A case of pancreatic cancer with ascites. Another diagnostic enigma.

DOI

Bibliographic Information

Other Title
  • 診断困難であった腹水合併すい癌の１症例　すい外性（腹腔内）発育型粘液産生管状腺癌の存在について
  • -ANOTHER DIAGNOSTIC ENIGMA-
  • ―膵外性(腹腔内)発育型粘液産生管状腺癌の存在について―

Abstract

A 63-year-old man who complained of loss of appetite, was found to have cysts of the pancreas tail by CT examination. Past history showed chronic pancreatitis and a drinking habit that had continued for more than 30 years at the rate of 80-110g per day. The abdomen was slightly distended, but Kouyama's upper abdominal oppressive pain was not noted nor lower back knock pain. There was no bruit in the upper abdomen. Serum amylase level was 59IU/l (%P/T55), HbA1 7.3% serum CEA 3.3ng/dl, CA 19-9 450U/ml. Secretin test (examination on pancreatic exocrine function) showed decrease of both the volume and the bicarbonate output of duodenal juice. A 75g OGTT showed a borderline pattern. A solid mass with microcysts and light neo-vascularity were found by US and angiography, respectively. Cytology of the ascites demostrated class V (PAS positive). Chemotherapy (Tegafur+MMC) was ineffective and the patient passed away 6 months later after admission. The final diagnosis by autopsy was pancreatic ductal cell adenocarcinoma (well-differentiated) which invaded into the abdminal cavity from the tail of the pancreas. No metastasis was found in the liver. Among our autopsy cases of pancreatic cancer, those with liver metastasis were found in 81.1% and those without liver metastasis and peritoneal dissemination were in 8.1%. It is suggested that there was a type of mucin-producing pancreatic ductal cell adenocarcinoma which developed from the pancreas into the abdominal cavity (peritoneum).

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Details 詳細情報について

  • CRID
    1390282681291110912
  • NII Article ID
    130004107348
  • DOI
    10.11261/iryo1946.46.225
  • ISSN
    18848729
    00211699
  • Text Lang
    ja
  • Data Source
    • JaLC
    • CiNii Articles
  • Abstract License Flag
    Disallowed

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