Case Report of Side Branch Intra-Ductal Papillary Mucinous Neoplasm of Pancreas


Dr. Pavankumar Suraparaju Varaprasadvarma, Dr. Anjali Pawar
Pages: 61-76
ISBN: 978-93-5834-667-1


Research Trends and Case Reports in Radiology (Volume -1)

Research Trends and Case Reports in Radiology
(Volume - 1)

Abstract

Learning objective To study the imaging features in USG, CECT & MRCP of side branch Intraductal Papillary Mucinous Neoplasm (IPMN) and correlate with its pathological findings. Background Intraductal Papillary mucinous neoplasm is benign neoplastic lesion of pancreas characterised by ductal dilation, intraductal papillary growth, and thick mucus secretion. The incidence of IPMNs are rare with estimates between 0.48-2.04 per 100,000 persons [1]. According to location IPMNs can be main duct type, branch type or mixed type. It is characterised by intraductal proliferation of papillary mucin-secreting cells, multiple cysts and variable degrees of cellular atypia. Clinical presentation includes recurrent episodes of abdominal pain mimicking acute pancreatitis or overt signs of chronic pancreatitis due to duct destruction. Case & Imaging details We present a 25yr old female patient with complaints of epigastric pain since 1 month, no c/o vomiting/ fever/jaundice. The patient underwent USG, CECT and MRCP scans. CECT and MRCP scans were suggestive of pancreatic benign cystic lesion likely Side branch IPMN. Under USG guidance Fine needle aspiration cytology done and it was negative for malignant cells. Amylase, lipase and Carcino-embryonic antigen levels were raised favouring side branch IPMN. The patient was taken for surgical resection. Conclusion Side branch IPMN is rare in incidence. Radiological imaging and treatment options of IPMN may change depending on the type and size of the tumor and components of the accompanying soft tissue. IPMN has relatively better prognosis as compared to other cystic neoplasms. The main ductus type and mixed-type IPMN have high malignancy potential Moreover, it can be misdiagnosed as diseases such as chronic pancreatitis and pseudocyst.

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