Presentation
Abdominal discomfort.
Patient Data
Multilobulated cystic mass of the neck of the pancreas composed of numerous small cysts "bunch of grapes" not communicating with the main pancreatic duct. It elicits a low signal on T1, high signal on T2 and T2 fat sat with a central fibrous scar of low signal. The postcontrast sequences show mild enhancement of the fibrous septa. No restricted diffusion is seen on DWI-ADC.
small simple hepatic cyst of the right lobe is noted.
Case Discussion
MRI features suggestive of serous cystadenoma the pancreas which is considered as an uncommon type of benign cystic pancreatic neoplasm with a strong female predilection.
On imaging, the main differential diagnoses include:
intraductal papillary mucinous tumor (IPMN) of the pancreas: communicates with pancreatic ducts
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mucinous cystic neoplasm of the pancreas (e.g. mucinous cystadenoma)
calcification tends to be peripheral
usually unilocular
if multilocular type, individual cysts tend to be >20 mm in size
solid pseudopapillary tumor with cystic changes and necrosis