title: Bone morphogenetic protein-2 expression in an intraductal papillary mucinous neoplasm with marked ossification: A case report.
abstract: Intratumoral ossification has been reported in a number of epithelial tumors, but its presence in intraductal papillary mucinous neoplasms (IPMNs) is very rare. Herein, we present a rare case of IPMN with marked ossification. A 56-year-old Japanese man was under follow-up for a previously diagnosed IPMN. Seven years later, he was found to have dilatation of the main pancreatic duct and an enlarged solid mass, for which pancreaticoduodenectomy was performed. Macroscopically, multiple and cystically dilated pancreatic branch ducts, as well as a dilated main pancreatic duct, were identified. There was a solid, polypoid hard mass measuring 15 × 12 mm in the cystically dilated branch of the duct in the pancreatic head. Histological examination revealed papillary proliferation of atypical cuboidal or columnar epithelial cells in the dilated main and branch pancreatic ducts. The solid mass included an invasive adenocarcinoma component with a tubular or trabecular structure that showed pronounced ossification. We diagnosed the patient with invasive IPMN accompanied by marked ossification. Immunohistochemically, tumor cells in both the non-invasive and invasive lesions expressed bone morphogenetic protein-2 (BMP-2). While the mechanism of intratumoral ossification is unclear, it may have involved BMP-2 in the present case.
authors.affiliation: Department of Gastroenterology and Hepatology, Tokai University School of Medicine.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Hadano
authors.affiliation: Department of Pathology, Tokai University School of Medicine.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hirabayashi
authors.affiliation: Department of Radiology, Tokai University School of Medicine.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamuro
authors.affiliation: Department of Pathology, Tokai University School of Medicine.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Takanashi
authors.affiliation: Department of Pathology, Tokai University School of Medicine.|Department of Surgery, Tokai University School of Medicine.
authors.forename: Misuzu
authors.initials: M
authors.lastname: Yamada
authors.affiliation: Department of Gastroenterology and Hepatology, Tokai University School of Medicine.
authors.forename: Aya
authors.initials: A
authors.lastname: Kawanishi
authors.affiliation: Department of Gastroenterology and Hepatology, Tokai University School of Medicine.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kawaguchi
authors.affiliation: Department of Surgery, Tokai University School of Medicine.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Furukawa
authors.affiliation: Department of Surgery, Tokai University School of Medicine.
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakagohri
authors.affiliation: Department of Radiology, Tokai University School of Medicine.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
authors.affiliation: Department of Pathology, Tokai University School of Medicine.
authors.forename: Naoya
authors.initials: N
authors.lastname: Nakamura
authors.affiliation: Department of Gastroenterology and Hepatology, Tokai University School of Medicine.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mine
keywords: bone morphogenetic protein-2; intraductal papillary mucinous neoplasm; invasion; ossification; pancreas