Lymphoepithelial Cyst of Pancreas; a Case Report

Abstract

Introduction: A lymphoepithelial cyst(LEC) of the pancreas is very rare benign cystic lesion of pancreas and is not associated with malignant potential. The differential diagnosis of LEC with other cystic tumor of pancreas by pre-operative imaging study is almost impossible. Method: A 55 years old man was referred to our hospital presenting incidentally detected cystic mass in retropancreatic space on abdominal computed tomography. He was treated with endoscopic submucosal dissection for gastric high grade dysplasia a month ago. Abdominal computed tomography showed about 6 cm sized septated cystic lesion with septal enhancement in pancreas head. Laboratory findings including tumor marker were all within normal range. Pancreas magnetic resonance imaging showed about 6 cm sized multiloculated and septated cystic mass along hepatoduodenal ligament abutting to hepatic caudate lobe and pancreas head. Preoperative diagnosis was thought to be extrapancreatic retroperitoneal tumor such as lymphangioma or neurogenic tumor, or exophytic pancreatic cystic tumor, less likely. Result: In operative findings, 6x5 cm sized conglomerated cystic mass in retropancreatic space abutting to pancreas head was observed and was filled with caseous material. Mass excision with wedge resection of pancreas was performed. In histopathologic examination of the specimen, the cystic mass was confirmed by LEC of pancreas. Conclusion: Here in, we present a case of LEC of pancreas. It is difficult to diagnose LEC of pancreas preoperatively because of the limitation of specific findings of LEC in imaging modality.