pancreatic cystic lesion

Hello! For approximately two months I have been having left thoracic pain only when sleeping. It would be so bad that I would wake up. I found leaning forward and getting out of bed would make it go away. For the most part, I wouldn't think about it again during the day. I have no history of any back injury. I do have terrible heartburn. If I skip one day of prilosec, it is so bad that I can vomit.

Last week, pain was horrible at night, but didn't go away during the day. It now is more epigastric and to the left of this area, and goes straight through me to the back.

CT scan showed low attentuation 1.3 X 1.4 cm cystic lesion in distal body/proximal tail of the pancreas just superior to the splenic artery. It has grown in size since a CT was done in 2006.

I have never had pancreatitis or abdominal injury. I had an MRCP done yesterday that showed the same lesion, but the gallbladder, ducts, and liver and everything else is fine (except a small kidney cyst).

I do not drink alcohol. We celebrated our 20th anniversary last October, and I had a pina colada. It was the only alcoholic drink I have had in 10 years. The last time before that was a pina coloda on a cruise!

The pain is pretty intense at times, and it is fairly constant now. I am waiting on an appointment with a oncology surgeon per my family doctor recommendation.

I realize that this is information,and not medical advice. :) I will not use this as a substitute for medical care or seeing my doctor.

My weight is fairly stable. I have lost some in the past 6 months, but nothing earth shattering.

Does this sound like a neoplasm? Should I be more concerned about this pain? Is it reasonable to wait it out to see a doctor in a week or two? I tolerate pain like this usually very well........so concerned that I should listen to my body and go to the ER.

Thank you!
Kathy

[Kevin Pho, MD]

At this point, I can't comment on whether the lesion is a cancer or not.

I agree with the tests that have been done thus far.  Another test to consider would be an endoscopic ultrasound, which can give more visualization to determine what the lesion is.

I agree with the referral to an oncology surgeon.  Another possibility to consider would be a pancreatic pseudocyst.  

Depending on their suspicion for cancer, and size and location of the mass, removing part of the pancreas, or the entire organ, are possibilities.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin Pho, M.D.
www.kevinmd.com
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