75-year-old man presented...

A 75-year-old man presented with epigastric pain as his main complaint to the physician. During imaging, a pancreatic head cyst was discovered. According to a physical examination, he exhibited no anaemia, jaundice, visible abdominal swelling, or pain, and no distinguishing marks other than a postoperative scar from the bypass graft. Biochemistry tests revealed no abnormalities (WBCs of 9,200/L, Hg of 14.4 g/dL, platelet count of 24,200/L, serum glutamic-oxaloacetic transaminase level of 24 IU/L, serum glutamic-pyruvic transaminase level of 19 IU/L, lactate dehydrogenase level of 242 IU/L, total bilirubin level of 0.9 mg/dL,  and c-reactive protein level of 0.09 mg/dL) and tumour markers (carcinoembryonic antigen level of 3.6 ng/mL, CA19–9 level of 9.7 U/mL, SPAN-1 level of 7.3 U/mL, soluble IL-2R level of 325 U/mL, IRI antibody level of 0.4 U/mL, gastrin level of 400 pg/mL, and vasoactive intestinal peptide level of 5 pg/mL). A computed tomography (CT) of the abdomen was also performed.

A massive cyst of 55 mm in the pancreatic head, a 20 mm mass with a gradually increasing contrast effect on the caudal side of the cyst, and nodular lesions of 10 mm each with a contrast effect in the pancreatic body and tail was found. The pancreatic parenchyma was somewhat thinner overall, and there was no extension into the main pancreatic duct. There was no lymph node enlargement around the pancreas, and extrapancreatic mass lesions were not observed.