Curative resection for a pancreatic endocrine carcinoma involving the portal vein.
A 68-year-old male was admitted to our hospital for worsening of diabetes mellitus. Abdominal computed tomography showed a well-enhanced tumor in the head of the pancreas. Endoscopic retrograde cholangiopancreatography revealed tapering obstruction of the main pancreatic duct and stricture of the common bile duct. Celiac angiography demonstrated a vague tumor stain. Percutaneous transhepatic portography disclosed stricture of the portal vein. Pylorus-preserving pancreatoduodenectomy with segmental resection and reconstruction of the portal vein was performed under a diagnosis of nonfunctioning endocrine carcinoma of the pancreas. Histological examination demonstrated that the tumor was composed of small nests and cords of cuboidal cells with nodal invasion, and was proven to be nonfunctioning endocrine carcinoma of the pancreas. Microscopically, the tumor invaded the portal vein, common bile duct and main pancreatic duct. The postoperative course was uneventful, and he is now well without any evidence of recurrent disease 14 months after surgery.
Sakamoto
Eiji
E
Department of Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan. sakaeiji@nagoya2.jrc.or.jp
Hasegawa
Hiroshi
H
Ogiso
Seiji
S
Igami
Tsuyoshi
T
Mori
Toshiharu
T
Mizuno
Takashi
T
Hattori
Kotaro
K
Sugimoto
Masayuki
M
Fukami
Yasuyuki
Y
D007516:Adenoma, Islet Cell / Q000175:diagnosis / Q000601:surgery*; D000368:Aged; D001707:Biopsy, Needle; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011169:Portal Vein / Q000473:pathology* / Q000601:surgery; D011172:Portography; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome