부산대학교 도서관

Early detection of pancreatic cancer is difficult; therefore, it is not uncommon for it to be diagnosed at an advanced stage, even among individuals who undergo annual Ningen Dock examinations. Here, we describe a case of early-stage pancreatic cancer diagnosed 9 years after an abnormality was identified by Ningen Dock. The patient was a 64-year-old man who had been undergoing Ningen Dock every year since 2004. In his 2011 Ningen Dock, his CA19-9 levels were elevated, and an abdominal contrast-enhanced computed tomography examination was performed. An intraductal papillary mucinous neoplasm of the pancreas (pancreatic IPMN) was discovered. Follow-up with the gastroenterology department was conducted in parallel with Ningen Dock. In March 2020, pancreatic magnetic resonance imaging (MRI) showed irregular narrowing of the main pancreatic duct in the head of the pancreas and endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) were performed. Cancer cells were identified in the pancreatic juice and pancreatic duct scraping cytology, and the patient was subsequently diagnosed with pancreatic head carcinoma, T1N0M0 Stage IA. After receiving neoadjuvant chemotherapy, the patient underwent surgical treatment on June 15, 2020, and the resected specimen was diagnosed with pancreatic cancer of IPMN origin. Notably, the pancreas had not been visualized on the patient’s January 2020 Ningen Dock abdominal echography, which had been carried out just before the MRI that led to the diagnosis. To increase the early detection rate of pancreatic cancer in Ningen Dock, it is advisable for physicians to take note of how visible the pancreas is on the abdominal echography and recommend pancreatic examination through MRI or a second abdominal echography for examinees with risk factors, such as a family history of pancreatic cancer and pancreatic cysts, and for those whose pancreas was not adequately visualized.