2015 Volume 48 Issue 6 Pages 513-520
A 66-year-old woman visited our hospital with a chief complaint of obstructive jaundice. CT revealed a hypodense tumor in the head of the pancreas, of about 3 cm, protruding into the dilated common bile duct, and FDG-PET was strongly positive. On the other hand, the cystic duct was intact in all examinations. After percutaneous transhepatic gallbladder drainage, subtotal stomach-preserving pancreaticoduodenectomy was performed with a diagnosis of carcinoma of the pancreas. The resected specimen showed a solid tumor of 3.5 cm located in the pancreatic head, and an elevated lesion of 6 mm in the cystic duct. Immunohistochemically, the two tumors of the pancreas and cystic duct were similar, and the cystic duct tumor was diagnosed as a disseminated pancreatic cancer metastasis. Such a case is very rare in the literature. It can be speculated that the cystic duct tumor was due to disseminated metastasis along the path of the bile duct from the pancreatic head carcinoma.
