A case of intraductal papillary mucinous neoplasm of the pancreas rupturing both the stomach and duodenum

Background

Intraductal papillary mucinous neoplasm (IPMN) of the pancreas may extend to other organs. However, it is rare for a histopathologically benign IPMN to rupture other organs, particularly multiple organs. There has been no report of a benign IPMN rupturing both the stomach and duodenum.

Objective

We experienced a very rare case and make personal remarks based on bibliographical consideration.

Design

Case report.

Setting

National Defense Medical College.

Patient

A patient with IPMN.

Intervention

EGD, ERCP, and pancreatoduodenectomy.

Conclusions

We report a case of benign IPMN of the pancreas extending to two adjacent organs. A 77-year-old male who was diagnosed as having IPMN by CT, MRI, upper GIF, and ERCP underwent pancreatoduodenectomy for a mass of 4.2 cm in diameter. Pathological examinations revealed that the IPMN was composed of adenoma. Intraluminal nodular growth was observed in the duodenal gland tissue, and abnormal growth was observed in the fistula to the stomach. According to a literature review based on PubMed data up until March 2009, it is rare for a benign IPMN to penetrate two adjacent organs.

Abbreviations: IPMN, intraductal papillary mucinous neoplasm, UGI, upper GI