Cystic Pancreatic Mass in an 81-Year Old Lady Presenting with an Abnormal LFT

Clinical History

An 81-year old lady presented with acute deterioration of her recent liver function tests which progressively worsened. ALP – 890, Bilirubin 28, ALT 195.

Case Description

Abdominal ultrasound performed revealed the presence of a 42 mm complex cystic lesion (cystic pancreatic mass) at the pancreatic head. The gallbladder was also distended with a thickened and oedematous wall morphology. Also, there was sludge seen within the gallbladder lumen. The common bile duct was dilated at 9 mm in AP calibre.

Diagnosis/ Discussion/ Treatment/ Follow up

The patient was referred to have an MRCP which confirmed the ultrasound findings including the complex cystic lesion at the pancreatic head which was suggested to be due an IPMN.

IPMNs are commonly benign tumours, however, some have been reported to progress into being cancerous. In this case, the cystic pancreatic lesion was causing some biliary obstruction.