A Case of Ductal Carcinoma in Situ of the Pancreas Associated with Miltiple Cysts Detected by Ultrasonic Examination

Yoshito Iida*, Syujirou Ohta*, Shin Watanabe*, Syunji Futagawa*, Kazuhiro Satoh**, Kaori Wakabayashi**, Joe Ariyama**, Kouichi Suda***

*The Second Department of Surgery, **Department of Gastroenterology, **Department of Pathology, Juntendo University of School of Medicine

Ductal carcinoma in situ of the pancreas which is defined as a carcinoma localized within the ductal epithelium with little or no papillary proliferation has rarely been reported. A patient with this disorder was treated in our department and is reported herein. The patient is a 74-year-old man who underwent a total thyroidectomy for thyroid carcinoma 11 years ago. During the period of follow-up by ultrasonic screening of the abdomen, multiple cystic lesions were detected at the head of the pancreas. Detailed examination of the pancreas by transduodenal endoscopic ultrasonography and endoscopic retrograde pancreatography revealed stenosis of the primary branch of the pancreatic duct. Under diagnosis of non-invasive pancreatic carcinoma, pancreatoduodenectomy was performed. Pathologic examination of the resected specimen revealed carcinoma in situ arising from the primary to secondary pancreatic duct and retention cysts that developed at the distal duct. P-53 and Ki-ras proteins could not be demonstrated by immunohistochemical procedures. This patient was initially thought to have an abnormality in the head of the pancreas as a result of ultrasonic screening of the abdomen and was successfully treated as pancreatic carcinoma. More careful analysis of imaging examinations makes possible to detect earlier stage of carcinoma.

Key words
ductal carcinoma in situ of the pancreas, multiple cysts of the pancreas head

Reprint requests
Yoshito Iida Second Department of Surgery, Juntendo University 2 1 Hongo, Bunkyou-ku, Tokyo, 113 JAPAN

Accepted
March 19, 1997

To read the PDF file you will need Abobe Reader installed on your computer.