十二指腸副乳頭部に腫瘤を形成した副膵管領域原発膵管癌の1例

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  • A case of pancreatic ductal carcinoma presenting as a tumor at the minor duodenal papilla
  • ショウレイ ジュウニシチョウ フクニュウトウブ ニ シュリュウ オ ケイセイ シタ フクスイカンリョウイキ ゲンパツスイカンガン ノ 1レイ

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A 61-year-old man was admitted due to jaundice and upper abdominal discomfort. CT and MRI indicated the presence of a tumor in the lumen of the descending duodenum and dilation of the common bile duct. Gastro-intestinal endoscopy indicated an elevated tumor at the minor duodenal papilla. An interruption in accessory pancreatic duct flow and compression of the lower bile duct were observed on ERCP. The biopsy indicated a moderately to poorly differentiated tubular adenocarcinoma ; a pancreaticoduodenectomy was performed. On pathology, the 3.3 cm in diameter carcinoma, had invaded into the pancreas, duodenum, perineural space, and lymph nodes. There are only a few reported cases of carcinoids, adenocarcinomas, neuroendocrine tumors, and other tumors occurring at the minor duodenal papilla. Since the physiological environments of the major and minor duodenal papillae differ, the therapeutic strategy adopted for tumors at the minor duodenal papilla should be carefully considered with respect to both its genesis and histology.

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