A 62 year old woman was referred for management of the incidental finding of a 1.5 cm solid and cystic lesion in the head of the pancreas.
Staging CT scans suggested interval growth to 2cm.
EUS and aspiration yielded a complex lesion with both cystic and solid components, not typical of a serous cystadenoma. FNA yielded 'atypical cells in a mucinous background'.
Working diagnosis was an Intraductal Papillary Mucinous Neoplasm (IPMN). Because of the apparent growth and solid components, resection was recommended. A pancreatico-duodenectomy (Whipple procedure) was planned.