부산대학교 도서관

This case involved a 68-year-old woman who had undergone pancreatoduodenectomy for an intraductal papillary mucinous neoplasm (IPMN) in the head of the pancreas. On histopathological examination, the diagnosis was invasive intraductal papillary mucinous carcinoma (IPMC), pT1N0M0, pStage I. The intraductal papillary mucinous adenoma was widely observed in the branched pancreatic duct of the resected specimen. The patient received S-1 as adjuvant chemotherapy. Five years after surgery, enhanced abdominal CT and MRI showed a 35-mm-sized mass lesion in the residual pancreas. FDG-PET showed strong FDG uptake in the mass, but there was no evidence of metastasis. Total residual pancreatectomy was then performed. Histopathological examination showed that the tumor was composed of adenocarcinoma and squamous cell carcinoma. Proliferation of atypical cells considered to be IPMC was observed in the expanded main pancreatic duct, and transition to both adenocarcinoma and squamous cell carcinoma was observed. The tumor was therefore diagnosed as IPMN-derived adenosquamous carcinoma (ASC). Only six cases of IPMN-derived pancreatic ASC have been reported, and the present case is the first report of pancreatic ASC in the residual pancreas after IPMC resection.