A Case of Mucin-Producing Duodenal Carcinoma Arising from the Aberrant Pancreas

Toshihiko Waku, Hirokazu Uetsuka, Naoki Watanabe, Takashi Mori, Shigeo Shiiki, Hajime Nakai, Yohjiroh Orita, Izumi Harafuji

Department of Surgery, Chyugoku Chyuoh Hospital

This paper describes a case of mucin-producing duodenal carcinoma arising from the aberrant pancreas. An 81-year-old woman was seen at a nearby hospital because of appetite loss as the chief complaint. She was found to have an ulcerative lesion in the wall of the duodenal bulb and was admitted to our department for close examiation. CT scanning showed a tumor (2 cm in diameter) with a cystic change in the bulb. Gastrointestinal endoscopy revealed two depressed lesions on the greater wall of hte duodenal bulb. Biopsy revealed adenocarcinoma. Under a diagnosis of advanced cancer of the duodenal bulb, laparotomy was performed. Since peritoneal lavage cytology showed malignant cells, distal gastrectomy was peformed. Histologically the tumor was a papillary and partially mucinous adenocarcinoma found mostly in the muscularis propria. The aberrant pancreas (Heinrich I type) with acinar cells, pancreatic ducts and Langerhans' islets bordered on the tumor. Adenocarcinoma arising from the aberrant pancreas was diagnosed from these findings. To our knowledge, this is the fourth case reported in the Japanese literature.

Key words
aberrant pancreas, duodenal carcinoma

Reprint requests
Toshihiko Waku Department of Surgery, Chyugoku Chyuoh Hospital
6-3-1, Nishifukatsu-cho, Fukuyama, 721 JAPAN

Accepted
September 11, 1996

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