A Rare Cause of Abdominal Pain by Pancreatic Mass in a Young Female Patient

摘要: Gastroent Question: A 24-yearold woman presented with epigastric pain which began about 2 years ago and progressively worsened over the past 6 months. The occurred intermittently but usually after a meal, lasted for 1 hour, radiated to back. patient said that she also had lost 4 kg during 3 Her medical history was unremarkable physical examination positive only mild tenderness. Laboratory test results at admission were as follows: amylase, 208 U/L; lipase, 261 total serum bilirubin, 0.48 mg/dL; direct 0.1 aspartate transaminase, 14 IU/L; alanine alkaline phosphatase, 49IU/L; g-glutamyl transferase, 12 carbohydrate antigen 19-9, 7.7 IU/mL; a-fetoprotein, 1.0 ng/mL; carcinoembryonic antigen, cancer 125, 7.1 U/mL. To evaluate cause of weight loss, an abdominal CT taken revealed 4.8-cm mass in tail pancreas. On pre–contrast-enhanced image, hypoattenuated central portion focal high attenuated lesion (white arrow), suggesting presence both hemorrhage necrosis (Figure A). This pancreatic showed peripheral enhancement it progressed from arterial phase B) portal C). In addition, there infiltration around (the splenic vein obstructed by mass, evidenced gastric fundal varix formation (black arrow; Figure D). Laparoscopic distal pancreatectomy splenectomy performed on this mass. What is diagnosis young female patient?