Kurata Toru, Asakawa Tetsuya, Fujimori Daisuke, Tsuneda Atsushi, Kadoya Naotaka
Dept. of Surgery, Toyama Rosai Hospital.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2545-2547.
We report a case of intraductal papillary mucinous carcinoma(IPMC)penetrating the colon in an 82-year-old man. He visited our hospital with left upper abdominal pain. Abdominal CT showed IPMC of the pancreatic tail, measuring 7 cm, with tumor penetration to the colon and retrograde infection. After the antibacterial treatment, we performed distal pancreatectomy with colectomy. Pathological examination showed proliferation of adenocarcinoma of the gastrointestinal tract with penetration to the colon. Severe fibrosis and calcification surrounding the invasive cancer cells suggested a long disease duration. Despite adjuvant chemotherapy, he developed recurrence of peritoneal dissemination after 9 postoperative months, and subsequently, systemic chemotherapy was started. As intraductal papillary mucinous neoplasm(IPMN)might penetrate the adjacent organs, leading to a poor prognosis, even over a prolonged time period, IPMN should be followed-up appropriately and resected soon after the suspicion of malignant transformation.
我们报告一例82岁男性的导管内乳头状黏液性癌（IPMC）侵犯结肠的病例。他因左上腹疼痛前来我院就诊。腹部CT显示胰尾有IPMC，大小为7 cm，肿瘤侵犯结肠并伴有逆行感染。抗菌治疗后，我们实施了胰体尾切除术联合结肠切除术。病理检查显示胃肠道腺癌增殖并侵犯结肠。侵袭性癌细胞周围严重纤维化和钙化提示病程较长。尽管进行了辅助化疗，但他术后9个月出现腹膜播散复发，随后开始全身化疗。由于导管内乳头状黏液性肿瘤（IPMN）可能侵犯邻近器官，即使在较长时间内也会导致预后不良，因此IPMN应进行适当随访，并在怀疑发生恶性转化后尽快切除。
