BACKGROUND: Pancreatic cystic lesions are a group of pancreatic neoplasms with different behavior and risk of malignancy. Imaging diagnosis and differentiation of these lesions remain a challenge. AIMS: The aim of this study was to evaluate the agreement between computed tomography and/or magnetic resonance imaging and post-operative pathologic diagnoses of Pancreatic cystic lesions in a University Hospital of São Paulo State. METHODS: A total of 39 patients with surgically diagnosed Pancreatic cystic lesions were enrolled, as a study cohort from 2009 to 2019. Preoperative radiological and final pathological diagnosis was correlated to measure computed tomography and/or magnetic resonance imaging diagnostic. Pancreatic adenocarcinoma, choledochal pancreatic cyst, mucinous cystadenoma, serous cystadenoma, intraductal papillary mucinous neoplasms, and pancreatic pseudocyst were classified as neoplastic cysts. RESULTS: It was noted that 27 patients (69.23%) had preoperative computed tomography and magnetic resonance imaging, 11 patients (28.20%) had preoperative computed tomography only, and 1 patient had preoperative magnetic resonance imaging only. The values for diagnoses made only with computed tomography (p=0.47) and from the combination of computed tomography+magnetic resonance imaging (p=0.50) did also point to moderate agreement with the anatomopathological findings. The values pointed to a fair agreement for the diagnosis of mucinous cystadenoma (p=0.3), moderate agreement for intraductal papillary mucinous neoplasms (p= 0.41), good agreement for serous cystadenoma (p=0.79), and excellent agreement for choledochal pancreatic cyst (p=1), pancreatic pseudocyst (p=0.84), and Frantz tumor (p=1) (p<0.05). CONCLUSIONS: The findings of computed tomography and/or magnetic resonance imaging have an equivalent diagnostic agreement with an anatomopathological diagnosis for differentiating benign from malignant Pancreatic cystic lesions and in suggesting a specific diagnosis. There is no statistical difference between the use of computed tomography alone and computed tomography+magnetic resonance imaging in the improvement of diagnostic accuracy.

Introduction: Gallbladder cancer is a rare type of biliary tract malignancy with poorly defined pathogenesis, difficult treatment and often inoperable. Case Report: A 84-year-old male presented with pain in the right hypochondrium with three months of progressive worsening. Ultrasound routine examination showed the presence of a large mass in the gallbladder adjacent topography that also showed signs of invasion in the liver tissue. He was submitted to preoperative staging with chest and abdomen MRI with intravenous contrast. A resection of the IVB, V and VI hepatic segments was performed associated to complete resection of the extra hepatic bile duct en bloc. Main bile duct reconstruction with Y-Roux jejunostomy was also performed. Discussion: Gallbladder carcinoma with squamous component is a rare type of cancer with poor prognosis whose treatment with a curative potential is only possible with surgery, in case the lesion is resectable.

Introdução: A cirurgia guiada por fluorescência é uma modalidade promissora que pode ser usada em diferentes contextos como subsídio diagnóstico ou terapêutico. Relato do caso: Trata-se de um paciente de sexo masculino, de 67 anos, com diagnóstico prévio de cirrose por vírus da hepatite e submetido a ressecção de hepatocarcinoma videolaparoscópica de lobo esquerdo com o uso da substância Verde de Indocianina (VIC). Conclusão: No caso relatado a técnica cirúrgica videolaparoscópica guiada por imunofluorencência utilizando a substância Verde de Indocianina foi decisiva na ressecção do hepatocarcinoma com margem de segurança. Palavras-chave: Verde de Indocianina. Relatos de Casos. Neoplasias Hepáticas.