A CASE OF INTRADUCTAL PAPILLARY ADENOMA WITH SCANT MUCIN PRODUCTION OF THE PANCREAS

Abstract

A 64-year-old man was found to have a filling defect of 10 mm diameter with slight movability in the dilated main pancreatic duct on endoscopic retrograde cholangiopan creatography (ERCP) performed as part of further examinations on the diagnosis of acute pancreatitis. Peroral transpapillary pancreatoscopy (POPS) demonstrated a papillary tumor without mucin production in the main pancreatic duct and intraductal ultrasonography (IDUS) gave images of a pedunculated polyp without involment of the pancreatic parenchema. It was, therefore, diagnosed as an adenoma or carcinoma in situ, presenting as a intraductal papillary tumor with scant mucin production of the pancreas. Histological diagnosis of the resected specimen was a papillary adenoma with a background of chronic pancreatitis. Intraductal papillary tumor with scant mucin production is very rare in the pancreas, and in case with a filling defect in the main pancreatic duct, POPS and IDUS were established to be useful methods for making a differential diagnosis.