title: Intraductal mucinous tumors occurring simultaneously in the liver and pancreas.
abstract: A case of simultaneous intraductal mucinous tumors of the liver and pancreas in a 67-year-old man is described. Abdominal ultrasonography and computed tomography (CT) revealed the presence of cystic lesions with intraluminal septae both in the caudate lobe of the liver and in the uncinate process of the pancreas; these cystic lesions communicated with the hepatic duct and pancreatic duct, respectively. Mucin retention was observed in the cysts, and cholestasis was induced by mucin secretion into the common bile duct. The lesions were resected by left hepatic lobectomy with caudate lobectomy, and segmental pancreatectomy. Both lesions were multilocular cystic tumors with no papillary projections or focal mass effect in their walls. Histologically, both cystic lesions were a mixture of hyperplasia and adenoma lined by low papillary columnar epithelium. There were no cellular or histological features to suggest malignant change. The fibrous intratumor interstitium lacked any mesenchymal or ovarian-like stroma. The hepatic lesion was considered to be of a similar nature to intraductal papillary mucinous tumor (IPMT) of the pancreas. However, the two lesions occurred simultaneously in the liver and pancreas. This case is of interest in regard to the diagnosis and management of mucinous hepatopancreatobiliary lesions.
authors.affiliation: First Department of Surgery, Fukui Medical University, 23-3 Shimoaizuki, Matsuoka-cho, Yoshida-gun, Fukui 910-1193, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ishida
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Seki
authors.forename: Kei
authors.initials: K
authors.lastname: Honda
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Kimura
authors.forename: Kanji
authors.initials: K
authors.lastname: Katayama
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hirose
authors.forename: Manabu
authors.initials: M
authors.lastname: Dojo
authors.forename: Takeshi
authors.initials: T
authors.lastname: Azuma
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Imamura
authors.forename: Robert R
authors.initials: RR
authors.lastname: Hutchins
authors.forename: Akio
authors.initials: A
authors.lastname: Yamaguchi
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde; D018291:Cystadenoma, Mucinous / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry; D007813:Laparotomy; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome