Giant Mucinous Cystadenoma of the Pancreatic Tail in a Young Adult Patient: A Case Report

Abstract

Background: Mucinous cystic neoplasms of the pancreas are uncommon premalignant lesions that occur predominantly in women and usually arise in the pancreatic body or tail. Giant lesions may present with nonspecific symptoms and create substantial operative difficulty because of their relationship with adjacent vessels and viscera. Case Presentation: A 38-year-old woman with no previous medical history presented with a 6-month history of epigastric and left hypochondrial pain. Physical examination identified a mobile mass in the left hypochondrium. Computed tomography and magnetic resonance imaging demonstrated a 10 × 11 cm cystic lesion centred in the pancreatic tail, with close relationships to the spleen, stomach, aorta, coeliac trunk, diaphragm, renal hilum, and jejunal loops. Tumour markers were within normal limits. Through a midline laparotomy, the patient underwent distal pancreatectomy with splenectomy and gastric wedge resection. Histopathological examination confirmed a benign, non-invasive mucinous cystic neoplasm without malignant cells. The postoperative course was uncomplicated; no pancreatic fistula occurred, and the patient was discharged on postoperative day 4. At follow-up visits conducted at 3 months, 6 months, and 1 year, she remained well, and follow-up computed tomography showed no recurrence. Conclusion: This case demonstrates that a giant pancreatic tail mucinous cystic neoplasm may remain non-invasive despite its size. Careful preoperative characterisation and an individualised operative strategy are important when the lesion is closely related to major vascular and visceral structures.