Miyamoto Ryoichi, Amikura Katsumi, Matsudaira Shinichi, Ishida Hiroyuki, Ogura Toshiro, Takahashi Amane, Kihara Atsushi, Kanda Hiroaki, Kawashima Yoshiyuki
Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina-machi, Kita-Adachi-gun, Saitama, 362-0806, Japan.
Department of Pathology, Jichi Medical University, Tochigi, Japan.
Surg Case Rep. 2021 Sep 6;7(1):202. doi: 10.1186/s40792-021-01286-5.
Colloid carcinoma derived from intraductal papillary mucinous neoplasm (IPMN) of the pancreatic head with prominent calcification is exceedingly rare. Only a few studies about this entity have been reported in the literature. Therefore, its biological behavior, appropriate treatment modalities, and overall patient prognosis remain largely unclear. In this report, we present a case of a resected colloid carcinoma derived from IPMN with prominent calcification. In addition, we review the relevant literature and discuss the clinical management of colloid carcinoma derived from IPMN with prominent calcification, including the histopathological features.
A 75-year-old man presented with a pancreatic tumor measuring 58 mm on the head of the pancreas that was incidentally detected by abdominal ultrasonography. Abdominal computed tomography and endosonography revealed a multilobular cystic lesion with a 17 mm mural nodule in the pancreatic head. Furthermore, prominent calcification was observed on part of the cyst wall. Magnetic resonance cholangiopancreatography showed a multilobular cyst in the branch duct lacking communication between the cystic lesion and the main pancreatic duct. Thus, the lesion was diagnosed as intraductal papillary mucinous carcinoma (IPMC) with a preoperative classification of T1N0M0 stage IA according to the 8th Union for International Cancer Control (UICC) guidelines, and the patient underwent conventional pancreatoduodenectomy. The resected specimen was microscopically found to contain colloid carcinoma, probably derived from IPMN. In addition, marked calcification was confirmed in the partition wall of the cystic mass. The postoperative course was uneventful, and no evidence of recurrence or metastasis was observed after 10 months of follow-up.
We consider that colloid carcinoma derived from IPMN should be differentially diagnosed as a pancreatic multilobular cystic lesion with prominent calcification that shows no sign of systemic chronic pancreatitis.
源自胰头导管内乳头状黏液性肿瘤（IPMN）且伴有显著钙化的胶样癌极为罕见。文献中仅报道了少数关于该实体的研究。因此，其生物学行为、合适的治疗方式以及患者的总体预后在很大程度上仍不明确。在本报告中，我们呈现了一例经手术切除的源自IPMN且伴有显著钙化的胶样癌病例。此外，我们回顾了相关文献，并讨论了源自IPMN且伴有显著钙化的胶样癌的临床管理，包括组织病理学特征。
一名75岁男性因腹部超声偶然发现胰头有一个大小为58毫米的胰腺肿瘤。腹部计算机断层扫描和内镜超声显示胰头有一个多叶囊性病变，伴有一个17毫米的壁结节。此外，在部分囊肿壁上观察到显著钙化。磁共振胰胆管造影显示分支导管内有一个多叶囊肿，囊性病变与主胰管之间无连通。因此，根据国际癌症控制联盟（UICC）第8版指南，该病变被诊断为导管内乳头状黏液癌（IPMC），术前分期为T1N0M0期IA，患者接受了传统的胰十二指肠切除术。切除的标本经显微镜检查发现含有胶样癌，可能源自IPMN。此外，在囊性肿块的分隔壁上证实有明显钙化。术后过程顺利，随访10个月后未观察到复发或转移迹象。
我们认为源自IPMN的胶样癌应作为一种伴有显著钙化且无系统性慢性胰腺炎迹象的胰腺多叶囊性病变进行鉴别诊断。
