History of urothelial cancer status post neoadjuvant chemotherapy with cystoprostatectomy and bilateral pelvic lymph node dissection, who was initially seen in May of 2016 for a 1.1 cm pancreatic body cyst indecently discovered on surveillance CT for his urothelial cancer, most likely representing a branch duct IPMN. After being seen by Dr. Roggin in clinic at the end of May, he had an EUS on 6/14/16 which showed 3 cysts in the pancreatic body measuring 5mm, 10mm, and 12 mm in size, all anechoic, thin walled and communicate to the main PD via small dilated side branch ducts. ABDOMEN:LIVER, BILIARY TRACT: The liver demonstrates normal parenchymal signal intensity without focal lesions. There is no biliary ductal dilation. The gallbladder appears within normal limits. SPLEEN: No significant abnormality noted.PANCREAS: The pancreatic parenchyma demonstrates normal signal intensity and enhancement. The pancreatic duct is not dilated. There are two cystic structures in the pancreatic body which appear to communicate with the pancreatic duct and which are compatible with side-branch IPMNs. No associated worrisome features are identified. The more anterior cystic structure measures 8 x 11 mm (4/34), the more posterior 6 x 8 mm (4/30), not significantly changed from prior CTs. ADRENAL GLANDS: Mild nodularity of the left adrenal gland with drop out of signal on out-of-phase images compatible with small adrenal adenoma. KIDNEYS, URETERS: Simple right renal cyst, not significantly changed from prior CTs. RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic disease of the abdominal aorta and its branches. BOWEL, MESENTERY: Post-surgical changes to the bowel. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Post-surgical changes related to cystoprostatectomy and ileal conduit.
Two cystic structures in the pancreatic body which are compatible with side branch IPMNs the largest of which measures up to 11mm, not significantly changed. 