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Bone morphogenetic protein‐2 expression in an intraductal papillary mucinous neoplasm with marked ossification: A case report
Author(s) -
Hadano Atsuko,
Hirabayashi Kenichi,
Yamamuro Hiroshi,
Takanashi Yumi,
Yamada Misuzu,
Kawanishi Aya,
Kawaguchi Yoshiaki,
Furukawa Daisuke,
Nakagohri Toshio,
Imai Yutaka,
Nakamura Naoya,
Mine Tetsuya
Publication year - 2016
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/pin.12416
Subject(s) - ossification , medicine , pathology , intraductal papillary mucinous neoplasm , pancreatic duct , pancreaticoduodenectomy , adenocarcinoma , pancreas , bone morphogenetic protein 2 , anatomy , biology , cancer , biochemistry , in vitro
Intratumoral ossification has been reported in a number of epithelial tumors, but its presence in intraductal papillary mucinous neoplasms (IPMNs) is very rare. Herein, we present a rare case of IPMN with marked ossification. A 56‐year‐old Japanese man was under follow‐up for a previously diagnosed IPMN. Seven years later, he was found to have dilatation of the main pancreatic duct and an enlarged solid mass, for which pancreaticoduodenectomy was performed. Macroscopically, multiple and cystically dilated pancreatic branch ducts, as well as a dilated main pancreatic duct, were identified. There was a solid, polypoid hard mass measuring 15 × 12 mm in the cystically dilated branch of the duct in the pancreatic head. Histological examination revealed papillary proliferation of atypical cuboidal or columnar epithelial cells in the dilated main and branch pancreatic ducts. The solid mass included an invasive adenocarcinoma component with a tubular or trabecular structure that showed pronounced ossification. We diagnosed the patient with invasive IPMN accompanied by marked ossification. Immunohistochemically, tumor cells in both the non‐invasive and invasive lesions expressed bone morphogenetic protein‐2 (BMP‐2). While the mechanism of intratumoral ossification is unclear, it may have involved BMP‐2 in the present case.