ANNULAR PANCREAS ASSOCIATED WITH CARCINOMA IN THE DORSAL PART OF PANCREAS DIVISUM

A carcinoma in the dorsal part of the pancreas divisum with an annular pancreas in the anterior part is reported. A 79-yr-old female was adm itted in our hospital complaining of epigastralgia. Computed tomograph y (CT) and ultrasound (US) showed an irregular mass in the pancreatic body. A pancreatogram obtained through the major duodenal papilla demo nstrated only the ventral pancreatic duct that encircled the duodenum. Contrast medium injected from the minor duodenal papilla showed Santo rini's duct obstruction at the neck portion of the pancreas without co mmunication with the ventral pancreatic duct. The patient died with li ver metastases. Autopsy confirmed annular pancreas and a 6-cm tumor in the pancreatic body extending to the pancreatic head and pancreas div isum. Pancreatic carcinoma; histologically a moderately differentiated adenocarcinoma; originated from the dorsal part of pancreas divisum. To our knowledge this is the first report of pancreatic carcinoma asso ciated with annular pancreas coexistent with pancreas divisum.