A Case of Duodenal Leiomyoma Grown Up Exclusively in the Parenchyma Caput Pancreatitis -With Special Reference to Its Mode of Formation-

Yoshihiro Akazai, Tetsushige Mimura, Yasunobu Shioji, Takaomi Takahata, Yasuhisa Okamoto, Kotaro Toda, Hideyuki Kimura, Toshinori Ohara, Nobumasa Tsutsui, Shuhei Hirose, Kazuo Kataoka, Soichirou Nose*

Department of Surgery, Department of Pathology*, Okayama Saiseikai General Hospital

A 64-year-old woman underwent emergent operation for bleeding from duodenal ulcer, i.e., duodenonesidiectomy, for a tumor caput pancreatic forming duodenal fistula. The resected specimen indicated a 5×3 cm tumor in the same region, the center of which showed hemorrhagic necrosis rupturing the duodenal wall. Pathohistological findings confirmed leiomyoma in continuation to the tunica muscularis propria duodenalis. The growth of duodenal leiomyoma within the parenchyma caput pancreatis is reported for the second time in this country, and its rare mode of growth was examined; the regio caput pancreatis has an area of union of the ventral pancreas and dorsal pancreas, which forms the so-called "weak spot". The tumor developed pancreato-dorsally on the adoral side of the duodenal Vater papilla and was thought to develop intrapancreatically, slipping into the above "weak spot."

Key words
pancreas head tumor, duodenal leiomyoma, mode of growth within pancreas head parenchyma

Reprint requests
Yoshihiro Akazai Department of Surgery, Okayama Saiseikai General Hospital
1-17-18, Ifukucho, Okayama, 700 JAPAN

Accepted
July 6, 1994

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