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Application of End-to-end Anastomosis in Robotic Central Pancreatectomy
Published on: June 2, 2018
Multi-centric pancreatic cancer without PanIN lesion
Yoshiki Naito1, Naofumi Eriguchi, Tohru Kume
1Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan. nyoshiki@med.kurume-u.ac.jp
Journal of Hepato-Biliary-Pancreatic Surgery
|April 1, 2009
Summary
This case study describes a 67-year-old man with two independent pancreatic invasive ductal carcinomas (IDCs) in the body and tail, diagnosed after a year of follow-up for gastric cancer. Surgical resection confirmed the independent nature of these pancreatic cancers.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Pathology
Background:
- A 67-year-old male patient with a history of gastric cancer surgery was monitored for a pancreatic mass.
- Initial CT showed a 14mm hypovascular pancreatic body mass; the patient declined treatment.
- Follow-up revealed elevated fasting blood glucose and HbA1c, indicating new-onset diabetes mellitus.
Observation:
- Abdominal CT identified two masses: a 20mm mass in the pancreatic body and a 12mm mass in the pancreatic tail.
- Magnetic resonance imaging cholangiopancreatography (MRCP) demonstrated discontinuity of the main pancreatic duct (MPD).
- These imaging findings raised suspicion for invasive ductal carcinoma (IDC) in both the pancreatic body and tail.
Findings:
- Distal pancreatectomy with splenectomy was performed.
- Histological examination confirmed the presence of invasive ductal carcinomas (IDCs) in both the pancreatic body and tail.
- Notably, pancreatic intraepithelial neoplasia (PanIN) was absent in the main pancreatic duct between the two diagnosed carcinomas, supporting their independent origin.
Implications:
- The case highlights the possibility of multiple, independent primary pancreatic invasive ductal carcinomas.
- This finding has implications for surgical planning and understanding pancreatic cancer development.
- Further research may elucidate the specific mechanisms leading to multifocal, independent pancreatic tumorigenesis.
