術前画像診断に苦慮した膵invasive intraductal papillary mucinous carcinomaの1例

A case of invasive intraductal papillary mucinous carcinoma（IPMC）with atypical imaging findings

intraductal papillary mucinous neoplasm（IPMN）は膵嚢胞性腫瘍の中でも頻度が高い疾患であり，拡張分枝膵管が集簇した形態を示すことが多く，malignant potentialを有する。今回我々は，膵外に突出し厚い線維性被膜を有したことから，術前診断に難渋した膵invasive intraductal papillary mucinous carcinoma（IPMC）の1例を経験したので報告する。

We report a case of IPMC showed exophytic multilocular cystic lesion with fibrous capsule on CT and MRI. The patient was a 70 years old man. CT and MRI showed 30 mm diameter multilocular cystic mass with capsule-like rim in the splenic hilum adjacent to the stomach and pancreas. Adenocarcinoma was confirmed by EUS biopsy and distal pancreatectomy was performed in the diagnosis of mucinous cystadenocarcinoma or IPMC of the pancreas. Microscopic examination confirmed the invasive IPMC.