Symptomatic pancreatic body endometrial cyst requiring en bloc distal pancreatectomy

Cameron Ludwig, Avery Kopacz, Madhuri Warren, M Logan Warren, Edwin Onkendi
BMJ case reports · 2021 · vol. 14(9) , pp. e244911 · doi:10.1136/bcr-2021-244911 · PMID:34588203 · W3204042074
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This report details a case of symptomatic pancreatic body endometriosis necessitating en bloc spleen-preserving distal pancreatectomy after initial management with cystogastrostomy failed.

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Abstract

Pancreatic endometriosis is an extremely rare condition, with only a few cases described in the literature. Definitive diagnosis is often difficult to elucidate and will almost always require biopsy or surgical resection. We present a case of a female in her early thirties with a well-known history of widespread endometriosis presenting with vague epigastric pain. CT imaging showed an 11 cm well-circumscribed simple-appearing cyst in the lessor sac. Its origin could not be determined preoperatively but it appeared to involve the parenchyma of the body of the pancreas. Due to the associated pain and indeterminate nature, subtotal surgical resection of the extrapancreatic cyst was performed with the intrapancreatic cyst being managed by a cystogastrostomy to the adjacent stomach in a planned pancreas-sparing procedure following intraoperative confirmation it was arising within the pancreas. Pathological evaluation of the resected cyst confirmed it to be an endometrial cyst. The cystogastrostomy anastomosis subsequently obstructed a few weeks postoperatively and symptoms recurred from cyst enlargement. Redo robotic resection with resection of the remnant cyst, cystogastrostomy and en bloc spleen-preserving distal pancreatectomy was performed. The patient had an uneventful recovery. She has had no recurrence of cyst or symptoms since. A procedure video is included in the report.

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Condition tags

endometriosis

MeSH descriptors

Epidermal Cyst Epidermal Cyst Pancreatic Neoplasms Pancreatic Neoplasms Adult Female Humans Neoplasm Recurrence, Local Pancreas Pancreas Pancreatectomy Spleen Spleen

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Cited by (5)

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