title: Mucinous cystic neoplasm of the pancreas presenting with hemosuccus pancreaticus: report of a case.
abstract: Hemosuccus pancreaticus (HP) is mostly induced by a ruptured pseudoaneurysm or hemorrhage from a pseudocyst in chronic pancreatitis. We herein report a rare case with HP induced by tumor hemorrhage. The present patient is a 71-year-old woman referred to us with a diagnosis of severe progressive anemia. Endoscopy revealed hemorrhage from the papilla of Vater. Computed tomography showed a multilocular cystic tumor in the tail of the pancreas. The patient underwent a distal pancreatectomy. The histopathological diagnosis was carcinoma in mucinous cystadenoma. No cancer infiltration into the pancreatic duct was detected. Pancreatography of the resected specimen demonstrated an overt communication between the main pancreatic duct and the cystic cavity of the tumor, which was not demonstrated preoperatively by endoscopic retrograde pancreatography. Although the cause of HP is mainly acute or chronic pancreatitis, we should bear in mind that a pancreatic tumor may be a possible cause of HP and that, as such, prompt and proper treatment is mandatory.
authors.affiliation: Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Shinzeki
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hori
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujino
authors.forename: Ippei
authors.initials: I
authors.lastname: Matsumoto
authors.forename: Hirochika
authors.initials: H
authors.lastname: Toyama
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Tsujimura
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sakai
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ajiki
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kuroda
authors.forename: Yonson
authors.initials: Y
authors.lastname: Ku
mesh_terms: D000368:Aged; D018291:Cystadenoma, Mucinous / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D003952:Diagnostic Imaging; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010180:Pancreatectomy; D010181:Pancreatic Cyst / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery*