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[Intraductal Papillary Mucinous Carcinoma with Penetration in the Colon and Retrograde Infection-A Case Report]

Toru Kurata1, Tetsuya Asakawa, Daisuke Fujimori

  • 1Dept. of Surgery, Toyama Rosai Hospital.

Gan to Kagaku Ryoho. Cancer & Chemotherapy
|March 12, 2020
PubMed

Insights

This case study highlights intraductal papillary mucinous carcinoma (IPMC) penetrating the colon, a rare complication. Early detection and resection of IPMN are crucial for better patient outcomes.

Area of Science:

  • Gastroenterology and Oncology
  • Surgical Pathology

Background:

  • Intraductal papillary mucinous neoplasm (IPMN) is a premalignant lesion of the pancreas.
  • IPMN can transform into invasive adenocarcinoma, posing a risk of local invasion and metastasis.

Observation:

  • An 82-year-old male presented with left upper abdominal pain.
  • Abdominal CT revealed a 7 cm IPMC of the pancreatic tail penetrating the colon, with evidence of retrograde infection.
  • Surgical resection (distal pancreatectomy with colectomy) was performed after antibacterial treatment.

Findings:

  • Pathological examination confirmed adenocarcinoma invading the colon, with extensive fibrosis and calcification suggesting a long disease duration.
  • Despite adjuvant chemotherapy, the patient experienced recurrence with peritoneal dissemination 9 months post-surgery.
  • Systemic chemotherapy was initiated for recurrent disease.

Implications:

  • IPMNs have the potential to invade adjacent organs, leading to a poor prognosis even after prolonged periods.
  • Appropriate follow-up and timely resection of IPMN are essential, particularly upon suspicion of malignant transformation.
  • This case underscores the importance of vigilance in managing IPMN to prevent advanced disease and improve patient survival.

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