Oma's Appt with the Pancreatic Surgeon

Oma had another CT scan of her abdomen and pelvis yesterday, both with and without contrast.

Oma finally had her appointment with the pancreatic surgeon today.  According to him, it appears that the mass on her pancreas (On top of her pancreas? Near her pancreas? Behind her pancreas?  The location isn't exactly clear.) is a cyst.  There aren't too many things that can cause the cyst.  Auto-immune hepatitis (which Oma has) can cause auto-immune pancreatitis, which in turn, could have caused the cyst.  It was discovered that Oma also has gall stones and a rogue gall stone could have caused pancreatitis as well.  Many of Oma's symptoms are consistent with those of pancreatitis.

If it is a "pseudo-cyst," it will most likely resolve within twelve weeks.  As of right now, there has been no change in the cyst.  The CT scan taken yesterday looked the same as the CT scan taken six weeks ago.

There are a few cysts of the pancreas that are cystic tumors and can be cancerous.  One cystic tumor is called a mucinous tumor, but none of Oma's pathology reports saw any mucine.  There is a 25% chance of malignancy with these tumors.  Another cystic tumor is called a serous tumor.  Typically, these have a honeycombed appearance, which again did not show up on Oma's pathology.  There is a 1% chance of malignancy with these tumors.

It is the recommendation of the pancreatic surgeon that Oma undergo another CT scan in 6 weeks (to see if maybe it was a "pseudo-cyst" and has resolved itself, as it will have been 12 weeks from the time it was first noticed).  It was further recommended that she be re-imaged approximately six months from now to look for any growth, spider webbing, or nodules (none of which was seen at this point).  They want to make sure that the mass is not growing into something dangerous.  There is no need to do anything surgically unless the mass grows or changes.  Because Oma is going to undergo surgery for the ovarian mass already, if the pancreatic surgeon is available, he indicated that he may want to take a "peek" at the pancreas during the surgery.

Oma has to have some more labwork done tomorrow.  Although we were previously told that the the CA 19-9 (a tumor marker test for the pancreas) was normal, the pancreatic surgeon could find no record of it in Oma's file.  Therefore, he is ordering another CA 19-9.  He is also ordering another tumor marker test for neuroendocrine tumors called the Chromogranin A.  If those labs are elevated, there would be more imaging in store.

That's it for now.  Oma is still waiting on a date for her ovarian surgery.