POPSが腫瘍進展範囲の把握に有用であった主膵管型IPMN(gastric type)の1例  [in Japanese] Successful definition of tumor extension of main duct-type intraductal papillary-mucinous neoplasm (gastric type) of the pancreas with peroral pancreatoscopy  [in Japanese]

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A 61-year-old man was admitted to our hospital after detection of pancreatic duct dilation on abdominal computed tomography that was performed to investigate his weight loss. Multidetector computed tomography and magnetic resonance cholangiopancreatography revealed irregular dilation of the main pancreatic duct in the body and tail of the pancreas. Endoscopic ultrasonography revealed multiple papillary lesions in the sac-like, dilated main pancreatic duct. The lesions were visualized as papillary protrusions with redness of vascular vessels on peroral pancreatoscopy, and they were diagnosed as low-grade dysplasia on examination of biopsies. Based on the preoperative examinations, including peroral pancreatoscopy, surgery was decided. A distal pancreatectomy was performed, and the margin was described as negative. It is often difficult to correctly diagnose the range of intraductal expanse before surgical removal in "main duct type intraductal papillary-mucinous neoplasms". We report a case of main duct-type intraductal papillary-mucinous neoplasm with low- or intermediate-grade dysplasia of the pancreas in which a preoperative peroral pancreatoscopy was useful to evaluate tumor extension and was contributed to avoid unnecessary surgery.<br>


  • Suizo

    Suizo 28(5), 666-673, 2013

    Japan Pancreas Society


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