The endoscopic ultrasound diagnosis of pancreatic ductal adenocarcinoma with cystic degeneration

Abstract

Here, we present the case of an 87‐year‐old man who had dull upper abdominal pain for a month. Abdominal ultrasound and magnetic resonance imaging (MRI) demonstrated a cystic tumor in the pancreatic tail. Endoscopic ultrasound (EUS) showed a solid tumor with cystic degeneration, and fine‐needle aspiration (FNA) confirmed it was a pancreatic adenocarcinoma with tumor hemorrhage. The patient underwent a laparoscopic distal partial pancreatectomy and splenectomy. In this report, we emphasize that tumor hemorrhage‐related cystic degeneration is an uncommon manifestation of pancreatic ductal adenocarcinoma, and EUS with FNA may be more suitable for differential diagnosis than computed tomography or MRI.