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Intraductal papillary‐mucinous adenocarcinoma in the remnant pancreas after pancreatoduodenectomy for cancer of Vater's papilla associated with intraductal papillary‐mucinous adenoma
Author(s) -
Ishida Masaharu,
Egawa Shinichi,
Sakata Naoaki,
Mikami Yukio,
Motoi Fuyuhiko,
Abe Tadayoshi,
Fukuyama Shoji,
Sunamura Makoto,
Furukawa Toru,
Unno Michiaki
Publication year - 2007
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-006-1199-9
Subject(s) - major duodenal papilla , medicine , pancreas , intraductal papillary mucinous neoplasm , adenocarcinoma , pancreatic duct , papillary adenocarcinoma , pancreaticoduodenectomy , mucinous tumor , duct (anatomy) , cancer , pathology , gastroenterology
A 72‐year‐old woman, who had undergone pylorus‐preserving pancreatoduodenectomy 3 years before for cancer of Vater's papilla associated with a branch‐type intraductal papillary‐mucinous adenoma (IPMA), developed dilatation of the main duct and a nodular lesion in the remnant pancreas. Total pancreatectomy was performed, which revealed that the lesion was intraductal papillary‐mucinous adenocarcinoma (IPMC) with minimal invasion, suggesting the metachronous multicentric occurrence of this intraductal papillary‐mucinous neoplasm (IPMN). Because there were no malignant cells at the pancreaticojejunostomy, and because the histological appearance of the main‐duct IPMC was different from that of the IPMA in the primary specimen, the main‐duct IPMC was thought to be of different origin from the IPMA. These findings suggest that careful surveillance of the gastrointestinal tract and careful follow up are necessary for IPMN, because an IPMN could be associated with other gastrointestinal tract malignancies.