Multifocal branch-duct pancreatic intraductal papillary mucinous neoplasms.
The appropriate management for patients with multifocal branch-duct intraductal papillary mucinous neoplasms (IPMNs) of the pancreas involving the entire pancreatic gland remains unclear. We present a 66-year-old woman who underwent pylorus-preserving pancreaticoduodenectomy for a branch-duct intraductal papillary mucinous carcinoma demonstrating a grape-like multilocular cyst, 35 mm in diameter, in the head of the pancreas along with numerous number of small branch-duct IPMNs in the whole pancreas. Histologically, the multifocal cystic lesions were lined by a single row of columnar mucin-containing epithelial cells without atypia. The patient has been doing well without any recurrence during 9-year follow-up after surgery. Surgical removal of the prominent lesions suspicious of malignancy and a close observation of the remaining lesions in the remnant pancreas may be a reasonable treatment plan for patients with multifocal branch-duct IPMNs involving the entire pancreatic gland.
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. ytajima@net.nagasaki-u.ac.jp
Yoshitsugu
Y
Tajima
Tamotsu
T
Kuroki
Noritsugu
N
Tsuneoka
Amane
A
Kitasato
Tomohiko
T
Adachi
Takehiro
T
Mishima
Taiichiro
T
Kosaka
Takashi
T
Kanematsu
D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000601:surgery*; D000231:Adenocarcinoma, Papillary / Q000175:diagnosis / Q000601:surgery*; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D005260:Female; D006801:Humans; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*