A Case with in Situ Carcinoma of the Pancreas and Intraductal Papillary-Mucinous Tumors

Nobuhiko Ueda, Motomi Kawasaki, Seiko Uwafuji, Hajime Furuya, Hisatoshi Nakagawara, Shouichi Okada, Yutaka Yoshimitu, Toshiharu Sawa and Fumio Konishi*

Department of Surgery, National Fukui Hospital
Department of Pathology, Fukui Red Cross Hospital*

We report a case with in situ carcinoma of the pancreas (CIS) and intraductal papillary-mucinous tumors (IPMTs). A 68-year-old man was found in abdominal CT on admission to have acute pancreatitis with dilation of the main pancreatic duct at the body and tail of the pancreas and local inflammation had no recognizable mass at the head or body even after inflammation was reduced. ERP showed stenosis of the main pancreatic duct at the body of the pancreas and slight dilation at the tail, but inadequate representation of branches. Cytology of the pancreatic juice was class IV, so we conducted pancreatectomy of the body and tail and splenectomy with D1 lymph node dissection. Pathological findings showed fibrous thickening of the main pancreatic duct at the stenotic portion and atrophy of the acinus around the duct. Although the epithelium of the main pancreatic duct at the stenotic portion was CIS, the epithelium at the tail of the stenotic portion showed intraductal papillary-mucinous adenoma with moderate dysplasia. Most epithelium of branches at the tail of the stenotic portion had IPMTs with dysplasia and part of the epithelimu was CIS. The patient has been followed up for 7 months without evidence of recurrence.

Key words
in situ carcinoma of the pancreas, intraductal papillary-mucinous tumors, acute pancreatitis

Reprint requests
Nobuhiko Ueda Department of Surgery, National Fukui Hospital
33-1 Sakuragaoka-cho, Turuga, 914-0195 JAPAN

Accepted
December 19, 2003

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