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. Sonograms Dilated CBD measuring 9 mm in AP calibre A distended thin-walled gallbladder containing some sludge within its lumen A cystic lesion at the head of the pancreas (HOP) adjacent to the thick-walled gallbladder Cystic lesion at the head of pancreas (HOP) with some normal pancreatic tissues seen around it Published on: September 12, 2024
