A Case of Pacreatic Endocrine Carcinoma That Invaded to the Main Pancreatic Duct with Difficulty in Diagnosis to Invasive Ductal Cancer

Takashi Hiromatsu, Masatoshi Akita, Hiroshi Hasegawa, Eiji Sakamoto, Shunichiro Komatsu, Kiyotaka Kawai, Tomotake Tabata, Taro Aoba and Toyonori Tsuzuki*

Department of Surgery and Department of Pathology*, Nagoya Daini Red Cross Hospital

A 30-year-old man admitted for epigastralgia was found in abdominal computed tomography (CT) to have a 42×39 mm mass in the body of the pancreas. T1-weighted MRI showed a hypointensive tumor with a smooth margin at the anticipated site. T2-weighted MRI showed a hyperintensive tumor compressing the splenic artery and vein. Endoscopic retrograde pancreatography and magnetic resonance cholangiopancreatography showed the main pancreatic duct to be obstructed. Angiography showed no tumor staining, but the splenic artery and vein were encased. Endoscopic ultrasonography-guided needle biopsy for a definitive diagnosis indicated an endocrine tumor of the pancreas. After pancreatosplenectomy, histological examination confirmed poorly differentiated endocrine carcinoma. Immunochemical staining results were positive for CD56, synaptophysin, and Chromogranin-A. The pancreatic duct was infiltrated by tumor cells. The patient remains alive without recurrence 14 months after surgery.

Key words
endocrine carcinoma, main pancreatic duct

Reprint requests
Takashi Hiromatsu Department of Surgery, Nagoya Daini Red Cross Hospital
2-9 Myoken-cho, Showa-ku, Nagoya, 466-8650 JAPAN

Accepted
November 30, 2005

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