Growth and rupture of pancreatic mucinous cystic neoplasm following hormonal stimulation for in vitro fertilization: a case report

Abstract

Mucinous cystic neoplasms (MCNs) of the pancreas are rare mucin-producing epithelial tumors that predominantly affect middle-aged women and typically contain ovarian-type stroma responsive to hormonal stimulation. While progression and rupture of MCNs during pregnancy have been documented, the effects of exogenous hormonal stimulation remain uncertain. We present a unique case of a 39-year-old woman who experienced rapid cystic enlargement and rupture of a pancreatic MCN following hormonal therapy for in vitro fertilization (IVF). Imaging demonstrated progressive cyst growth with radiologic evidence of rupture, which was confirmed intraoperatively. Histopathological analysis revealed an MCN with low-grade dysplasia and immunohistochemical positivity for estrogen receptors. This case represents the first description of a potentially severe complication of gonadotropin stimulation in pancreatic MCNs and underscores the importance of screening for cystic pancreatic lesions in patients undergoing assisted reproductive therapies.