Abstract
A 76-year-old male with a chief complaint of epigastralgia was referred to our hospital for further examination of pancreatic mass on March 16, 1987. A huge mass was recognized at the pancreatic body and tail on the pictures of US (Figure 1), CT (Figure 2) and angiography (Figure 3). But ERCP through major papilla showed only a short pancreatic duct without irregularity and a normal biliary tract (Figure 4-a, 4-b). Therefore, non-fusion of pancreatic ducts was strongly suspected. Pancreatography through accessory papilla was performed, and a irregularly interrupted image at pancreatic body was observed (Figure 4-c). From these findings, this case was diagnosed as dorsal pancreatic cancer associated with non-fused pancreatic ducts. Because of the multiple lung metastasis. he was treated conservatively. Unfortunately, he died on June 15, 1987. Autopsy revealed a huge pancreatic tumor 8×6×4cm in size, and the histological finding was moderately differentiated tubular adenocarcinoma (Figure 7). Until now only 17 cases of pancreatic cancer with non-fused pancreatic ducts were reported in Japan including this case (Table 2), and the cancer developed on the dorsal pancreas in all the cases except one. This fact could suggest the connection between dorsal pancreatitis and cancer, but there is a controversy over this issue. It may be considered that a positive examination of dorsal pancreatography through accessory papilla is necessary to elucidate this issue, if non-fusion of pancreatic ducts is suspected.
