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Case Reports
. 2020 Oct 7;13(10):e236255.
doi: 10.1136/bcr-2020-236255.

Pancreatic mesothelial cyst

Charbel Chater  1   2 , Joseph Obeid Obeid  3   2 , Seba Mhanna  3   2
Affiliations
Case Reports

Pancreatic mesothelial cyst

Charbel Chater et al. BMJ Case Rep. .

Abstract

A 60-year-old woman was investigated for abdominal pain and increasing asthenia. Abdominal CT revealed a 25 mm hypodense cystic lesion in the tail of the pancreas. MRI showed a multiloculated cystic lesion, T1-hypointense and T2-hyperintense lesion, without wall enhancement. Endoscopic ultrasound detected a 25 mm multi-loculated cystic lesion, with regular margin and without pancreatic duct communication. Diagnosis of pancreatic mucinous cystadenoma was discussed and the patient was referred to surgery. She underwent distal pancreatectomy with spleen preservation. Pathological examination revealed the diagnosis of pancreatic mesothelial cyst. Histologically, the cyst was multiloculated, lined by cuboidal epithelium, ovoid nuclei and amphophilic cytoplasm, without mucin deposition or cytological atypia. Immunohistochemistry examination revealed positive staining for cytokeratin 5/6, vimentin and calretinin. At 1-year follow-up, she is in her usual health, without any symptoms.

Keywords: gastrointestinal surgery; general surgery; pancreas and biliary tract.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Abdominal CT revealing hypodense cystic lesion in the tail of the pancreas.
Figure 2
Figure 2
MRI showing a multiloculated cystic lesion, without wall enhancement after injection of gadolinium-based contrast.
Figure 3
Figure 3
Intraoperative picture showing the mesothelial cyst in the tail of the pancreas.
Figure 4
Figure 4
Pathological findings showing cyst wall lined by cuboidal epithelium, with ovoid nuclei and amphophilic cytoplasm.
Figure 5
Figure 5
Pathological findings showing multiloculated cyst without mucin deposition or cytological atypia. The rest of the pancreas tissue is unremarkable.
See this image and copyright information in PMC

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