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Small Carcinoma of the Head of the Pancreas, Report of a Case H. Ozaki 1 , H. Ohkura 2 , K. Nakamura 2 , M. Yoshimori 2 , Y. Oka 2 , K. Kishi 3 1Department of Surgery, National Cancer Center Hospital 2Department of Internal Medicine, National Cancer Center Hospital 3Department of Pathology, National Cancer Center Hospital pp.647-651
Published Date 1980/6/25
DOI https://doi.org/10.11477/mf.1403106907
  • Abstract
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 The patient was a 77 year-old male who had been followed up because of gastric ulcer since 1964. On February 16, 1979, he suddenly had migrane with anorexia and hoarseness of the voice. At that time glycosuria was detected by his home doctor. In April, abnormally high level of amylase was detected in his urine and serum and he was admitted to the National Cancer Center Hospital for further examinations.

 Endoscopic retrograde cho1angio-pancreatography revealed a remarkable stenosis of the main pancreatic duct in the head of the pancreas, suggesting carcinoma of the pancreas. The caudal part of the pancreatic duct was tortuous and dilated. The dilatation of the caudal pancreatic duct was also med by computed tomography and ultrasonography. However, malignancy was not pointed out by these examinations. Selective abdominal angiography was negative for malignancy.

 On June 19, 1979, the patient was operated on. Marked adhesion was observed in the upper abdominal cavity, but neither ascites nor metastatic lesions were detected. A pigeon-egg sized tumor was found in the head of the pancreas. On palpation the caudal part of the pancreas was hard and there was possibility of cancer infiltration to the pancreatic body and tail, so total pancreatectomy was carried out.

 On cut surface of the resected specimen, a tumor measuring 1.8×1.2 cm was observed in the head of the pancreas. The main pancreatic duct adjoining the tumor was stenotic and the caudal part was remarkably dilated. Histological diagnosis was moderately differentiated adenocarcinorna. Five of the 57 lymph nodes examined were positive for cancer cells.

 The patient is alive at this writing. (May, 1980)


Copyright © 1980, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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