title: A case of intraductal papillary mucinous neoplasm of the pancreas rupturing both the stomach and duodenum.
abstract: 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.
authors.affiliation: Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
authors.forename: Motonori
authors.initials: M
authors.lastname: Shimizu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawaguchi
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Nagao
authors.forename: Hideaki
authors.initials: H
authors.lastname: Hozumi
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Komoto
authors.forename: Ryota
authors.initials: R
authors.lastname: Hokari
authors.forename: Soichiro
authors.initials: S
authors.lastname: Miura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hatsuse
authors.forename: Sho
authors.initials: S
authors.lastname: Ogata
mesh_terms: 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