A case of intraductal papillary mucinous neoplasm of the pancreas rupturing both the stomach and duodenum.
BACKGROUND
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas may extend to other organs. However, it is rare for a histopathologically benign IPMN to rupture other organs, particularly multiple organs. There has been no report of a benign IPMN rupturing both the stomach and duodenum.


OBJECTIVE
We experienced a very rare case and make personal remarks based on bibliographical consideration.


METHODS
Case report.


METHODS
National Defense Medical College.


METHODS
A patient with IPMN.


METHODS
EGD, ERCP, and pancreatoduodenectomy.


CONCLUSIONS
We report a case of benign IPMN of the pancreas extending to two adjacent organs. A 77-year-old male who was diagnosed as having IPMN by CT, MRI, upper GIF, and ERCP underwent pancreatoduodenectomy for a mass of 4.2 cm in diameter. Pathological examinations revealed that the IPMN was composed of adenoma. Intraluminal nodular growth was observed in the duodenal gland tissue, and abnormal growth was observed in the fistula to the stomach. According to a literature review based on PubMed data up until March 2009, it is rare for a benign IPMN to penetrate two adjacent organs.
Shimizu
Motonori
M
Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
Kawaguchi
Atsushi
A
Nagao
Shigeaki
S
Hozumi
Hideaki
H
Komoto
Shunsuke
S
Hokari
Ryota
R
Miura
Soichiro
S
Hatsuse
Kazuo
K
Ogata
Sho
S
D002288:Adenocarcinoma, Mucinous / Q000556:secondary* / Q000601:surgery; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000556:secondary* / Q000601:surgery; D002291:Carcinoma, Papillary / Q000556:secondary* / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D004379:Duodenal Neoplasms / Q000150:complications / Q000556:secondary* / Q000601:surgery; D019160:Endosonography / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000379:methods; D035583:Rare Diseases; D018570:Risk Assessment; D012422:Rupture, Spontaneous / Q000209:etiology / Q000601:surgery; D013274:Stomach Neoplasms / Q000150:complications / Q000556:secondary* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome