title: Postoperative recurrence of an IPMN of the pancreas with a fistula to the stomach.
abstract: We report on a case of a 74 year old man who was diagnosed with a recurrence of non-invasive carcinoma of intraductal papillary mucinous neoplasm (non-invasive IPMN) by postoperative gastroscopy (GS). A pylorus preserving pancreatico duodenectomy for IPMN in the pancreatic head was performed. A histopathological study revealed non-invasive adenocarcinoma. At first, the local recurrence of the tumor around the superior mesenteric artery circumference was diagnosed and disappeared with gemcitabine. Later, the GS showed the elevated lesion with mucin hypersecretion in the remnant stomach. The lesion had a central dip and a fistula common to the pancreas was confirmed on fisterography. We diagnosed a recurrence of IPMN and administered chemotherapy again. However, he died of his original illness. There are no reports of postoperative recurrence of IPMN checked by GS. It should be remembered that the elevated lesion of the remnant stomach is considered as one of the recurrent patterns of IPMN.
authors.affiliation: Masaya Uesato, Yoshihiro Nabeya, Takashi Akai, Kiyohiko Shuto, Hisahiro Matsubara, Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Uesato
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nabeya
authors.forename: Shinichi
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Taito
authors.initials: T
authors.lastname: Aoki
authors.forename: Takashi
authors.initials: T
authors.lastname: Akai
authors.forename: Kiyohiko
authors.initials: K
authors.lastname: Shuto
authors.forename: Tohru
authors.initials: T
authors.lastname: Tanizawa
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Matsubara