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  Vol. 138 No. 10, October 2003 TABLE OF CONTENTS
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Image of the Month—Quiz Case

Miguel Echenique-Elizondo, MD
From the Department of Surgery, Basque Country University School of Medicine, San Sebastián, Spain.

Arch Surg. 2003;138:1157.

INTRODUCTION

WIDESPREAD USE of abdominal imaging techniques has resulted in increasing diagnoses of pancreatic cyst and masses, which are asymptomatic otherwise. This has produced a growing interest in more acute and refined preoperative diagnostic interventions to guide surgical approach and technique.

A 57-year-old woman had symptoms of epigastric fullness and a palpable mass. A computed tomographic (CT) scan showed a well-defined pancreatic tumor localized in the body (Figure 1). The patient was scheduled for surgery. At celiotomy, a large capsulated pancreatic tumor was identified, and a distal near-total pancreatectomy with splenectomy was performed (Figure 2). The patient recovered uneventfully and is free of disease 8 years later. Results of a glucose tolerance test are within normal limits despite extended pancreatic resection.



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Figure 1.




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Figure 2.



What Is the Diagnosis?
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A. Hydatid disease of the pancreas

B. Giant serous microcystic adenoma of the pancreas

C. Mucinous cystic neoplasm of the pancreas

D. Papillary cystic neoplasm of the pancreas

Answer


AUTHOR INFORMATION
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Corresponding author and reprints: Echenique-Elizondo, MD, Basque Country University, Unidad Docente de Medicina de San Sebastián, Paseo Dr Beguiristain, 105, 20014 San Sebastián, Spain (e-mail: gepecelm{at}sc.ehu.es).

SECTION EDITOR: GRACE S. ROZYCKI, MD


RELATED ARTICLE

Image of the Month—Diagnosis
Arch Surg. 2003;138(10):1158.
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