Ohmoto K, Shimizu M, Mikami Y, Yamamoto S, Mori T, Sano K, Hirano Y, Ohashi K
Department of Medicine, Kawasaki Medical School, Okayama, Japan.
Zentralbl Pathol. 1994 Aug;140(3):281-8.
We report a case of biliary obstruction by a large amount of mucinous material produced by a cystadenocarcinoma of the pancreas invading the common bile duct. This diagnosis was made preoperatively by various imaging methods. Endoscopic retrograde pancreatography (ERP) revealed a mucus-containing cyst with a communication to the main pancreatic and common bile ducts due to a fistulization. Mucinous biliary obstruction was observed. This case indicates that mucinous biliary obstructions should be considered in patients with a mucinous cystic neoplasm of the pancreatic head in the presence of jaundice and that mucinous cystadenocarcinoma may develop into mucinous carcinoma, especially in cases with fistula formations. ERP is useful for detecting the presence of a fistula to the common bile duct or other neighboring organs in such cases. Surgical treatment is recommended because the prognosis of mucinous cystadenocarcinoma is better than that of the usual pancreatic cancer, even though the tumor shows a communication with neighboring organs.
我们报告一例胰腺囊腺癌产生大量黏液性物质侵犯胆总管导致胆道梗阻的病例。术前通过多种影像学方法做出了该诊断。内镜逆行胰胆管造影（ERP）显示一个含黏液的囊肿，由于瘘管形成与主胰管和胆总管相通。观察到黏液性胆道梗阻。该病例表明，对于胰头部黏液性囊性肿瘤且伴有黄疸的患者，应考虑黏液性胆道梗阻的可能，并且黏液性囊腺癌可能发展为黏液腺癌，尤其是在有瘘管形成的病例中。ERP对于检测此类病例中与胆总管或其他邻近器官的瘘管存在情况很有用。尽管肿瘤显示与邻近器官相通，但由于黏液性囊腺癌的预后优于普通胰腺癌，因此建议进行手术治疗。
