Microcystic adenoma of the pancreas.

Case Report. A 66 year old lady presented with back pain so severe that she had remained in bed for the preceding four months. A mass was palpable in the left hypochondrium. She had a macrocytic anaemia (Hb 11 1 g/dl MCV 111 fl) due to vitamin B12 deficiency. There was no hyperbilirubinaemia and the liver transaminase concentration in the blood was normal. A random plasma glucose was also normal. Ultrasound and CT scans of the abdomen revealed a cystic mass related to the tail of the pancreas and a cystic tumour of the left ovary. At laparotomy a large mass was identified in the tail of the pancreas, which was attached to the transverse colon by a few adhesions. When these adhesions were broken the mass shelled out easily. The presence of a left ovarian cyst was confirmed and this was also excised. She made an uneventful recovery and was discharged from hospital after three weeks. Her anaemia was treated with hydroxycobalamin injections and she remains well one year later.