Two Cases of Mucin Producing Pancreatic Cancer with Extension to the Main Pancreatic Duct and its Branches in the Whole Pancreas

Akira Komiyama, Kazuo Hatsuse, Hidetaka Mochizuki, Makoto Maemura, Noriyuki Kunimatsu, Syoetsu Tamakuma, Shintarou Terahata*

First Department of Surgery, *Laboratory Medicine, National Defense Medical College

Two cases of so-called mucin producing pancreatic cancer are reported. Both of these tumors were histologically found to have extended in to the main pancreatic duct and its branches in the whole pancreas. Both patients were male, 74 and 46 years of age, respectively. They had epigastralgia in common as the chief complaint and, by several examinations, dilation of the main pancreatic duct and mucin pooling were observed. Total pancreatectomy was performed on both under the diagnosis of a mucin producing pancreatic tumor. In the first case, the main pancreatic duct was markedly dilated from the body through the tail and contained mucin. and an elevated lesion was noted at its tail. Histologically, the tumor was non-invasive adenocarcinoma and cancer cells spread in the fashion of intraductal growth continuously almost all the way to the peripheral branches. In the second case, mucus pooling as rather mild, and the main pancreatic duct and its branches were dilated owing to obstructive growth of the tumor which replaced almost all of the pancreas. Histologically, the tumor was noninvasive papillotubular adenocarcinoma. Only two cases of non-invasive ductal carcinoma with extension to the main pancreatic duct and its branches from head to the tail have been reported as mucin producing pancreatic cancer in Japan. In light of the pathological feature of mucin producing pancreatic cancer, this entity is considered to be an indication for total pancreatectomy.

Key words
mucin producing pancreatic tumor, pancreatic cancer, total pancreatectomy

Reprint requests
Akira Komiyama First Department of Surgery, National Defense Medical college
3-2 Namiki, Tokorozawa, 359 JAPAN

Accepted
February 14, 1990

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