Abstract
A 79-year-old male was hospitalized to our hospital, complaining of sensation of fullness in the right upper quadrant. Abdominal ultrasonography demonstrated the swelling of the pancreatic head and a swollen gallbladder with no sign of gall stones. Computed tomography showed swelling of the gall bladder and of the pancreatic head, and suggested abscence of the body and tail of the pancreas. Endoscopic retrograde cholangiopancreato-graphy (ERCP) demonstrated a short main pancreatic duct measuring a total length of 7.5 cm with a normal-appearing accessory pancreatic duct, and the common bile duct oppacified normal with complete obstruction of the proximal cystic duct. These findings supported a diagnosis of agenesis or hypogenesis of the body and tail of the pancreas associated with a cystic duct tumor. A surgical procedure including cholecystectomy revealed a tumor measuring 1.5 × 1.2 cm in size localized to the cystic duct as well as the enlarged pancreatic head associated with agenesis or hypogenesis of the body and tail of the pancreas. The cystic duct tumor was confirmed pathohistologically as adenosquamous carcinoma invading to the subserosa.Those cases of agenesis or hypogenesis (so-called agenesis) of the body and tail of the pancreas which were suspected by ERCP and confirmed either surgically or by autopsy were only 29 (including our present case) in the Japanese literature, and our case was the first associated with primary carcinoma of the cystic duct reported in the Japanese literature.
