A case of intraductal papillary-mucinous carcinoma of the pancreas with the onset of acute pancreatitis

Abstract

Intraductal papillary-mucinous carcinoma of the pancreas has been reported with increasing frequency. We report a case with intraductal papillary-mucinous carcinoma of the pancreas and discuss surgical treatment and current imaging modalities. A case with intraductal papillary-mucinous carcinoma was analyzed by radiological findings and clinical course. A 47-year-old man developed abdominal pain and nausea. Computed tomography showed a diffusely dilated main pancreatic duct. Duodenoscopy showed a patulous orifice of the pancreas with massive mucus secretion, but the pancreatic juice was not positive for malignant cells. Endoscopic retrograde cholangiopancreatography revealed a markedly dilated pancreatic duct extending from the body to the tail of the pancreas. Distal pancreatectomy was performed with splenectomy and lymph nodes dissection. Histopathological diagnosis was intraductal papillary-mucinous carcinoma. Endoscopic retrograde cholangiopancreatography is useful for diagnosing intraductal papillary mucin-producing tumors. To avoid unnecessary total pancreatectomy and preserve pancreatic function, intraoperative frozen section examination is widely available for the surgical treatment of intraductal papillary mucin-producing tumors.