A Case of Aberrant Pancreas Cancer in the Jejunum

Yoshio Uemura, Kenji Kobayashi, Koji Yoshida, Yosuke Seki, Jin Matsuyama, Taro Aoki, Toshisada Ukei, Keisuke Miyauchi and Tadashi Kaneko

Department of Surgery, Kinki Central Hospital

A 72-year-old man suffering from vomiting with abdominal pain was diagnosed with ileus. A small intestinal enema study revealed obstruction of the jejunum by a tumor. Laboratory tests showed elevated CA19-9 of 70U/ml. Under a diagnosis of cancer of the jejunum, we conducted laparotomy and found an obstruction of the jejunum about 130cm distal from Treitz's ligament. We partially resected the jejunum, including the 4×3cm tumor and dissected regional lymph nodes. The tumor was mostly covered with intact jejunal mucosa, resembling a submucosal tumor. Histopathologically, the diagnosis was tubular adenocarcinoma adjacent to aberrant pancreas with acinar cells and pancreatic ducts (Heinrich II type). Regional lymph node involvement was confirmed. Pathological diagnosis showed well-differentiated adenocarcinoma, se, n₁, ly₂, v₀, INFγ. To our knowledge, this is the fifth such case reported in the Japanese literature.

Key words
aberrant pancreas, jejunum, adenocarcinoma

Reprint requests
Yoshio Uemura Department of surgery, kinki Central Hospital 3-1 Kurumazuka, Itami, 664-8533 JAPAN

Accepted
December 19, 2000

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