Total pancreatectomy for recurrent intraductal papillary mucinous carcinoma in remnant pancreas of pancreaticoduodenectomy for intraductal papillary mucinous adenocarcinoma. 2013

Yu Ohkura, and Kazunari Sasaki, and Masamichi Matsuda, and Masaji Hashimoto
Toranomon Hospital, Tokyo, Japan. yu.ohkura107@gmail.com

A 62-year-old man underwent pancreaticoduodenectomy (PD) for intraductal papillary mucinous carcinoma (IPMC) in 2006. No signs of adenocarcinoma at the resection margin were found by intraoperative pathological examination of frozen sections. The postoperative pathological diagnosis was invasive carcinoma derived from IPMC and moderately differentiated tubular adenocarcinoma. A blood analysis in 2011 showed serum (CA19-9) to be increased since the initial resection. Imaging test showed a recurrent tumour at the site of the pancreaticogastrostomy (PG) in the remnant pancreas. We conducted total remnant pancreatectomy for recurrent IPMC and partial gastrectomy. Because both lesions had a histopathological resemblance, the pathological diagnosis was recurrent invasive IPMC. Based on this experience, it is important to facilitate early detection by annual check-up. And also, we recommend PG as a reconstructive intervention in patients at high risk of IPMC recurrence in the remnant pancreas following PD as it is grossly visible on upper gastrointestinal endoscopy.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D010180 Pancreatectomy Surgical removal of the pancreas. (Dorland, 28th ed) Pancreatectomies
D010190 Pancreatic Neoplasms Tumors or cancer of the PANCREAS. Depending on the types of ISLET CELLS present in the tumors, various hormones can be secreted: GLUCAGON from PANCREATIC ALPHA CELLS; INSULIN from PANCREATIC BETA CELLS; and SOMATOSTATIN from the SOMATOSTATIN-SECRETING CELLS. Most are malignant except the insulin-producing tumors (INSULINOMA). Cancer of Pancreas,Pancreatic Cancer,Cancer of the Pancreas,Neoplasms, Pancreatic,Pancreas Cancer,Pancreas Neoplasms,Pancreatic Acinar Carcinoma,Pancreatic Carcinoma,Acinar Carcinoma, Pancreatic,Acinar Carcinomas, Pancreatic,Cancer, Pancreas,Cancer, Pancreatic,Cancers, Pancreas,Cancers, Pancreatic,Carcinoma, Pancreatic,Carcinoma, Pancreatic Acinar,Carcinomas, Pancreatic,Carcinomas, Pancreatic Acinar,Neoplasm, Pancreas,Neoplasm, Pancreatic,Neoplasms, Pancreas,Pancreas Cancers,Pancreas Neoplasm,Pancreatic Acinar Carcinomas,Pancreatic Cancers,Pancreatic Carcinomas,Pancreatic Neoplasm
D002288 Adenocarcinoma, Mucinous An adenocarcinoma producing mucin in significant amounts. (From Dorland, 27th ed) Carcinoma, Colloid,Carcinoma, Mucinous,Adenocarcinomas, Mucinous,Carcinomas, Colloid,Carcinomas, Mucinous,Colloid Carcinoma,Colloid Carcinomas,Mucinous Adenocarcinoma,Mucinous Adenocarcinomas,Mucinous Carcinoma,Mucinous Carcinomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000231 Adenocarcinoma, Papillary An adenocarcinoma containing finger-like processes of vascular connective tissue covered by neoplastic epithelium, projecting into cysts or the cavity of glands or follicles. It occurs most frequently in the ovary and thyroid gland. (Stedman, 25th ed) Adenocarcinomas, Papillary,Papillary Adenocarcinoma,Papillary Adenocarcinomas
D016577 Pancreaticoduodenectomy The excision of the head of the pancreas and the encircling loop of the duodenum to which it is connected. Duodenopancreatectomy,Pancreatoduodenectomy,Duodenopancreatectomies,Pancreaticoduodenectomies,Pancreatoduodenectomies
D021441 Carcinoma, Pancreatic Ductal Carcinoma that arises from the PANCREATIC DUCTS. It accounts for the majority of cancers derived from the PANCREAS. Pancreatic Ductal Carcinoma,Carcinoma, Ductal, Pancreatic,Duct-Cell Carcinoma of the Pancreas,Duct-Cell Carcinoma, Pancreas,Ductal Carcinoma of the Pancreas,Pancreatic Duct Cell Carcinoma,Carcinoma, Pancreas Duct-Cell,Carcinomas, Pancreas Duct-Cell,Carcinomas, Pancreatic Ductal,Duct Cell Carcinoma of the Pancreas,Duct Cell Carcinoma, Pancreas,Duct-Cell Carcinomas, Pancreas,Ductal Carcinoma, Pancreatic,Ductal Carcinomas, Pancreatic,Pancreas Duct-Cell Carcinoma,Pancreas Duct-Cell Carcinomas,Pancreatic Ductal Carcinomas

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