2024 Volume 66 Issue 1 Pages 36-42
A 72-year-old man was referred to our department because a 7-mm hyperechoic region in the pancreatic body was noted on abdominal ultrasonography. The pancreatic tumor was not visible on contrast-enhanced CT. MRI showed it as a defect in the pancreatic duct, with a main pancreatic duct (MPD) diameter of 4 mm in the pancreatic body. EUS showed an 11 mm isoechoic papillary tumor in the MPD of the pancreatic body. Pancreatography revealed an intraductal tumor without mucus. Serial pancreatic juice aspiration cytologic examination revealed columnar epithelial cell-containing mucus. Based on these findings, the patient was preoperatively diagnosed with intraductal papillary mucinous adenoma (IPMA) of the MPD with mild dilation, and laparoscopic distal pancreatectomy was performed. Pathological examination showed a solid mass measuring 10 × 4 × 4 mm in the MPD and the diagnosis was gastric-type IPMA with low-grade dysplasia.
