A case of intraductal papillary-mucinous neoplasm of the pancreas penetrating into the stomach and spleen successfully treated by total pancreatectomy

Surgical Case Reports
Takashi HarinoKeizo Dono

Abstract

Intraductal papillary-mucinous neoplasms (IPMNs) are potentially malignant intraductal epithelial neoplasms that sometimes penetrate into other organs. To the best of our knowledge, no report has yet described a case with penetration into the spleen. We recently encountered a case of IPMN with penetration of the stomach and spleen that was successfully treated by total pancreatectomy. A 70-year-old female visited our hospital with a complaint of fever and abdominal pain. Contrast-enhanced computed tomography (CT) revealed dilatation of the main pancreatic duct in the entire pancreas and penetration into the stomach and spleen. Upper gastrointestinal endoscopy revealed mucin extruding from four openings of the fistula in the stomach. No malignancy was detected based on cytology of the mucin. Inflammation markers and tumor markers (CEA, CA19-9) were elevated in the blood. The pre-operative diagnosis was IPMN of main pancreatic duct type penetrating into the stomach and spleen. A total pancreatectomy and splenectomy were performed, combined with distal gastrectomy including resection of the fistulas between the pancreas and stomach. No postoperative complications were noted. Histopathological examination of the resected specimen r...Continue Reading

References

Dec 6, 2005·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Masao TanakaUNKNOWN International Association of Pancreatology
Jun 16, 2010·Journal of Gastroenterology·Go KobayashiTakashi Sawai
Jun 13, 2012·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Masao TanakaUNKNOWN International Association of Pancreatology

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