title: [Pancreatic Adenosquamous Carcinoma That Developed after Resection of IPMA in the Pancreatic Tail].
abstract: Pancreatic adenosquamous carcinoma coexisting with intraductal papillary mucinous neoplasm(IPMN)is extremely rare. We report a rare case of pancreatic adenosquamous carcinoma that developed after resection of intraductal papillary mucinous adenoma(IPMA). A 67-year-old man was suspected of having a pancreatic cystic lesion. MRCP demonstrated a cystic lesion measuring 25mm in the pancreatic tail, which had an enhanced nodule. We therefore diagnosed branch duct type IPMN of the pancreas. Although pancreatic juice cytology did not indicate malignancy, we performed laparoscope-assisted distal pancreatectomy. The reason why the IPMN lesion had an enhanced nodule. The histopathological diagnosis was IPMA without malignancy. One year and 5 months after surgery, blood analysis showed an elevated tumor marker level, and abdominal CT demonstrated a pancreatic head tumor with lymphadenopathy. EUS-FNA was performed and the patient was diagnosed with pancreatic adenosquamous carcinoma based on immunohistochemical staining. We administered chemotherapy with gemcitabine and S-1. After 3 courses of this chemotherapy, the size of the pancreatic tumor and the tumor marker level decreased. The patient achieved a partial response. He is still receiving chemotherapy after 7 courses.
authors.affiliation: Dept. of Surgery, Iwase General Hospital.
authors.forename: Akinao
authors.initials: A
authors.lastname: Kaneta
authors.forename: Takao
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Takahiro
authors.initials: T
authors.lastname: Saito
authors.forename: Satoshi
authors.initials: S
authors.lastname: Otani
authors.forename: Fujio
authors.initials: F
authors.lastname: Ito
authors.forename: Junichi
authors.initials: J
authors.lastname: Miura
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018196:Carcinoma, Adenosquamous / Q000188:drug therapy / Q000601:surgery*; D021441:Carcinoma, Pancreatic Ductal / Q000601:surgery; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004338:Drug Combinations; D006801:Humans; D008297:Male; D010094:Oxonic Acid / Q000008:administration & dosage; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D005641:Tegafur / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine