title: Resection of carcinoma in situ and minimally invasive carcinoma of the pancreas in a patient presenting with stenosis and post-stenotic dilatation of the main pancreatic duct on endoscopic ultrasonography and positive serial pancreatic juice aspiration cytology.
abstract: We report a rare case of a 67-year-old man who underwent resection of carcinoma in situ and minimally invasive carcinoma of the pancreas. The patient presented with upper abdominal and back pain. No definite pancreatic mass was detected on abdominal ultrasonography, computed tomography, magnetic resonance imaging (MRI), or endoscopic ultrasonography (EUS). However, EUS and MRI demonstrated stenosis of the main pancreatic duct (MPD) in the body and post-stenotic dilatation, resulting in mild dilatation of MPD in the tail. Serial pancreatic juice aspiration cytology after endoscopic nasopancreatic drainage was suggestive of pancreatic adenocarcinoma. Examination of the distal pancreatectomy specimen demonstrated carcinoma in situ in MPD and branches, with multiple intraepithelial neoplastic lesions in the background pancreas and an additional focus of minimally invasive carcinoma.
authors.affiliation: Division of Cancer Center, Kanazawa University Hospital.
authors.forename: Koushiro
authors.initials: K
authors.lastname: Ohtsubo
authors.forename: Hisatsugu
authors.initials: H
authors.lastname: Mouri
authors.forename: Kaname
authors.initials: K
authors.lastname: Yamashita
authors.forename: Isamu
authors.initials: I
authors.lastname: Makino
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Tajima
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ohta
authors.forename: Dai
authors.initials: D
authors.lastname: Inoue
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Gabata
authors.forename: Hiroko
authors.initials: H
authors.lastname: Ikeda
authors.forename: Yoh
authors.initials: Y
authors.lastname: Zen
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D002278:Carcinoma in Situ / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D003251:Constriction, Pathologic; D004108:Dilatation, Pathologic; D019160:Endosonography; D006801:Humans; D008297:Male; D064847:Multimodal Imaging; D009361:Neoplasm Invasiveness; D010189:Pancreatic Juice / Q000166:cytology*; D010190:Pancreatic Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed