1987 Volume 29 Issue 1 Pages 122-129
A 53-year-old male was referred to our hospital with a complaint of left hypochondralgia. ERCP was performed because of elevated serum amylase and CA 19-9 levels. The main pancreatic duct was tapered and obstructed at its tail, and lack of the branches and a pooling of the contrast medium were also observed. On angiography, no major vessels showed obvious abnormalities, but there was a finding of encasement involving a part of pancreatic magna artery. Caudal pancreatectomy was carried out uneventfully and the histological study confirmed the existance of a tomor in the tail, 1.3×1.0×1.0 cm in size, localized within the parenchyma of the pancreas with no evidence of metastasis. Thirteen cases of small carcinomas (T1) of the tail of the pancreas including ours were reviewed literally. All cases in which laboratory tests were reported showed elevated serum and/or urine amylase levels and abnormal changes in the main pancreatic duct on ERCP. To improve the rate of resectability and prognosis of the cancer of the pancreas tail, synthetical assessment of amylase, tumor markers, US, CT, ERCP, angiography and so on would be important considering the possibility of this disease.
