title: [A resected case of non-invasive type of intraductal papillary mucinous carcinoma penetrating to the duodenum].
abstract: A 74-year-old man was admitted to a nearby clinic complaining of high fever. Abdominal CT showed a 10 mm diameter cystic mass in the head of pancreas and dilation of the pancreatic duct. Endoscopy revealed a fistula filled with mucin in the posterior wall of the duodenum. The patient was referred to our institution for a surgical resection. Endoscopic ultrasonography revealed dilation of the pancreatic duct and also mural nodules in the pancreatic duct, ERP demonstrated a fistula from the pancreatic duct to the duodenum. Biopsied specimen from the papillary nodule in the pancreatic duct showed adenoma. We performed pancreaticoduodenectomy for main-duct IPMN penetrating to the duodenum. Pathological findings showed a non-invasive type of IPMC. Furthermore, a cancer invasion to the duodenum was not detected. These findings suggest that the increased pressure within the pancreatic duct caused a fistula to the duodenum.
authors.affiliation: Dept. of General Surgery, Chiba University Graduate School of Medicine.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nojima
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Fumio
authors.initials: F
authors.lastname: Kimura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshidome
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohtsuka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kato
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Yoshitomi
authors.forename: Katsunori
authors.initials: K
authors.lastname: Furukawa
authors.forename: Dan
authors.initials: D
authors.lastname: Takeuchi
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Takayashiki
authors.forename: Kousuke
authors.initials: K
authors.lastname: Suda
authors.forename: Shigetsugu
authors.initials: S
authors.lastname: Takano
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuboki
authors.forename: Masahisa
authors.initials: M
authors.lastname: Kato
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000150:complications / Q000473:pathology* / Q000601:surgery; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications / Q000473:pathology* / Q000601:surgery; D004378:Duodenal Diseases / Q000209:etiology*; D004386:Duodenum / Q000473:pathology; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology*; D008297:Male; D010185:Pancreatic Fistula / Q000209:etiology*; D010190:Pancreatic Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy