Y. Kojima et al., MULTIFOCAL INTRADUCTAL PAPILLARY ADENOCARCINOMA OF THE PANCREAS - REPORT OF A CASE, SURGERY TODAY-THE JAPANESE JOURNAL OF SURGERY, 23(5), 1993, pp. 471-475
This paper descibes a case of a mucin-producing tumor of the pancreas,
histologically diagnosed as multifocal intraductal papillary adenocar
cinoma. The patient had a markedly dilated main pancreatic duct, detec
ted by ultrasound (US) and computed tomography (CT), and endoscopy sho
wed a papillary tumor projecting from the patulous orifice of the enla
rged papilla of Vater. Several biopsies taken from the tumor indicated
a diagnosis of papillary adenocarcinoma. Total pancreatectomy was thu
s performed, revealing a multifocal papillary tumor growing along the
main duct in the head, body, and tail of the pancreas. Microscopically
, these multiple tumors were found to be mucin-producing papillary ade
nocarcinoma of the main and subsidiary pancreatic ducts with nodular a
nd microfocal periductal invasion. The surgical treatment of multifoca
l tumors, may therefore necessitate total pancreatectomy to achieve cu
rative resection, in some cases.