{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T09:47:14Z","timestamp":1782899234680,"version":"3.54.5"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Mucinous cystic neoplasms (MCNs) of the pancreas are slow-growing tumours but carry a risk of malignant transformation and massive enlargement if left untreated. We present a rare case of a 49-year-old female initially diagnosed in 2022 with a 14-cm pancreatic cyst. After declining surgery, she presented four years later with acute bowel obstruction and a distended abdomen. Imaging revealed dramatic progression to a giant 31\u2009\u00d7\u200922.7\u00a0cm mass displacing most abdominal viscera. An emergency distal pancreatectomy and splenectomy were performed, followed by a staged second-look laparotomy to ensure colonic viability. Despite the massive size, tumour markers remained normal. Histopathology confirmed MCN with focal high-grade dysplasia but no invasive carcinoma. This case demonstrates that extreme mass effect from a giant MCN can cause acute intestinal obstruction and emphasizes that size alone, while increasing surgical complexity, is not an absolute predictor of invasive malignancy.<\/jats:p>","DOI":"10.1093\/jscr\/rjag528","type":"journal-article","created":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T11:33:08Z","timestamp":1782041588000},"source":"Crossref","is-referenced-by-count":0,"title":["A giant 31-cm pancreatic mucinous cystic neoplasm: a 4-year progression and surgical challenge"],"prefix":"10.1093","volume":"2026","author":[{"given":"Fahad Saleh","family":"Alanazi","sequence":"first","affiliation":[{"name":"General Surgery and Hepatopancreatobiliary (HPB) Surgery, King Fahad Specialist Hospital , Buraydah ,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hind Khalaf","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Department of General Surgery, King Fahad Specialist Hospital , Buraydah ,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shatha Mohammed","family":"Alotaibi","sequence":"additional","affiliation":[{"name":"Department of General Surgery, King Fahad Specialist Hospital , Buraydah ,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"2026063015155027200_ref1","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/S0039-6109(05)70139-0","article-title":"Cystic neoplasms of the pancreas: benign to malignant epithelial neoplasms","volume":"81","author":"Sarr","year":"2001","journal-title":"Surg Clin North Am"},{"key":"2026063015155027200_ref2","first-page":"638","article-title":"International consensus guidelines 2017 for the management of IPMN and MCN of the pancreas","volume":"17","author":"Tanaka","year":"2017","journal-title":"Pancreatology"},{"key":"2026063015155027200_ref3","first-page":"15","article-title":"Giant mucinous cystic neoplasm of the pancreas: a case report and review of the literature","volume":"1","author":"Park","year":"2015","journal-title":"J Pancreat Cancer"},{"key":"2026063015155027200_ref4","first-page":"2043","article-title":"A review of 139 consecutive resected cystic neoplasms of the pancreas: exhibit of a changing profile of cystic neoplasms of the pancreas in a single institution","volume":"30","author":"Goh","year":"2006","journal-title":"World J Surg"},{"key":"2026063015155027200_ref5","first-page":"644","article-title":"Management of large pancreatic cystic neoplasms","volume":"138","author":"Walsh","year":"2005","journal-title":"Surgery"},{"key":"2026063015155027200_ref6","first-page":"204","article-title":"Mucinous cystic neoplasms of the pancreas: the \"surgical\" challenge","volume":"14","author":"Sarr","year":"2010","journal-title":"J Gastrointest Surg"},{"key":"2026063015155027200_ref7","first-page":"142","article-title":"Natural history of pancreatic cystic lesions: a multicenter prospective study","volume":"264","author":"Jang","year":"2016","journal-title":"Ann Surg"},{"key":"2026063015155027200_ref8","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjaa085","article-title":"Large mucinous cystic neoplasm of the pancreas during pregnancy: a case report","volume":"2020","author":"Carvalho","year":"2020","journal-title":"J Surg Case Rep"},{"key":"2026063015155027200_ref9","first-page":"410","article-title":"Mucinous cystic neoplasm of the pancreas with high-grade dysplasia: a clinicopathologic study of 42 cases","volume":"18","author":"Thompson","year":"2005","journal-title":"Mod Pathol"},{"key":"2026063015155027200_ref10","first-page":"213","article-title":"Peritoneal seeding of pancreatic mucinous cystadenocarcinoma after cyst rupture","volume":"98","author":"Sugiyama","year":"2003","journal-title":"Am J Gastroenterol"},{"key":"2026063015155027200_ref11","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1097\/SLA.0b013e31811f4449","article-title":"Mucinous cystic neoplasm of the pancreas is not always a benign disease: a risk factor analysis of 163 surgically resected tumors","volume":"247","author":"Crippa","year":"2008","journal-title":"Ann Surg"},{"key":"2026063015155027200_ref12","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1097\/01.sla.0000237652.84466.54","article-title":"A selective approach to the resection of cystic lesions of the pancreas: results from 539 consecutive patients","volume":"244","author":"Allen","year":"2006","journal-title":"Ann Surg"},{"key":"2026063015155027200_ref14","first-page":"750","article-title":"The planned second-look laparotomy: a strategic approach in complex abdominal surgery","volume":"187","author":"Sugrue","year":"2004","journal-title":"Am J 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