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Image of the Month—Quiz Case
Giuseppe Portale, MD;
Emanuela Guirroli, MD;
Mario Costantini, MD;
Giovanni Zaninotto, MD;
Sabrina Rampado, MD;
Ermanno Ancona, MD
Arch Surg. 2007;142(4):401.
INTRODUCTION
A 63-year-old otherwise healthy woman presented with a 2-month history of right-upper quadrant and epigastric abdominal pain. She denied experiencing nausea, vomiting, fever, or weight loss. Physical examination revealed a discrete intra-abdominal mass that was elastic and freely mobile in all directions. Laboratory findings were unremarkable. Surgical history was positive for appendectomy and hysterectomy.
Ultrasound and magnetic resonance imaging of the abdomen revealed a cystic lesion in the right hypochondrium, close to the duodenum and the gastric antrum, with a thick and irregular wall and thin septa inside the cyst (Figure 1).
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Figure 1. Magnetic resonance images revealed an inhomogeneous, well-delineated mass with a size of 6 x 6 cm, which was hypointense on T1-weighed spin echo images and intensely hyperintense on T2-weighted spin echo images.
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What Is the Diagnosis?
A. Pancreatic cyst neoplasm
B. Cystic lymphangioma
C. Cystic mesothelioma
D. Duodenal duplication cyst
Answer
Author Affiliations: Department of Medical and Surgical Sciences, Clinica Chirurgica III, University of Padova School of Medicine, Padova, Italy.
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Image of the Month—Diagnosis
Arch Surg. 2007;142(4):402.
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