A GASTRIC-TYPE INTRADUCTAL PAPILLARY MUCINOUS ADENOMA OF THE MAIN PANCREATIC DUCT WITH MILD DUCT DILATION

DOI
  • ASAHARA Kazuhisa
    Department of Hepatobiliary and Pancreas, Shizuoka General Hospital.
  • KAWAGUCHI Shinya
    Department of Hepatobiliary and Pancreas, Shizuoka General Hospital.
  • SATO Tatsunori
    Department of Hepatobiliary and Pancreas, Shizuoka General Hospital.
  • TERADA Shuzo
    Department of Hepatobiliary and Pancreas, Shizuoka General Hospital.
  • ENDO Shinya
    Department of Hepatobiliary and Pancreas, Shizuoka General Hospital.
  • SHIRANE Naofumi
    Department of Hepatobiliary and Pancreas, Shizuoka General Hospital.
  • TAKAHASHI Ryugen
    Department of Hepato-Biliary-Pancreatic Surgery, Shizuoka General Hospital.
  • TOKUDA Satoshi
    Department of Hepato-Biliary-Pancreatic Surgery, Shizuoka General Hospital.
  • KANEMOTO Hideyuki
    Department of Hepato-Biliary-Pancreatic Surgery, Shizuoka General Hospital.
  • SUZUKI Makoto
    Department of Diagnostic Pathology, Shizuoka General Hospital.

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Other Title
  • 病変頭側の膵管拡張が乏しい胃型主膵管型膵管内乳頭粘液性腺腫の１切除例

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Abstract

<p>A 72-year-old man was referred to our department because a 7-mm hyperechoic region in the pancreatic body was noted on abdominal ultrasonography. The pancreatic tumor was not visible on contrast-enhanced CT. MRI showed it as a defect in the pancreatic duct, with a main pancreatic duct (MPD) diameter of 4 mm in the pancreatic body. EUS showed an 11 mm isoechoic papillary tumor in the MPD of the pancreatic body. Pancreatography revealed an intraductal tumor without mucus. Serial pancreatic juice aspiration cytologic examination revealed columnar epithelial cell-containing mucus. Based on these findings, the patient was preoperatively diagnosed with intraductal papillary mucinous adenoma (IPMA) of the MPD with mild dilation, and laparoscopic distal pancreatectomy was performed. Pathological examination showed a solid mass measuring 10 × 4 × 4 mm in the MPD and the diagnosis was gastric-type IPMA with low-grade dysplasia.</p>

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