Fistulising Pancreatic Mucinous Cystic Neoplasm to the Portal Vein
Bibliographic record
Abstract
Mucinous Cystic Neoplasms (MCNs) of the pancreas are rare, typically affecting women and carrying potential for malignant transformation. While complications like fistulas between MCNs and adjacent structures are rarely reported, this case presents the first documented fistula between a pancreatic MCN and the portal venous system. A 56-year-old woman with acute abdominal pain was found to have a 10.4 cm cystic mass in the pancreatic tail, consistent with an MCN. The lesion exhibited high-risk features. During her admission, a progressive venous filling defect, presumed to be a thrombus, developed despite anticoagulation therapy. Percutaneous thrombectomy revealed a communication between the splenic vein and the cystic mass, with mucinous content aspirated, confirming a fistula with direct extension of mucin into the vein. Distal pancreatectomy confirmed the diagnosis of an MCN with high-grade dysplasia and ovarian-like stroma. This case highlights the rare occurrence of a fistula between a pancreatic MCN and the portal venous system, underscoring the importance of early recognition for proper treatment and surgical planning.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".