1985 Volume 27 Issue 10 Pages 2027-2035
Mucin producing pancreatic carcinoma associated with pancreatic calculi is uncommon. The case reported here is worth recording. A 62-year-old man was admitted to our hospital because of fever and epigastralgia. Laboratory findings on admission (Table 1) showed leukocytosis and positive CRP test and serum CEA level rose to 5.4 ng/ml. Abdominal ultrasonogram (Figure 2-a, b) and CT with contrast enhancement (Figure 3) disclosed the multiloculated tumor and the dilated main pancreatic duct at the body and calculi at the tail of the pancreas. Endoscopic findings (Figure 4) were characterized by widely opened orifice of the major papilla and mucous excretion from there. ERCP findings with balloon catheter (Figure 5) demonstrated diffusely dilated main pancreatic duct and its obstruction by a calculus at the tail of the pancreas. At the same time, a protruded lesion in the body of the pancreas was clearly visible. Celiac angiography (Figure 6) revealed the displacement of the arteries neighboring the head and body of the pancreas. Pancreatic juice (Figure 7) obtained from main pancreatic duct by US guided aspiration procedure was extremely mucinous and turbid. No malignancy was confirmed by cytological examination of pancreatic juice. Pancreaticoduodenectomy was performed and histological examination of the resected specimen (Figure 12) revealed well differ-entiated mucinous cystadenocarcinoma of the body of the pancreas. Histological findings of the pancreas proximal (Figure 13) and distal (Figure 14) to the tumor were compatible with those of chronic pancreatitis. Unfortunately, the patient died of multiple organ failure on 35th day after operation.
