Abstract
A 70-year-old male visited one doctor for upper abdominal pain and loss of weight and was pointed out the enlargement of the cervical lymphnodes. Lymphnode biopsy revealed adenocarcinoma. Therefore, he was referred to our hospital for the evaluation of origin of cancer. Serum levels of CA19-9 and CEA were remarkably high. ERCP with the cannulation through major papilla showed the short and dendriform ventral pancreatic duct without pathological changes and normal cholangiogram. The cannulation into minor papilla was failed. Angiogram of the celiac artery revealed the remarkable encasement of the splenic artery. And, thus, dorsal pancreatic cancer accompanied with pancreas divisum was highly suspected. The pancreatogram on outopsy demonstrated that the dorsal pancreatic duct was abruptly interrupted about 9cm apart from the minor papilla. And these findings proved to be the changes caused by pancreatic cancer. The histological findings of the pancreas tumor was moderately differentiated adenocarcinoma. It seemed that the further examination of the dorsal pancreas should have been performed because pancreatic cancer might be accompanied with pancreas divisum like our case.
