Large pancreatic mass in a young woman.

A 26-year-old woman presented with several months’ history of abdominal discomfort, postprandial bloating and nausea. The patient was otherwise well and had no significant medical or family history. A computed tomography scan revealed a heterogeneous cystic and solid mass 14 cm in size in the right upper quadrant. There was no vascular involvement or lymphadenopathy, or biliary or pancreatic duct dilation (Figure 1A). Subsequent endoscopic ultrasound revealed a homogenous solid mass occupying most of the pancreas parenchyma (Figure 1B). Fine-needle aspiration revealed abundant tumour cells, characterized by granular cytoplasm and round to oval nuclei with finely textured chromatin and an indistinct nucleolus (Figure 1C); in areas, the tumour cells surrounded delicate hyalinized fibrovascular cores (Figures 1C and ​and1D).1D). The tumour cells showed strong nuclear immunoreactivity for beta-catenin (Figure 1E). Figure 1) A Abdominal computed tomography scan demonstrating a mass 14 cm in size in the right upper quadrant. B Endoscopic ultrasound image demonstrating a homogenous solid mass 12.8 cm in size. C Cellular specimen, composed of neoplastic cells with round to oval ...