학술논문

Two Cases of Pancreatic Cystic Tumor Associated with Pancreas Divisum / 膵管癒合不全に伴った膵嚢胞性腫瘍の2例
Document Type
Journal Article
Source
日本臨床外科学会雑誌 / Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association). 2013, 74(12):3472
Subject
intraductal papillary mucinous neoplasm (IPMN)
pancreas divisum
serous cystic neoplasm (SCN)
漿液性嚢胞腫瘍(SCN)
膵管内乳頭粘液性腫瘍(IPMN)
膵管癒合不全
Language
Japanese
ISSN
1345-2843
1882-5133
Abstract
We present 2 cases of pancreatic cysts associated with pancreas divisum. Case 1 was a 70-year-old woman who had an elevated serum amylase. Computed tomography (CT) showed a 15 × 16-mm cystic lesion in the pancreatic head with a mural nodule and dilation of the pancreatic duct. Endoscopic retrograde cholangiopancreatography (ERCP) through the accessory papilla revealed an enlarged dorsal pancreatic duct. Magnetic resonance cholangiopancreatography (MRCP) revealed absence of communication between the ventral and dorsal pancreatic ducts. A subtotal stomach-preserving pancreaticoduodenectomy was performed. On pathology an intraductal papillary mucinous adenoma was diagnosed. Case 2 was a 70-year-old woman who had abnormal liver function tests ; a pancreatic cyst was discovered on ultrasonography. CT showed a 23 × 23-mm cystic lesion in the pancreatic head. ERCP through the papilla of Vater revealed the presence of only the ventral pancreatic duct, while MRCP revealed a dilated main pancreatic duct draining into the accessory papilla. The patient had a pylorus-preserving pancreatoduodenectomy. On pathology a macrocystic type serous cystadenoma (SCA) was diagnosed. Pancreatic cystic tumors associated with pancreas divisum are rare ; we report our case along with a discussion of the appropriate literature.