Cystadenocarcinoma of the pancreas.

The case presented herein has two exciting aspects. First, the cystadenocarcinoma may have developed in a previously existing pseudocyst secondary to trauma 4 years earlier. The history of trauma certainly pointed the author to a diagnosis of pseudocyst. The possibility has to be entertained that a long dormant pseudocyst underwent cystadenomatous and, ultimately, cystadenocarcinomatous change. The acute nature of the patient's clinical problem seems explainable on the basis of recent hemorrhage. The second point is more gratifying. The identification of omental spread at the time of the first operation led to a second and ultimately a third look in this young patient, with a fortunate result. It is only fair to restate the concept that the results in the treatment of malignant disease are more strongly influenced by the "biologic predeterminism" of the tumor than by any of our surgical manipulations [18]. Nonetheless, an aggressive approach to resectable disease in young patients appears justified.