Intraductal Papillary Mucinous Neoplasm Localized in Ventral Pancreas in a Patient with Pancreas Divisum

Masahide Hiyoshi, Jiro Ohuchida, Kazuo Chijiiwa, Ichiro Makino, Masahiro Kai, Kazuhiro Kondo, Kouki Nagaike* and Hiroaki Kataoka*

Department of Surgery 1 and Department of Pathology 2*, Miyazaki University School of Medicine

We report a rare case of intraductal papillary mucinous neoplasm localized in the ventral pancreas associated with pancreas divisum. A 74-year-old man was admitted for further examination of a cystic lesion in the pancreatic head. Ultrasonography and computed tomography showed a multilocular cystic lesion in the pancreatic head. MRCP suggested a cystic lesion with pancreas divisum. ERCP via the major papilla showed only the cystic lesion, and it was unsuccessful via the minor papilla. The size of the cystic lesion, which was greater than 3 cm, and the presence of a mural nodule greater than 5 mm suggested a malignant neoplasm. Subtotal stomach-preserving pancreaticoduodenectomy with D2 lymph node dissection was performed. The pathological diagnosis of the resected specimen was intraductal papillary mucinous adenoma. Since to our knowledge only four cases of intraductal papillary mucinous neoplasm with pancreas divisum have ever been reported, we report our case and discuss it.

Key words
intraductal papillary mucinous neoplasm, pancreas divisum, ventral pancreas

Reprint requests
Kazuo Chijiiwa Department of Surgery 1, Miyazaki University School of Medicine
5200 Kihara, Kiyotake-cho, Miyazaki-gun, 889-1692 JAPAN

Accepted
March 30, 2005

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