A Patient with Small Pancreatic Cancer Who Survived More Than Three Years, Report of a Case Kenji Yamao 1 1The Second Department of Internal Medicine, Nagoya University School of Medicine pp.861-866
Published Date 1988/8/25
DOI https://doi.org/10.11477/mf.1403108327
  • Abstract
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 A 57-year-old woman was seen because of body weight loss and general fatigue. Laboratory findings were normal. Ultrasonography showed a hypoechoic mass,12 mm in diameter, in the body of the pancreas. Conventional ERCP revealed stenosis of the main duct in the pacreatic body. Magnified ERCP showed tapering stenosis of the main duct and branch ducts. Enhanced CT and angiography, however, showed no abnormality. Endoscopic ultrasonogram (EUS) demonstrated a well defined tumor mass with no dilatation of the caudal pancreatic duct. The tumor mass was hypoechoic as a whole, and centrally echogenic by EUS. Distal pancreatectomy was performed.

 Histological examination revealed moderately differentiated tubular adenocarcinoma, 8 mm in diameter, within the pancreatic capsule. We experienced 21 cases of pancreatic cancer smaller than 2 cm, including this case, and 4 cases of pancreatic carcinoma in situ. Based on these experiences, a new classification of pancreatic duct cancer was proposed to make diagnosis in early stage. That includes 1) scirrhous invasion type, 2) intraductal spreading with mucin hypersecretion type, 3) intraductal spreading without mucin hypersecretion type.

 It is necessary, we think, to make a judicious choice among a variety of imaging modalities and biopsy procedures according to this classification.

Copyright © 1988, Igaku-Shoin Ltd. All rights reserved.


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