A 60 year old man had a kidney transplantation for 30 years consulted for his allo graft dysfunction with blood urea of 100mg/do and serum creatinine of 2.9mg/dl.He had a lo g history of bilateral lyphodema of lower limvs.He had a 2+protein in urine and normal other lab.results.his abdominal Ultrasound and doppler showed a raised RI of the grafted kidney and his pancreas showed a suspicious mass at the head of it His MRCP showed a multiple different sizes cystic masses that most likely a mucinous cystic masses and a malignant cystic carcinoma needs further evaluations question is there any relation between mTor inhibitors rapamycin abd tbeses findings?
The attached files are the. RCP results and we consulted a specialist who decide exploration and preoperative biopsy then to decide about wipples surgery.
What is diameter of main pancreatic duct? Did you measured tumor marker Ca19.9? RCP is showing many cystic changes from head to tail of pancreas. So consider IPMN. It looks like branch duct type.
If diameter of main pancreatic duct is less than 2mm, then it looks like IPMN - branch duct type. So search for features which are suggestibile for high risk of malign alteration like cyst diameter >30 mm, presence of enhancing mural nodules on CT . It would be good to perform an endoscopic ultrasound procedure (EUS).
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