A Case of Agenesis of the Pancreatic Body and Tail with the Lower Bile Duct Carcinoma

Naohito Kanazumi, Shin Takeda, Kouji Miyoshi, Tetsuya Kaneko and Akimasa Nakao

Department of Surgery II, Nagoya University School of Medicine

We report a very rare case of agenesis of the pancreatic body and tail with lower bile duct cancer. A 47-year-old woman followed up for diabetes mellitus was found to have liver function disorder in blood chemistry tests done due to general fatigue. Abdominal ultrasonography (US) showed a highly echoic 14 mm tumor in the lower bile duct. Endoscopic retrograde pancreatography (ERCP) showed a defect in the lower bile duct and a short main pancreatic duct in the pancreatic head, but the accessory pancreatic duct and minor papilla were absent. Plain computed tomography (CT) showed no tissue of the pancreatic body and tail. A biopsy specimen in percutaneous transhepatic cholangioscope showed adenocarcinoma, so we conducted pylorus-preserving total pancreatectomy based on a diagnosis of lower bile duct cancer with agenesis of the pancreatic body and tail. On laparotomy, the pancreatic body and tail could not be found, and the splenic vein was completely exposed. Histopathological findings showed well-differentiated tubular adenocarcinoma. Agenesis of the pancreatic body and tail is rare, especially in bile duct cancer, with our case being only the fifth reported in the Japanese literature.

Key words
agenesis of the pancreatic body and tail, bile duct cancer

Reprint requests
Naohito Kanazumi Department of Surgery, Okazaki City Hospital
3-1 Goshoai, Koryuji-cho, Okazaki, 444-8553 JAPAN

Accepted
February 27, 2002

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