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Multifocal pancreatic ductal adenocarcinomas concomitant with intraductal papillary mucinous neoplasms of the pancreas detected by intraoperative pancreatic juice cytology. A case report.
JOP. 2010 Jul 05; 11(4):389-92.JOP

Abstract

CONTEXT

Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas have been detected with increasing frequency as a result of the progression of diagnostic modalities. Recently, invasive ductal carcinoma of the pancreas concomitant with IPMNs has been the focus of attention.

CASE REPORT

We report the case of a 57-year-old man with multifocal ductal carcinomas of the pancreas concomitant with IPMNs detected by intraoperative cytology. During a follow-up for branch duct IPMNs, a stenotic lesion of the main duct in the pancreatic body was found by ERCP, and brush cytology of the stenosis revealed an adenocarcinoma. A distal pancreatectomy was proposed; however, intraoperative pancreatic juice cytology from the pancreatic head also revealed adenocarcinoma, and a total pancreatectomy was finally carried out. Pathological examination of the resected specimen showed multifocal ductal carcinomas and IPMNs in the distal pancreas, and invasive ductal carcinoma in the pancreatic head which had not been detected by preoperative imaging studies.

CONCLUSIONS

Surgeons should be aware of the possibility of multifocal carcinomas in patients with concomitant IPMNs. Intraoperative pancreatic juice cytology should always be performed in order to confirm the absence of carcinoma in the pancreas to be left in place after planned resection.

Authors+Show Affiliations

Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

20601817

Citation

Mori, Yasuhisa, et al. "Multifocal Pancreatic Ductal Adenocarcinomas Concomitant With Intraductal Papillary Mucinous Neoplasms of the Pancreas Detected By Intraoperative Pancreatic Juice Cytology. a Case Report." JOP : Journal of the Pancreas, vol. 11, no. 4, 2010, pp. 389-92.
Mori Y, Ohtsuka T, Tsutsumi K, et al. Multifocal pancreatic ductal adenocarcinomas concomitant with intraductal papillary mucinous neoplasms of the pancreas detected by intraoperative pancreatic juice cytology. A case report. JOP. 2010;11(4):389-92.
Mori, Y., Ohtsuka, T., Tsutsumi, K., Yasui, T., Sadakari, Y., Ueda, J., Takahata, S., Nakamura, M., & Tanaka, M. (2010). Multifocal pancreatic ductal adenocarcinomas concomitant with intraductal papillary mucinous neoplasms of the pancreas detected by intraoperative pancreatic juice cytology. A case report. JOP : Journal of the Pancreas, 11(4), 389-92.
Mori Y, et al. Multifocal Pancreatic Ductal Adenocarcinomas Concomitant With Intraductal Papillary Mucinous Neoplasms of the Pancreas Detected By Intraoperative Pancreatic Juice Cytology. a Case Report. JOP. 2010 Jul 5;11(4):389-92. PubMed PMID: 20601817.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multifocal pancreatic ductal adenocarcinomas concomitant with intraductal papillary mucinous neoplasms of the pancreas detected by intraoperative pancreatic juice cytology. A case report. AU - Mori,Yasuhisa, AU - Ohtsuka,Takao, AU - Tsutsumi,Kosuke, AU - Yasui,Takaharu, AU - Sadakari,Yoshihiko, AU - Ueda,Junji, AU - Takahata,Shunichi, AU - Nakamura,Masafumi, AU - Tanaka,Masao, Y1 - 2010/07/05/ PY - 2010/7/6/entrez PY - 2010/7/6/pubmed PY - 2010/11/6/medline SP - 389 EP - 92 JF - JOP : Journal of the pancreas JO - JOP VL - 11 IS - 4 N2 - CONTEXT: Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas have been detected with increasing frequency as a result of the progression of diagnostic modalities. Recently, invasive ductal carcinoma of the pancreas concomitant with IPMNs has been the focus of attention. CASE REPORT: We report the case of a 57-year-old man with multifocal ductal carcinomas of the pancreas concomitant with IPMNs detected by intraoperative cytology. During a follow-up for branch duct IPMNs, a stenotic lesion of the main duct in the pancreatic body was found by ERCP, and brush cytology of the stenosis revealed an adenocarcinoma. A distal pancreatectomy was proposed; however, intraoperative pancreatic juice cytology from the pancreatic head also revealed adenocarcinoma, and a total pancreatectomy was finally carried out. Pathological examination of the resected specimen showed multifocal ductal carcinomas and IPMNs in the distal pancreas, and invasive ductal carcinoma in the pancreatic head which had not been detected by preoperative imaging studies. CONCLUSIONS: Surgeons should be aware of the possibility of multifocal carcinomas in patients with concomitant IPMNs. Intraoperative pancreatic juice cytology should always be performed in order to confirm the absence of carcinoma in the pancreas to be left in place after planned resection. SN - 1590-8577 UR - https://www.unboundmedicine.com/medline/citation/20601817/Multifocal_pancreatic_ductal_adenocarcinomas_concomitant_with_intraductal_papillary_mucinous_neoplasms_of_the_pancreas_detected_by_intraoperative_pancreatic_juice_cytology__A_case_report_ L2 - http://www.serena.unina.it/index.php/jop/article/view/3628/3967 DB - PRIME DP - Unbound Medicine ER -