title: Intraductal papillary and mucinous tumor of the pancreas: a case report of successful surgical treatment with decompression.
abstract: Intraductal papillary mucinous tumor of the pancreas is commonly regarded as histopathologically low-grade malignancy. As yet, no fixed strategy of treatment for the advanced aged patient with intraductal papillary mucinous tumor exists. An 80-year-old woman was admitted to our hospital in July 1996 because of back pain due to pancreatitis. Examinations showed a widely opened orifice of the ampulla of Vater, the mural nodule in the cystic lesion of the pancreas uncus, and a mucinous plug in the diffusely dilated main pancreatic duct, so the patient was diagnosed as having intraductal papillary mucinous tumor in the pancratic head. However, in view of the patient's advanced age and the fact that intraductal papillary mucinous tumor is commonly regarded as a slow growing and histopathologically low-grade malignancy, we refrained from radical operation and selected the best supportive care. Four years subsequent to this, her symptoms became uncontrollable and she returned to our hospital. In consideration of her age, side-to-side pancreaticojejunostomy as minimally invasive surgery was employed. The postoperative course was uneventful. The symptoms, biochemical profiles and images improved and she was discharged from the hospital 28 days after the operation. No event has been observed in the patient for one year after operation. Surgical decompression is considered to be effective minimally invasive surgery for intraductal papillary mucinous tumor.
authors.affiliation: First Department of Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan. hosokawa@sapmed.ac.jp
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hosokawa
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Mukaiya
authors.forename: Toshio
authors.initials: T
authors.lastname: Honma
authors.forename: Jun
authors.initials: J
authors.lastname: Araya
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Nishidate
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography