Pancreatic pseudocyst following acute pancreatitis induced by L-asparaginase treatment

The usefulness of L-asparaginase as a chemotherapeutic agent has been established for the treatment of various lymphoproliferative disorders including acute lymphoblastic leukemia and lymphoma. Pancreatitis is well recognized as a potential complication in 2% to 16% of patients undergoing treatment with L-asparaginase and the reported cases have usually been self-limited. Less well appreciated is the progression of such pancreatitis in some patients to pseudocyst formation which may sometimes necessitate surgical intervention. Only nine cases of pancreatic pseudocyst secondary to L-asparaginase have been reported so far. Eight of nine reported cases of pancreatic pseudocyst required surgical intervention. Our patient is the second case in whom non-surgical management was sufficient.