Cystic pancreatic neoplasm in pregnancy: a case report and review of the literature.

Mucinous cystic neoplasms of the pancreas are rare tumors that tend to occur in young women. They are thought to be responsive to sex hormones. We report a case of a 32-year-old pregnant woman with a 7-month history of pain and a left upper quadrant abdominal mass. She arrived at the emergency department with exacerbation of her symptoms during week 15 of gestation. Findings from ultrasonography and magnetic resonance imaging suggested a pancreatic cyst. Percutaneous aspiration of the cyst fluid yielded mucinous fluid with an elevated carcinoembryonic antigen level. The patient underwent a spleen-preserving distal open pancreatectomy. We present herein a brief review of the current literature on mucinous cystic neoplasms during pregnancy. On the basis of our experience and the existing knowledge of this condition, we advocate resection during the second trimester with splenic preservation.

[1]  N. Carrère,et al.  Spleen-preserving Distal Pancreatectomy with Excision of Splenic Artery and Vein: A Case-matched Comparison with Conventional Distal Pancreatectomy with Splenectomy , 2007, World Journal of Surgery.

[2]  P. Rhee,et al.  Splenectomy for Trauma Increases the Rate of Early Postoperative Infections , 2006, The American surgeon.

[3]  D. Sahani,et al.  Cystic pancreatic lesions: a simple imaging-based classification system for guiding management. , 2005, Radiographics : a review publication of the Radiological Society of North America, Inc.

[4]  B. Goh.  Diagnosis of pancreatic cystic neoplasms: a report of the cooperative pancreatic cyst study. , 2005, Gastroenterology.

[5]  N. Inaba,et al.  Huge mucinous cystadenoma of the pancreas developing during pregnancy: a case report. , 2005, Pancreas.

[6]  E. L. López-Tomassetti Fernández,et al.  Mucinous cystic neoplasm of the pancreas during pregnancy: the importance of proper management. , 2005, Journal of hepato-biliary-pancreatic surgery.

[7]  G. Pelosi,et al.  Expression of progesterone receptors in solid-cystic tumour of the pancreas , 2005, Virchows Archiv A.

[8]  Andrew L Warshaw,et al.  Cystic Neoplasms of the Pancreas , 2006 .

[9]  Elizabeth Lee-Lewandrowski,et al.  Diagnosis of pancreatic cystic neoplasms: a report of the cooperative pancreatic cyst study. , 2004, Gastroenterology.

[10]  A. Duarte-Rojo,et al.  Pancreas: a sex steroid-dependent tissue. , 2001, The Israel Medical Association journal : IMAJ.

[11]  A. Scarpa,et al.  Mucinous cystic tumors of the pancreas: clinicopathological features, prognosis, and relationship to other mucinous cystic tumors. , 1999, The American journal of surgical pathology.

[12]  G. Ganepola,et al.  Are Pancreatic Tumors Hormone Dependent?: A Case Report of Unusual, Rapidly Growing Pancreatic Tumor during Pregnancy, Its Possible Relationship to Female Sex Hormones, and Review of the Literature , 1999, The American surgeon.

[13]  R. Becker,et al.  Mucinous cystic neoplasm (mucinous cystadenocarcinoma of low-grade malignant potential) of the pancreas: a clinicopathologic study of 130 cases. , 1999, The American journal of surgical pathology.

[14]  J. Mclaughlin,et al.  Cancer risk after splenectomy , 1995, Ugeskrift for laeger.

[15]  J. Olsen,et al.  Cancer risk after splenectomy. , 1995, Cancer.

[16]  M. Machado,et al.  [Cystic neoplasm of the pancreas: analysis of 24 cases]. , 1994, Revista do Hospital das Clinicas.

[17]  M. Olsen.  Pancreatic mucinous cystadenoma during pregnancy , 1993 .

[18]  C. Scott-Conner,et al.  Distal pancreatectomy with and without splenectomy. A comparative study. , 1989, The American surgeon.

[19]  J. Oertel,et al.  Mucinous cystic neoplasms of the pancreas with overt and latent malignancy (cystadenocarcinoma and cystadenoma). A clinicopathologic study of 41 cases. , 1978, American journal of clinical pathology.