A Case of Intraductal Papillary Mucinous Tumor with Carcinoma In Situ in Branching Pancreatic Duct Apart from Main Lesion

Kiyokazu Hiwatashi¹⁾, Mineo Tabata¹⁾, Jun Kadono¹⁾, Masahiko Osako¹⁾, Hiroshi Shibuya¹⁾, Akiko Nakamura¹⁾, Juro Mizouchi¹⁾, Koro Sakoda¹⁾, Michiko Horinouchi²⁾ and Takashi Aikou³⁾

Department of Surgery, Kagoshimashi Medical Association Hospital¹⁾
Department of Pathology, Kagoshimashi Medical Association Hospital²⁾
First Department of Surgery, Kagoshima University School of Medicine³⁾

A 62-years-old man reporting upper abdominal pain and distension was found in laboratory studies to have high serum amylase of 403 U/l.Ultrasonography and CT showed dilation of the main pancreatic duct and a mass 10 mm long in diameter. ERCP also showed dilation of the main pancreatic duct from the pancreas head to the body, and Vater's ampulla dilation and a filling defect near Vater's ampulla were also seen. Histological examination of the biopsy specimen and cytological examination of pancreatic juice did not show malignant cells. He was diagnosed as intraductal papillary mucinous tumor (IPMT) of the main pancreatic duct and underwent pylorus-ring-preserving-pancreaticoduode-nectomy. Pathological findings showed intraductal papillary adenoma with moderate to focal severe atypia in the main pancreatic duct, and carcinoma in situ in the branching pancreatic duct.

Key words
intraductal papillary mucinous tumor, carcinoma in situ

Reprint requests
Kiyokazu Hiwatashi First Department of Surgery, Kagoshima University School of Medicine
8-35-1 Sakuragaoka, Kagoshima city, 890-8520 JAPAN

Accepted
January 28, 2004

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