MUCIN PRODUCING PANCREATIC CARCINOMA ; (REPORT OF TWO CASES PRESENTING WITH PECULIAR FINDINGS AT THE PAPILLA OF VATER)

Abstract

Two cases of mucin producing pancreatic carcinoma with characteristic findings excreting mucinous pancreatic juice from the orifice at the papilla of Vater were reported. Case 1: A 72-year-old male was admitted because of severe epigastralgia. Laboratory data revealed elevated serum amylase and lipase values. This case was characterized by endoscopic findings of papilla of Vater, excretion of mucinous pancreatic juice from a swollen orifice at the papilla of Vater, and diffusely dilated main pancreatic duct with a defect at the head of the pancreas on ERCP. Pancreatoduodenectomy was performed and histopathological findings was well differentiated mucinous cystoadenocarcinoma with the size of 4.0X4.0 cm. Case 2 : A 58-year-old male was admitted because of general fatigue and ascites. Upper GI series showed a Borrmann I type tumor in the antrum of stomach. Findings of papilla of Vater were similar to those of case 1. On ERCP, the main pancreatic duct was diffusely dilated and a defect in the main pancreatic duct was revealed at the head of the pancreas. Angiography revealed a hypervascular tumor in the right lobe of liver, and serum AFP value was elevated. He died because of disseminated intravascular coagulation (DIC). At autopsy, pancreatic carcinoma localizing in the intrapancreatic duct, 1.5X0.6 cm in size, gastric carcinoma and hepatocellular carcinoma were confirmed to coexist.