Sannappa Raghu M, Buragohain Jadunath, Sarma Dipti, Saikia Uma Kaimal, Choudhury Bipul Kumar
Department of Endocrinology, Gauhati Medical College and Hospital. Guwahati, India.
JOP. 2014 Sep 28;15(5):489-92. doi: 10.6092/1590-8577/2636.
Agenesis of the dorsal pancreas is one of the rare congenital malformations of pancreas. The association of agenesis of the dorsal pancreas with pancreatic tumors is extremely rare and only around 9 cases being reported till date.
We report a case of a fifty one year old woman with an agenesis of the dorsal pancreas with periampullary pancreaticobiliary adenocarcinoma. She presented with features of obstructive jaundice without pain abdomen or fever. Laboratory data showed conjugated hyperbilirubinemia, raised alkaline phosphatase and impaired glucose tolerance. Ultrasound abdomen showed periampullary mass. MRI abdomen and MRCP demonstrated dorsal agenesis of the pancreas, dilated intra and extra hepatic bile ducts with narrowing of distal CBD with periampullary mass. Pancreatic tumor was considered as preoperative diagnosis, and pancreaticoduodenectomy was performed. Histopathology confirmed pancreaticobiliary type of adenocarcinoma.
A rare case of dorsal agenesis of the pancreas with periampullary pancreaticobiliary type of adenocarcinoma was presented. Therefore this case therefore merits reference as a rare clinical presentation.
背侧胰腺发育不全是胰腺罕见的先天性畸形之一。背侧胰腺发育不全与胰腺肿瘤的关联极为罕见,迄今为止仅报道了约9例。
我们报告一例51岁女性,患有背侧胰腺发育不全并伴有壶腹周围胰胆管腺癌。她表现为梗阻性黄疸症状,无腹痛或发热。实验室检查数据显示结合胆红素血症、碱性磷酸酶升高以及糖耐量受损。腹部超声显示壶腹周围肿块。腹部MRI和磁共振胰胆管造影(MRCP)显示胰腺背侧发育不全、肝内外胆管扩张、胆总管远端狭窄以及壶腹周围肿块。术前诊断为胰腺肿瘤,并进行了胰十二指肠切除术。组织病理学证实为胰胆管型腺癌。
本文报告了一例罕见的背侧胰腺发育不全合并壶腹周围胰胆管型腺癌的病例。因此,该病例作为一种罕见的临床表现值得参考。