Zain Lara, Sweity Raghad, Alshawwa Khaled, Bannoura Sami, Jaber Bashar, Abu-Zaydeh Omar
Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Department of General Surgery, Al-Makassed Charitable Society Hospital, Jerusalem, Palestine.
Front Surg. 2023 Mar 10;10:1148308. doi: 10.3389/fsurg.2023.1148308. eCollection 2023.
Enteric duplication cysts (EDCs) are a benign and uncommon congenital malformation, with a nonspecific and extremely variable clinical presentation. EDCs associated with the pancreas are called pancreatic duplication cysts (PDCs). They are especially rare and can present with recurrent abdominal pain or even severe pancreatitis. These cysts often get confused with pancreatic neoplasms or pseudocysts, thus posing diagnostic and surgical challenges. Here, we report a case of a 20-year-old male patient with a 14-year history of recurrent abdominal pain and many hospital admissions, who had several imaging studies revealing a persistent focal heterogeneous lesion affecting the tail of the pancreas, surrounding a small pseudocyst. An ultrasound (U/S) guided biopsy was avoided due to the location of the mass. Surgical resection was carried out for the suspicion of malignancy and final pathology report showed benign findings while revealing that what was thought to be a pseudocyst turned out to be a gastric-type PDC, and after reviewing the available literature, we encountered 16 similar cases regarding misdiagnosing PDCs. We conclude that PDCs are very rare and have a variable clinical presentation as well as a likelihood of being confused with other pancreatic neoplasms. Therefore, PDCs need a high index of suspicion to avoid recurrent hospital admissions and unnecessary procedures due to the fact that sometimes a simple cystectomy is adequate.
肠重复囊肿（EDCs）是一种良性且罕见的先天性畸形，临床表现不具特异性且极为多样。与胰腺相关的肠重复囊肿称为胰腺重复囊肿（PDCs）。它们尤为罕见，可表现为反复腹痛甚至重症胰腺炎。这些囊肿常与胰腺肿瘤或假性囊肿相混淆，从而带来诊断和手术挑战。在此，我们报告一例20岁男性患者，有14年反复腹痛病史且多次住院，多项影像学检查显示胰腺尾部有一持续存在的局灶性不均匀病变，周围有一小假性囊肿。由于肿块位置原因，未进行超声（U/S）引导下活检。因怀疑为恶性而进行了手术切除，最终病理报告显示为良性结果，同时发现原本认为是假性囊肿的病变竟是胃型PDC，在查阅现有文献后，我们发现有16例类似的PDC误诊病例。我们得出结论，PDC非常罕见，临床表现多样，且有可能与其他胰腺肿瘤相混淆。因此，由于有时单纯囊肿切除术就足够了，PDC需要高度怀疑，以避免反复住院和不必要的手术。
