[Multiple primary intraductal tumors of Wirsung's duct: demonstration of a relation between benign and malignant tumors].
A case of multiple villous and, more rarely, tubulovillous adenomas of the main pancreatic duct, associated with a diffuse infiltrating adenocarcinoma of the pancreas in which evidence for a link between these lesions is supported by histopathologic features, is reported in a 53 year old patient. Clinical presentation included abdominal pain, weight loss and chronic diarrhea with steatorrhea related to pancreatic insufficiency. Retrograde endoscopic pancreatography showed a complete stenosis of the main pancreatic duct located 3 mm beyond the ampulla of Vater. CT scan showed an heterogeneous cephalic pancreatic tumor with extensive enlargement of the main pancreatic duct. After total pancreatectomy, recovery was maintained (follow-up 18 months). By analogy to colorectal tumors, a new pathologic classification of these rare neoplasms may be proposed.
Halphen
M
M
Service de Gastroentérologie, Hôpital Saint-Lazare, Paris.
Hoang
C
C
Hautefeuille
P
P
Marteau
P
P
Bitoun
A
A
Jacquenod
P
P
Caruana
A
A
Cochand-Priollet
B
B
Galian
A
A
D000230:Adenocarcinoma / Q000473:pathology*; D000236:Adenoma / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology*; D010183:Pancreatic Ducts; D010190:Pancreatic Neoplasms / Q000473:pathology*
Tumeurs intra-canalaires primitives multiples du canal de Wirsung: démonstration d'une filiation entre tumeurs bénignes et malignes.