A case of intraductal papillary mucinous neoplasm of the pancreas rupturing both the stomach and duodenum
Received 24 May 2009; accepted 21 September 2009. published online 18 November 2009.
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.
Current affiliations: Department of Internal Medicine, Division of Gastroenterology and Hepatology (M.S., A.K., S.N., H.H., S.K., R.H., S.M.), Departments of Surgery (K.H.) and Clinical Pathology (S.O.), National Defense Medical College, Saitama, Japan
Reprint requests: Motonori Shimizu, MD, Second Department of Internal Medicine, National Defense Medical College, 3-2 Namiki Tokorozawa, Saitama Prefecture 359-8513, Japan.
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
ABSTRACT