Pancreas

The incidental pancreatic lesion is most likely.

Well, I see a cystic lesion in the body of a pancreas

and this atrophy of the distal gland and this ductilitation.

The truth is this could be a musinous tumor,

great location if the patient was in their 40s.

It could be a cystic neuroendocrine tumor, again,

not all neuroendocrine tumors are vascular,

but with cystic neuroendocrine, I still like to see some room enhancement.

I don't see that, but it's a possibility.

Another possibility, of course, would be an IPMN.

That's a cystic lesion and with the atrophy of the gland

and dilated duct, you would then have to be concerned about a malignancy.

Syracist adenomas can vary, right?

We talk about an incidental syracist adenomas that can be large.

You can have ductilitation, calcification,

particularly central calcification is common.

I have to admit, this is a tough case.

You're going to need EUS and biopsy and this ended up being a syracist adenoma.

But if you set a musinous cystic neoplasm,

I'm going to give you full credit as well.

It's just a tough case and that's why we do pathology.