2020 Volume 45 Issue 2 Pages 140-145
A 56-year-old man with a family history of pancreatic cancer was referred to our hospital for upper abdominal pain. Contrast-enhanced CT showed enlargement of the pancreatic tail and peripancreatic fluid collection. MRCP and ERCP revealed localized main pancreatic duct (MPD) stenosis of the pancreatic body and dilatation of the upstream MPD, but endoscopic ultrasound revealed no mass. An endoscopic nasopancreatic drainage tube was inserted and serial pancreatic-juice aspiration cytological examinations were performed, however, the histopathological diagnosis remained elusive. Under the suspicion of pancreatic cancer, distal pancreatectomy was performed. Intraoperative ultrasonography revealed an iso to hyperechoic lesion in pancreatic body, and the pancreatic resection line was determined safely. The histopathological diagnosis was moderately differentiated adenocarcinoma (tumor size 14 mm) with lymph node metastasis.
