Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is well known as a safe diagnostic procedure. We report the first case of pancreatic pseudocyst after EUS-FNA of the pancreatic body mass. A 60-year-old male underwent EUS-FNA for incidentally detected pancreatic solid mass which was suspected as neuroendocrine tumor. Two weeks later, the patient visited emergency room with acute abdominal pain and right upper quadrant tenderness; leukocytosis and elevated C-reactive protein, amylase, and lipase levels were noted. Computed tomography discovered newly developed 11.5×9.5 cm sized cystic mass communicating with the main pancreatic duct. Cyst fluid analysis revealed amylase level of 3,423 U/L and fluid culture isolated Streptococcus parasanguinis. The cystic mass corresponds with pancreatic pseudocyst. FNA induced main pancreatic duct injury and fluid leakage may cause it. Endoscopists who perform EUS-FNA must remember that pancreatic main duct injury can occur as one of severe complications and that it could be treated successfully with endoscopic internal drainage.

Citations

Citations to this article as recorded by  

• Pancreatic Pseudocyst after Fully Covered Self-expandable Metallic Stent Placement
  Mitsuhito Koizumi, Sho Ishikawa, Kaori Marui, Masahito Kokubu, Yusuke Okujima, Yuki Numata, Yoshiki Imamura, Teru Kumagi, Yoichi Hiasa
  Internal Medicine.2024; 63(21): 2943.     CrossRef
• Needle tract seeding and abscess associated with pancreatic fistula after endoscopic ultrasound-guided fine-needle aspiration
  Takeshi Okamoto, Kenji Nakamura, Ayaka Takasu, Toshimi Kaido, Katsuyuki Fukuda
  Clinical Journal of Gastroenterology.2020; 13(6): 1322.     CrossRef
• Peripancreatic Fluid Collection Complicated by Endoscopic Ultrasound-Guided Fine-Needle Aspiration
  Tsuyoshi Suda, Kazuya Kitamura, Shuichi Kaneko
  ACG Case Reports Journal.2020; 7(7): e00432.     CrossRef
• Early pancreatic cancer — The role of endoscopic ultrasound with or without tissue acquisition in diagnosis and staging
  Pedro Moutinho-Ribeiro, Julio Iglesias-Garcia, Rui Gaspar, Guilherme Macedo
  Digestive and Liver Disease.2019; 51(1): 4.     CrossRef
• Endoscopic ultrasonography guided-fine needle aspiration for the diagnosis of solid pancreaticobiliary lesions: Clinical aspects to improve the diagnosis
  Hiroyuki Matsubayashi
  World Journal of Gastroenterology.2016; 22(2): 628.     CrossRef
• A Patient with a Wedge-shaped Pulmonary Lesion Associated with Streptococcus parasanguinis
  Hiroya MIYAMOTO, Harumi GOMI, Haruhiko ISHIOKA, taijiro SHIROKAWA
  Kansenshogaku Zasshi.2016; 90(3): 316.     CrossRef
• Immunodepletion Plasma Proteomics by TripleTOF 5600 and Orbitrap Elite/LTQ-Orbitrap Velos/Q Exactive Mass Spectrometers
  Kelly A. Jones, Phillip D. Kim, Bhavinkumar B. Patel, Steven G. Kelsen, Alan Braverman, Derrick J. Swinton, Philip R. Gafken, Lisa A. Jones, William S. Lane, John M. Neveu, Hon-Chiu E. Leung, Scott A. Shaffer, John D. Leszyk, Bruce A. Stanley, Todd E. Fox
  Journal of Proteome Research.2013; 12(10): 4351.     CrossRef

A 42-years-old woman had undergone operation for cholecochal cyst with gallbladder cancer 9 years ago. Pathology revealed a polypoid mass in the gallbladder with liver infiltration as poorly differentiated adenocarcinoma. Computed tomography, magnetic resonance cholangiopancreatography, and endoscopic ultrasound showed a newly developed suspected solid nodule in the peripheral portion of cystic lesion in the pancreas head. She underwent a pylorus preserving pancreaticoduodenectomy for the suspected mucinous cystic neoplasm of the pancreas. Pathology revealed poorly differentiated adenocarcinoma. The remnant choledochal cyst had developed to cholangiocarcinoma, which mimicked cystic neoplasm of the pancreas.

Citations

Citations to this article as recorded by  

• Carcinoma of the Papilla of Vater after Diversion Operation for Pancreaticobiliary Maljunction
  Takahiro Yamanaka, Kenichiro Araki, Norihiro Ishii, Mariko Tsukagoshi, Takamichi Igarashi, Akira Watanabe, Norio Kubo, Hiroyuki Kuwano, Ken Shirabe
  Case Reports in Gastroenterology.2017; 11(2): 265.     CrossRef
• Treatment and outcomes of adults with remnant intrapancreatic choledochal cysts
  Hong-Tian Xia, Tao Yang, Bin Liang, Jian-Ping Zeng, Jia-Hong Dong
  Surgery.2016; 159(2): 418.     CrossRef