title: A case of pancreatic heterotopy of duodenal wall, intraductal papillary mucinous tumor and intraepithelial neoplasm of pancreas, papillary carcinoma of kidney in a single patient.
abstract: We report a case of the contemporaneous presence of two histologically different pancreatic neoplasms, one renal cancer and one embryogenic duodenal anomaly in a single patient. A 66-year-old man underwent ultrasound examination because of urinary disorders; a solid neoformation within the inferior pole of the left kidney was observed. Computed tomography confirmed the renal lesion, but also a heterogeneous mass within the pancreatic head appeared without bile ducts dilatation. Abdominal magnetic resonance revealed a multiloculated cystic component of the pancreatic mass. A second CT scan confirmed the renal and biliary findings, but it revealed a modest enlargement of the pancreatic asymptomatic mass. A resection of the left kidney inferior pole and a pylorus-preserving pancreaticoduodenectomy were performed. Histopathologic analysis of the surgical specimen revealed mild differentiated papillary renal carcinoma, intraductal papillary mucinous adenoma of the pancreatic head, foci of intraepithelial pancreatic neoplasm and pancreatic heterotopy of duodenal muscular and submucosal layers. The coexistence of several primaries and anomalies in one patient led us to suppose a genetic predisposition to different lesions, even in the absence of known familial genetic syndromes. The study of such cases may help to improve the investigation of molecular correlations and etiological factors of different solid tumors. Nowadays, surgery is the only effective cure.
authors.affiliation: Department of Surgery, San Gerardo Hospital, University of Milan-Bicocca, Monza, Italy. cinzia.nobi@libero.it
authors.forename: Cinzia
authors.initials: C
authors.lastname: Nobili
authors.forename: Claudio
authors.initials: C
authors.lastname: Franciosi
authors.forename: Luca
authors.initials: L
authors.lastname: Degrate
authors.forename: Roberto
authors.initials: R
authors.lastname: Caprotti
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Romano
authors.forename: Elisa
authors.initials: E
authors.lastname: Perego
authors.forename: Rosangela
authors.initials: R
authors.lastname: Trezzi
authors.forename: Biagio Eugenio
authors.initials: BE
authors.lastname: Leone
authors.forename: Franco
authors.initials: F
authors.lastname: Uggeri
mesh_terms: D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis; D002291:Carcinoma, Papillary / Q000175:diagnosis; D002292:Carcinoma, Renal Cell / Q000175:diagnosis; D002828:Choristoma / Q000175:diagnosis; D018282:Cystadenocarcinoma, Mucinous / Q000175:diagnosis; D004378:Duodenal Diseases / Q000175:diagnosis; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis; D009392:Nephrectomy / Q000379:methods; D010179:Pancreas / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis; D016577:Pancreaticoduodenectomy; D014057:Tomography, X-Ray Computed