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Answer 3
  1. Distal pancreatectomy with splenectomy. The patient has a cystic mucinous lesion of her pancreas. Differentiating between a benign mucinous cystadenoma (which can undergo malignant transformation) and a malignant mucinous cystadenocarcinoma is difficult, even when good imaging studies are obtained. Surgical resection is warranted, and because the lesion is located in the pancreatic tail, a distal pancreatectomy and splenectomy would again be the procedure of choice. Surgical enucleation alone would be inadequate for a possibly malignant cyst. Endoscopic drainage of the lesion is contraindicated in this patient.

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