PROBLEMS IN THE DIAGNOSIS AND TREATMENT OF A SO-CALLED MUCIN-PRODUCING TUMOR OF THE PANCREAS

Reports of a so-called ''mucin-producing tumor of the pancreas'' are i ncreasing worldwide. Although the clinicopathologic features and thera peutic strategies of this tumor have been enthusiastically investigate d, there are still many unanswered questions regarding this ailment. I n this study, problems in the diagnosis and treatment of mucin-produci ng tumor were analyzed, based on the 259 reported cases of this tumor. The overall 5-year survival rate for resected cases is 83%, which is much higher than that for ordinary duct cell carcinoma (17.3%). Howeve r, the 5-year survival rate for carcinoma cases with infiltration into other organs is 28%, which is much lower than those for carcinoma cas es without infiltration (86%) and carcinoma cases with infiltration th at remained within the pancreatic parenchyma (74%). These results demo nstrate that patients with this tumor have a poor prognosis if the tum or infiltrates other organs. In addition, when the spread of the tumor is >6 cm, the prognosis is significantly worse than when the tumor ha s a spread of <6 cm. The significance of using the presence of K-ras m utation in the pancreatic juice for diagnosis of this tumor and proble ms of duodenum-preserving pancreatic head resection are discussed.