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

## TL;DR

A woman's pancreatic tumor grew and ruptured after fertility hormone treatment, highlighting a new risk for those undergoing IVF.

## Contribution

First reported case linking gonadotropin stimulation to rupture of a pancreatic mucinous cystic neoplasm.

## Key findings

- Hormonal therapy for IVF caused rapid growth and rupture of a pancreatic MCN.
- Histopathology confirmed low-grade dysplasia and estrogen receptor positivity in the tumor.
- The case highlights the need for pancreatic screening in patients undergoing assisted reproductive therapies.

## 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.