Mucinous Cystadenocarcinoma of Pancreas diagnosed by frozen section at the time of operation in a patient which was managed as traumatic pancreatic pseudo cyst

Introduction:Mucinous cystadenocarcinomas (MCAC) of the pancreas are rare tumors. When localized to the pancreas alone, surgical resection is mostly associated with a favorable prognosis. A pancreatic pseudo cyst is a circumscribed collection of fluid rich in pancreatic enzymes, blood, and necrotic tissue, typically located in the lesser sac of the abdomen. Pancreatic pseudo cysts are usually complications of pancreatitis, although in children they frequently occur following abdominal trauma.Case Presentation:A 10-year-old boy was referred to our hospital who was suffering from abdominal pain. He was admitted due to handle bar injury 3 months ago in another hospital. We had no documents of last medications. CT-Scan showed a mature cyst at the pancreas. The patient was prepared for operation as traumatic pancreatic pseudo cyst. At the time of operation, we found a large cyst with a thick wall, therefore frozen section of cyst was done. MCAC was diagnosed at the time of operation and complete resection of cyst was done.Discussion: Correct and early characterization of a premalignant or malignant mucinous cystic neoplasm and subsequent adequate surgical resection, if possible, offers a comparably favorable prognosis. Traumatic pseudo cysts of pancreas are cystic lesions of pancreas which need surgical drainage as cystogastrostomy or cystoenterostomy for treatment.About 2.4-14% of pancreatic cancers are cystic. Benign cysts do not require to be resected and drainage procedure is indicated when certain symptoms are present and when the lesion is large or enlarging within the observation period. In the case of such management, it is vital to unambiguously differentiate benign cysts from neoplastic cystic tumors of the pancreas.Conclusion:These two kinds of cystic presentation in pancreas can be difficult to be diagnosed by imaging techniques before surgery. Therefore, it is important to rule out malignancy in the cases of cystic elisions of pancreas even with typical history of recent trauma.