Spontaneous regression of pancreatic pseudocyst mimicking a submucosal tumor of the stomach with upper gastrointestinal bleeding: Report of a case

Hemorrhage of a pancreatic pseudocyst is one of the severe complications of pancreatitis. Erosion into adjacent organs, especially into the upper gastrointestinal tract, by pancreatic pseudocysts has been reported. The endoscopic imaging of involvement of the stomach by pancreatic pseudocyst can mimic a submucosal tumor of the stomach, which may rupture into the stomach and manifest as upper gastrointestinal bleeding. We report a 66-year-old male with alcoholism who presented with tarry stool passage for 2 to 3 days. Panendoscopy revealed a protruding mass, measuring about 6 cm in diameter, with central ulceration and adherent blood clot located over the posterior wall of the cardia. Biopsy showed a focal ulcer with infiltration of inflammatory cells, but without evidence of malignancy. Computed tomography of the abdomen showed a cystic lesion extending from the pancreatic tail to the cardia of the stomach in favor of a pancreatic pseudocyst. He refused either radiologic or surgical treatment and was treated in a conservative way only. Follow-up panendoscopy showed a complete regression of the pseudocyst 6 month later.